Journal of Traditional Chinese Medicine >
New approach to overcoming antimicrobial resistance of Staphylococcus aureus by combining Guanghuoxiang (Herba Pogostemonis) and Penicillin G Sodium treatments
Received date: 2025-04-12
Accepted date: 2025-08-25
Online published: 2025-11-24
Supported by
State Key Laboratory of Drug Regulatory Science, Establishment of a Comprehensive Evaluation Method for the Quality of Chinese Medicinal Herbs Pogostemon cablin (Blanco) Benth. and Saposhnikovia divaricata (Turcz) Schischk., Suited to the Characteristics of Traditional Chinese Medicine(2023SKLDRS0101)
OBJECTIVE: Antibiotics are the main drugs used to treat bacterial infections, which have been extensively utilized across various fields. However, the problem of antimicrobial resistance (AMR) has greatly limited its use, leading to the creation of various superbugs such as Methicillin-resistant Staphylococcus aureus (MRSA), making antibiotics less effective, become a major global public health challenge. MRSA, which is resistant to most β-lactam and cephalosporin antibiotics, poses a significant threat to public health. Combination therapy has shown promise as a strategy to combat multi-drug-resistant bacteria. Chinese medicine also has potential applications in this field. Thus, we tried to find a new approach to overcoming MRSA by combining Chinese herb and penicillin G sodium (PGS).
METHODS: The antibacterial activity of Guanghuoxiang (Herba Pogostemonis) samples was investigated by turbidimetry. Then using the checkerboard assay, live/ dead bacterial staining and scanning electron microscopy (SEM) to investigate whether the combination of Guanghuoxiang (Herba Pogostemonis) samples and PGS could improve the sensitivity of MRSA, and metabolomics was used to investigate the underlying mechanisms.
RESULTS: In this study, we find that the Guanghuoxiang (Herba Pogostemonis) samples had good inhibitory effects on MRSA, and showed a synergistic effect when combined with PGS, enhancing the sensitivity of MRSA to PGS. Metabolomics data further revealed that this combination exerts a broader impact on the energy and material metabolism of the bacteria, resulting in improved antibacterial efficacy.
CONCLUSION: Combining Guanghuoxiang (Herba Pogostemonis) with antibiotics could improve the sensitivity of drug-resistant bacteria, provided a new direction for solving the problem of AMR, and offered a valuable strategy for clinical response to MRSA.
Wenguang JING , Zhixia WANG , Wenmin PI , Haonan WU , Minghua LI , Penglong WANG , Xianlong CHENG , Feng WEI . New approach to overcoming antimicrobial resistance of Staphylococcus aureus by combining Guanghuoxiang (Herba Pogostemonis) and Penicillin G Sodium treatments[J]. Journal of Traditional Chinese Medicine, 2025 , 45(6) : 1283 -1294 . DOI: 10.19852/j.cnki.jtcm.2025.06.008
| 1. | Sovic J, Segovic S, Pavelic B, et al. Patterns of antibiotic prescription in endodontic therapy in the Republic of Croatia. Antibiotics (Basel) 2024; 13: 645. |
| 2. | Kang J, Yin ZL, Pei FY, et al. Aerobic composting of chicken manure with penicillin G: community classification and quorum sensing mediating its contribution to humification. Bioresour Technol 2022; 35: 127097. |
| 3. | Huynh D, Tung N, Dam Q, et al. Amoxicillin and penicillin G dosing in pediatric community-acquired pneumococcal pneumonia in the era of conjugate pneumococcal vaccines. Pharmacotherapy 2024; 44: 606-14. |
