Punicalagin, a pomegranate polyphenol sensitizes the activity of antibiotics against three MDR pathogens of the Enterobacteriaceae

Kiran, Saba; Tariq, Anam; Iqbal, Shoaib; Naseem, Zubera; Siddique, Waqar; Jabeen, Sobia; Bashir, Rizwan; Hussain, Ashfaq; Rahman, Moazur; Habib, Fazal-e; Rauf, Waqar; Ali, Aamir; Sarwar, Yasra; Jander, Georg; Iqbal, Mazhar

doi:10.1186/s12906-024-04376-7

BMC Complementary Medicine and Therapies

Table 5 Anti-Enterobacteriaceae activity of Punica granatum (2005–2022)

From: Punicalagin, a pomegranate polyphenol sensitizes the activity of antibiotics against three MDR pathogens of the Enterobacteriaceae

Sr. No.	Year	P. granatum part	Source	Concentration (mg/ml)	Bacteria	Antibiotic resistance profile	ZOI (mm)	MIC (mg/ml)	References
1	2005	Peel	Ethanol extract	2.5	E. coli (ATCC 25922)	ND^c	10.9	0.39	[53]
					E. coli O157: H7		12.7	3.13
					E. coli O26: H11		11.5	3.13
					E. coli O111: NM		11.6	3.13
					E. coli O22		12.0	1.56
2	2008	Peel	Methanol extract	250 μg/mL	S. typhi	ND^c	21.0	–	[54]
					S. typhimurium		25.0	–
					S. paratyphi A		15.0	–
					S. paratyphi B		18.0	–
					Sh. dysenteriae		22.0	–
					Sh. flexneri		25.0	–
3	2008	Peel	Ethanol extract	500 μg/ml	S. Dublin ATCC 39184, S. typhi ATCC 19943, S. paratyphi A, S. enteritidis, S. typhimurium, S. Derby ATCC 6960, S. gallinarum	ND^c	13.3 17.3 18.6 14.6 15.0 14.3 16.0	500 250 62.5 250 1000 500 250	[55]
					S. choleraesuis ATCC 7001	AM, SXT	16.0	62.5
					S. typhimurium	AM, C, G, S, TIC	12.6	250
					S. gallinarum	CTX, G, SXT	16.6	62.5
					S. gallinarum	CTX, NA, CP	17.6	62.5
					S. gallinarum	G, NA, S	16.3	125
					S. gallinarum ATCC 9184	AMP, AMC, C, G, S	13.0	1000 μg/ml
4	2009	Peel	Water ethanol extract	10	E. coli (ATCC 10536)	ND^c	16.0	1.0	[51]
4	2009	Peel	Water ethanol extract	10	K. pneumoniae ATCC 10031	ND^c	16.0	2.0	[51]
5	2010	Peel	Water methanol extract	60 μl	E. coli MTCC 732	ND^c	20.0	–	[56]
		Seed red					11.0	–
		Seed white					8.0	–
		Whole fruit					15.0	–
		Juice					17.0	–
6	2011	Peel	Water methanol extract	5% (w/w) extract-based ointment	S. Anatum	ND^c	–	0.25	[57]
					S. typhimurium		–	0.25
					E. coli (ATCC 25922)		–	0.5
7	2011	Juice	Non-probioticated	100 ml	S. typhi PTCC 1639	ND^c	18.0	–	[58]
			Non-probioticated		E. coli ATCC 8739		20.0	–
			Probioticated		S. typhi PTCC 1639		18.5	–
			Probioticated		E. coli ATCC 8739		20.0	–
8	2012	Peel	Methanol extract	1	E. coli (ATCC 35218)	ESBL producer	15.0		[59]
				10	E. coli (ATCC 35218)		15.0
		Peel		1	K. pneumoniae (ATCC 700603)		18.0
				10	K. pneumoniae (ATCC 700603)		12.0
		Peel		10,240–5 μg/mL	E. coli	Third generation cephalosporin^a / Second generation fluoroquinolone^b	–	640–2560 μg/ml
		Peel		10,240–5 μg/mL	K. pneumoniae		–	1280–2560 μg/ml
9	2012	Peel	Methanol extract	12.5	E. coli (ATCC 11775)	ND^c	–	0.39–0.78	[60]
9	2012	Peel	Methanol extract	12.5	K. pneumoniae (ATCC 13883)	ND^c	–	0.20–0.39	[60]
10	2014	Peel	Ethanol water extract	166.6	K. pneumoniae ATCC 10031	ND^c	16.0	2.0	[33]
			Ethanol water extract		K. pneumoniae		14.3
			Water extract		S. enterica serovar Typhi		28.0
11	2015	Peel	Ethanol extract	15	E. coli	ND^c	32	–	[61]
11	2015	Seed	Ethanol extract	60	E. coli	ND^c	22	–	[61]
12	2015	Peel	Methanol/Water extract	1024–0.5 μg/ml	K. pneumoniae	ESBL	- -	512- > 1024 μg/ml	[62]
12	2015	Peel	Methanol/Water extract	1024–0.5 μg/ml	K. pneumoniae	KPC	- -	512- > 1024 μg/ml	[62]
13	2016	Peel	Water methanol extract	10–100	E. coli	ND^c	–	50	[63]
13	2016	Peel	Water methanol extract	10–100	Salmonella spp.	ND^c	–	50	[63]
14	2018	Juice	–	10 g sugar + 12 ml pomegranate juice	E. coli	ND^c	19.0	–	[64]
15	2021	Whole fruit	5% aqueous extract	250	E. coli	non-ESBL producers	12.0	–	[65]
16	2022	peel	Ethanol extract	1.5–3.0%	S. enteritidis	E, OX, NA, CL, AM, K, CTX, CP, T, AK, SXT, CZ, G, IPM	–	2.2 log CFU/g reduction	[66]
17	2022	Peel	Acetone extract	20 μl of (extract from 10 g powder)	E. coli	CTX, CEF, ATM	28.0	8 μg/ml	[32]
		Juice	Ethanol extract				19.0	128 μg/ml
		Seed	Ethanol extract				12.0	256 μg/ml
		Peel	Acetone extract		K. pneumoniae	ATM	20.0	128 μg/ml
		Juice	Acetone extract				23.0	16 μg/ml
		Seed	Ethanol extract				14.0	256 μg/ml
		Peel	Acetone extract		Shigella spp.	CTX, CEF, ATM	26.0	–
		Juice	Ethanol extract				18.0	–
		Seed	Ethanol extract				14.0	–
18	2022	Leaves	Acetone water extract	5 to 0.04	E. coli	Penicillin	12.0	2.5	[27]
18	2022	Leaves	Acetone water extract	5 to 0.04	E. coli	CP /MDR	12.0	5	[27]

