In Vitro Synergistic Antibacterial Potential of Two Binary Combinations of Six Essential Oils Against Helicobacter Pylori Isolates

Abstract

Background and Aim: Helicobacter pylori (H. pylori) infection is a major health concern contributing to gastrointestinal diseases. Appropriate treatment to decrease the prevalence of such infections particularly in developing countries is the key factor. However, the emergence of antimicrobial resistance to conventional therapy protocols highlights the need for initiating alternative treatment approaches. This study aimed to explore novel essential oil combinations with potent activity against H. pylori isolates from Sudanese patients. Materials and Methods: H. pylori strains were isolated and identified phenotypically using conventional biochemical tests. Genetic identification was performed using polymerase chain reaction (PCR) targeted H. pylori 16S Ribosomal RNA (rRNA) primary tetracycline-binding-sites gene. Amplified gene was then sequenced using Sanger sequencing and analyzed using different bioinformatics tools. Moreover, six essential oils (Eos) were investigated for their in vitro activity against H. pylori clinical isolates. Results: The H. pylori isolates from Sudanese patients were identified by analysis of 16S rRNA sequences. All tested essential oils completely inhibited growth of the selected H. pylori clinical isolates at 125 µg/ml concentration. Clove and maharaib oils exhibited maximum activity and inhibited the growth of all studied strains even at of 3.9 µg/ml concentration. Moreover, the mixtures of cinnamon-lemongrass, cinnamon-maharaib, thyme-maharaib, frankincense-maharaib, and lemongrass-maharaib displayed potent synergism against tested strains with the fractional inhibitory concentration (FIC) indices ranged from 0.26 to 0.5. Conclusion: The synergistic combinations displayed promising alternative therapeutics and showed the capacity to be recommended for further additional studies as well as clinical trials targeting H. pylori infection.