| 4. | Ubals M, Nadal-Baron P, Arando M, et al. Oral linezolid compared with benzathine penicillin G for treatment of early syphilis in adults (Trep-AB Study) in Spain: a prospective, open-label, non-inferiority, randomised controlled trial. Lancet Infect Dis 2024; 24: 404-16. |
| 5. | Hla TK, Osowicki J, Salman S, et al. Study protocol for controlled human infection for penicillin G against Streptococcus pyogenes: a double-blinded, placebo-controlled, randomised trial to determine the minimum concentration required to prevent experimental pharyngitis (the CHIPS trial). BMJ Open 2022; 12: e064022. |
| 6. | Baran A, Kwiatkowska A, Potocki L. Antibiotics and bacterial resistance-a short story of an endless arms race. Int J Mol Sci 2023; 24(6): 5777. |
| 7. | Larsson DGJ, Flach CF. Antibiotic resistance in the environment. Nat Rev Microbiol 2022; 20: 257-69. |
| 8. | Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev 2010; 74: 417-33. |
| 9. | Bassetti S, Tschudin-Sutter S, Egli A, Osthoff M. Optimizing antibiotic therapies to reduce the risk of bacterial resistance. Eur J Intern Med 2022; 99: 7-12. |
| 10. | Honigsbaum M. Superbugs and us. Lancet 2018; 391: 420. |
| 11. | Sharma A, Rodriguez-Morales AJ, Traore T, et al. Globalisation of antibiotic-resistant bacteria at recurring mass gathering events. Lancet 2023; 402: e5-7. |
| 12. | Willems RPJ, van Dijk K, Vehreschild M, et al. Incidence of infection with multidrug-resistant Gram-negative bacteria and vancomycin-resistant enterococci in carriers: a systematic review and Meta-regression analysis. Lancet Infect Dis 2023; 23: 719-31. |
| 13. | Patil S, Chen H, Lopes BS, Liu SX, Wen FQ. Multidrug-resistant Streptococcus pneumoniae in young children. Lancet Microbe 2023; 4: e69. |
| 14. | Fursova NK, Fursov MV, Astashkin EI, et al. Multidrug-resistant and extensively drug-resistant Acinetobacter baumannii causing nosocomial meningitis in the Neurological Intensive Care Unit. Microorganisms 2023; 11: 2020. |
| 15. | Galar A, Weil AA, Dudzinski DM, Munoz P, Siedner MJ. Methicillin-resistant staphylococcus aureus prosthetic valve endocarditis: pathophysiology, epidemiology, clinical presentation, diagnosis, and management. Clin Microbiol Rev 2019; 32: e00041-18. |
| 16. | Jiang JH, Cameron DR, Nethercott C, Aires-de-Sousa M, Peleg AY. Virulence attributes of successful methicillin-resistant Staphy-lococcus aureus lineages. Clin Microbiol Rev 202; 36: e0014822. |
| 17. | Gopikrishnan M, Haryini S, C GPD. Emerging strategies and therapeutic innovations for combating drug resistance in Staphylococcus aureus strains: A comprehensive review. J Basic Microbiol 2024; 64: e2300579. |
| 18. | Mullard A. The deadly burden of drug-resistant bacteria. Nat Rev Drug Discov 2022; 21: 170. |
| 19. | Antimicrobial Resistance C. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 2022; 399: 629-55. |
| 20. | Collaborators GBDAR. Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050. Lancet 2024; 404: 1199-226. |
| 21. | Elbe S, Roemer-Mahler A, Long C. Medical countermeasures for national security: a new government role in the pharmaceuticalization of society. Soc Sci Med 2015; 131: 263-71. |
| 22. | Lewnard JA, Charani E, Gleason A, et al. Burden of bacterial antimicrobial resistance in low-income and middle-income countries avertible by existing interventions: an evidence review and modelling analysis. Lancet 2024; 403: 2439-54. |
| 23. | Wong F, de la Fuente-Nunez C, Collins JJ. Leveraging artificial intelligence in the Figureht against infectious diseases. Science 2023; 381: 164-70. |
