Abstract

Background: Because of increasing antibiotic failure and recurrence of infections in patients with P. aeruginosa, the present study was designed to determine the antibiotic resistance status, presence of persister cells and investigate the antipersister effect of Peganum harmala in P. aeruginosa clinical isolates in vitro in Ilam, Iran. Methods: Thirty P. aeruginosa urinary clinical isolates were collected from hospitals in Ilam, Iran and identified by common microbiological and biochemical tests. Afterward, antibiotic susceptibility assay, persister cell assay, P. harmala extraction, cell culture, and cell viability assays were performed. Results: A high rate of antibiotic resistance was observed. All isolates were resistant to co-amoxiclav. Also, 83.3 (n = 25), 90 (n = 27), and 36.6 (n = 11) of isolates showed resistance to ceftazidime, kanamycin, and tobramycin, respectively. The MIC and MBC values for imipenem were = 2 and 2 mu g/mL for susceptible isolates, respectively. In addition, 6.66 (n = 2) of isolates were persister cells and were also sensitive to imipenem by MIC but did not show any MBC. IC50 for P. harmala was 35 mu g/mL. Eventually, MIC value of P. harmala against two P. aeruginosa persister cell producer isolates was 3 mu g/mL and 1 mu g/mL, and the value of MBC was 10 mu g/mL and 30 mu l/mL. Conclusions: Our findings demonstrated that P. harmala may be a suitable antipersister herbal medicine against P. aeruginosa clinical isolates. In this regard, comprehensive research is needed in the future to gain more information in this area.