title: The Effects of Berberine and Palmatine on Efflux Pumps Inhibition with Different Gene Patterns inPseudomonas aeruginosaIsolated from Burn Infections.
abstract: BACKGROUND
  Related Multidrug Resistance (MDR) to efflux pumps is a significant problem in treating infections caused byPseudomonas aeruginosa(P. aeruginosa). Plant compounds have been identified as Pump Inhibitors (EPIs). In the current study, the potential effect of Berberine and Palmatine as EPIs were investigated on efflux pump inhibition through focusing on different gene patterns inP. aeruginosaisolated from burn infections.
  
  
  METHODS
  All isolates were collected and identified using the standard biochemical tests. Antimicrobial sensitivity was performed based on disk agar diffusion method for 12 antibiotics. MIC-MBC tests were also performed based on the broth microdilution method to detect synergistic relationship between ciprofloxacin, Berberine and Palmatine. Detection ofmexA, mexB, mexC, mexD, mexE, mexF and mexXwas conducted by PCR assay. Fisher's Exact test and Logistic Regression were used as statistical tools.
  
  
  RESULTS
  A total of 60P. aeruginosaisolates were collected. The highest and lowest levels of resistance were found to be respectively against clindamycin and tigecycline. Comparing the MIC with MBC distribution, it was found that Berberine and Palmatine lower the MIC-MBC level of ciprofloxacin. The PCR results indicated that the highest frequency is about MexAB-OprM operon. The statistical analysis among different gene patterns of efflux pumps showed that there were no significant relationships between the effectiveness of Berberine and Palmatine (p>0.05).
  
  
  CONCLUSIONS
  It can be speculated that Berberine and Palmatine both act as EPIs and can be used as auxiliary treatments with the purpose of increasing the effect of available antibiotics as well as decreasing the emergence of MDR bacteria. The efficiency of these combinations should be studied further underin vivoconditions to have a more comprehensive conclusion regarding this issue.
authors.affiliation: Department of Basic Sciences, Islamic Azad University, Damghan Branch, Damghan, Iran.
authors.forename: Seyed Sajjad
authors.initials: SS
authors.lastname: Aghayan
authors.affiliation: Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Kalalian Mogadam
authors.affiliation: Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Mozhgan
authors.initials: M
authors.lastname: Fazli
authors.affiliation: Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Darban-Sarokhalil
authors.affiliation: Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
authors.forename: Seyed Sajjad
authors.initials: SS
authors.lastname: Khoramrooz
authors.affiliation: Department of Microbiology Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Jabalameli
authors.affiliation: Department of Microbiology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Somayeh
authors.initials: S
authors.lastname: Yaslianifard
authors.affiliation: Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mirzaii
keywords: Berberine; Palmatine; Pseudomonas aeruginosa