| 24. | Krell T, Matilla MA. Antimicrobial resistance: progress and challenges in antibiotic discovery and anti-infective therapy. Microb Biotechnol 2022; 15: 70-8. |
| 25. | Barbarossa A, Rosato A, Corbo F, et al. Non-antibiotic drug repositioning as an alternative antimicrobial approach. Antibiotics (Basel) 2022; 11: 816. |
| 26. | Sikder A, Chaudhuri A, Mondal S, Singh NDP. Recent advances on stimuli-responsive combination therapy against multidrug-resistant bacteria and biofilm. ACS Appl Bio Mater 2021; 4: 4667-83. |
| 27. | Theuretzbacher U, Jumde RP, Hennessy A, Cohn J, Piddock LJV. Global health perspectives on antibacterial drug discovery and the preclinical pipeline. Nat Rev Microbiol 2025; 23: 474-90. |
| 28. | Ardal C, Balasegaram M, Laxminarayan R, et al. Antibiotic development - economic, regulatory and societal challenges. Nat Rev Microbiol 2020; 18: 267-74. |
| 29. | Theuretzbacher U. Market watch: Antibacterial innovation in European SMEs. Nat Rev Drug Discov 2016; 15: 812-3. |
| 30. | Yang Y, Kessler MGC, Marchan-Rivadeneira MR, Han Y. Combating antimicrobial resistance in the post-genomic era: rapid antibiotic discovery. Molecules 2023; 28: 4183. |
| 31. | Yang WQ, Li J, Yao ZL, Li M. A review on the alternatives to anti-biotics and the treatment of antibiotic pollution: current development and future prospects. Sci Total Environ 2024; 926: 171757. |
| 32. | Zhu ML, Tse MW, Weller J, Chen JL, Blainey PC. The future of antibiotics begins with discovering new combinations. Ann N Y Acad Sci 2021; 1496: 82-96. |
| 33. | Osman AH, Kotey FCN, Odoom A, et al. The potential of bacteriophage-antibiotic combination therapy in treating infections with multidrug-resistant bacteria. Antibiotics (Basel) 2023; 12: 1329. |
| 34. | Hernandez-Rodriguez P, Baquero LP. Combination therapy as a strategy to control infections caused by multi-resistant bacteria: current review. Curr Drug Targets 2022; 23: 260-5. |
| 35. | Wang Q, Lyu YM, Pang J, et al. In vitro and in vivo activity of d-serine in combination with beta-lactam antibiotics against methicillin-resistant Staphylococcus aureus. Acta Pharm Sin B 2019; 9: 496-504. |
| 36. | Abd El-Hamid MI, El-Tarabili RM, Bahnass MM, et al. Partnering essential oils with antibiotics: proven therapies against bovine Staphylococcus aureus mastitis. Front Cell Infect Microbiol 2023; 13: 1265027. |
| 37. | Weng ZB, Zeng F, Wang MX, et al. Antimicrobial activities of lavandulylated flavonoids in Sophora flavences against methicillin-resistant Staphylococcus aureus via membrane disruption. J Adv Res 2024; 57: 197-212. |
| 38. | Tian XH, Wang PL, Li T, et al. Self-assembled natural phytochemicals for synergistically antibacterial application from the enlightenment of Traditional Chinese Medicine combination. Acta Pharm Sin B 2020; 10: 1784-95. |
| 39. | Zhang F, Sun GQ, Zhao R, et al. Zwitterion-modified mxene quantum dot as a nanocarrier for Traditional Chinese Medicine sanguinarine delivery and its application for photothermal-chemotherapy synergistic antibacterial and wound healing. Langmuir 2024; 40: 11381-9. |
| 40. | Zeng WH, Qian J, Wang Y, Shou MY, Kai GY. Bletilla Striata polysaccharides thermosensitive gel for photothermal treatment of bacterial infection. Int J Biol Macromol 2023; 253: 127430. |
| 41. | Li JG, Chen XF, Lu TY, et al. Increased activity of beta-lactam antibiotics in combination with carvacrol against MRSA bacteremia and catheter-associated biofilm infections. ACS Infect Dis 2023; 9: 2482-93. |