E. aerogenes Enterobacter aerogenes: S. typhimurium: Salmonella enterica serovar Typhimurium; S. gallinarum: Salmonella Gallinarum; S. typhi: Salmonella Typhi; S. Dublin: Salmonella Dublin; S. Derby: Salmonella Derby; S. choleraesuis: Salmonella Choleraesuis; S. enteritidis: Salmonella Enteritidis; S. paratyphi A: Salmonella Paratyphi A; S. Anatum: Salmonella Anatum; E. coli: Escherichia coli; Sh. dysenteriae: Shigella dysenteriae; Sh. flexneri: Shigella flexneri; K. pneumoniae: Klebsiella pneumonia
ATCC American Type Culture Collection: PTCC Persian Type Culture Collection: MDR: Multi drug resistant: ESBL Extended spectrum β-lactamase
Erythromycin (E), Oxacillin (OX), Nalidixic acid (NA), Clindamycin (CL), Ampicillin (AM), Kanamycin (K), Ciprofloxacin (CP), Tetracycline (T), Amikacin (AK), Trimethoprim-sulfamethoxazole (SXT), Cefazolin (CZ), Gentamicin (G), Imipenem (IPM), Aztreonam (ATM), cephalothin (CEF), Cefotaxime (CTX), Ticarcillin (TIC), Streptomycin (S), Chloramphenicol (C), Cephalothin (CF), Sulfisoxazole (G)
^acefotaxime or ceftazidime/clavulanate (co-amoxiclav)
^bCiprofloxacin, Ofloxacin, Norfloxacin, Gatifloxacin
^cNot determined

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