| 42. | Kim M, Seo Y, Kim SG, et al. Synergistic antibiotic activity of ricini semen extract with oxacillin against methicillin-resistant Staphylococcus aureus. Antibiotics (Basel) 2023; 12: 340. |
| 43. | Peris MC, Martinez A, Ortiz MP, Sheth CC, Veses V. Icariin in combination with amoxycillin-clavulanate and ampicillin, but not vancomycin, increases antibiotic sensitivity and growth inhibition against methicillin-resistant Staphylococcus aureus. Antibiotics (Basel) 2022; 11: 233. |
| 44. | Al-Tawalbeh D, Alkhawaldeh Y, Abu Sawan H, et al. Assessment of carvacrol-antibiotic combinations' antimicrobial activity against methicillin-resistant Staphylococcus aureus. Front Microbiol 2023; 14: 1349550. |
| 45. | Jin YS, Lin JX, Shi HQ, et al. The active ingredients in Chinese peony pods synergize with antibiotics to inhibit MRSA growth and biofilm formation. Microbiol Res 2024; 281: 127625. |
| 46. | Peng XJ, Ang S, Zhang YZ, et al. Chemical constituents with antiproliferative activity from pogostemon cablin (Blanco) Benth. Front Chem 2022; 10: 938851. |
| 47. | Li D, Xing ZW, Yu TT, et al. Pogostone attenuates adipose tissue inflammation by regulating the adipocyte-macrophage crosstalk via activating SIRT1. Food Funct 2022; 13: 11853-64. |
| 48. | Jung Ha C, Daehyun K, Kyoungin M, So Young L, Nae Gyu K. Pogostemon cablin extract promotes wound healing through OR2AT4 activation and exhibits anti-inflammatory activity. Current Issues in Molecular Biology 2024; 46: 9136-48. |
| 49. | Fan YH, Zhang Q, Zhang W, et al. Inhibitory effects of Patchouli alcohol on the early lifecycle stages of influenza A virus. Front Microbiol 2022; 13: 938868. |
| 50. | Agung Fitri Kusuma S, Asmi Ramdani Lestari S, Moelyono M. GC-MS analysis and anti-malodor activity of Indonesian patchouli leaves essential oil Pogostemon cablin (Blanco) Benth. against Corynebacterium Sp isolate. Res J Chem Environ 2022; 26: 33-40. |
| 51. | Szewczuk MA, Zych S, Oster N, Karakulska J. Activity of patchouli and tea tree essential oils against Staphylococci Isolated from pyoderma in dogs and their synergistic potential with gentamicin and enrofloxacin. Animals 2023; 13: 1279. |
| 52. | Zhang QL, Zhang JX, Zhang Y, et al. Antifungal and anti-biofilm activities of patchouli alcohol against Candida albicans. Int J Med Microbiol 2024; 314: 151596. |
| 53. | Peng F, Wan F, Xiong L, et al. In vitro and in vivo antibacterial activity of Pogostone. Chin Med J (Engl) 2014; 127: 4001-5. |
| 54. | Wan F, Peng F, Xiong L, et al. In vitro and in vivo antibacterial activity of patchouli alcohol from pogostemon cablin. Chin J Integr Med 2021; 27: 125-30. |
| 55. | Li YC, Liang HC, Chen HM, et al. Anti-Candida albicans activity and pharmacokinetics of pogostone isolated from pogostemonis herba. Phytomedicine 2012; 20: 77-83. |
| 56. | Yu XD, Xie JH, Wang YH, et al. Selective antibacterial activity of patchouli alcohol against Helicobacter pylori based on inhibition of urease. Phytother Res 2015; 29: 67-72. |
| 57. | Jeong GJ, Khan F, Tabassum N, Cho KJ, Kim YM. Bacterial extracellular vesicles: modulation of biofilm and virulence properties. Acta Biomater 2024; 178: 13-23. |
| 58. | Ranjutha V, Chen Y, Al-Keridis LA, et al. Synergistic antimicrobial activity of ceftriaxone and polyalthia longifolia methanol (MEPL) leaf extract against methicillin-resistant Staphylococcus aureus and modulation of mecA gene presence. Antibiotics (Basel) 2023; 12: 477. |
/
| 〈 |
|
〉 |