In VitroSynergistic Effect ofPsidium guineense(Swartz) in Combination with Antimicrobial Agents against Methicillin-ResistantStaphylococcus aureusStrains
The aim of this study was to evaluate the antimicrobial activity of aqueous extract ofPsidium guineenseSwartz (Araçá-do-campo) and five antimicrobials (ampicillin, amoxicillin/clavulanic acid, cefoxitin, ciprofloxacin, and meropenem) against twelve strains ofStaphylococcus aureuswith a resistant phenotype previously determined by the disk diffusion method. FourS. aureusstrains showed resistance to all antimicrobial agents tested and were selected for the study of the interaction between aqueous extract ofP. guineenseand antimicrobial agents, by the checkerboard method. The criteria used to evaluate the synergistic activity were defined by the fractional inhibitory concentration index (FICI). AllS. aureusstrains were susceptible toP. guineenseas determined by the microdilution method. The combination of theP. guineenseextract with the antimicrobial agents resulted in an eight-fold reduction in the MIC of these agents, which showed a FICI ranging from 0.125 to 0.5, suggesting a synergistic interaction against methicillin-resistantStaphylococcus aureus(MRSA) strains. The combination of the aqueous extract ofP. guineensewith cefoxitin showed the lowest FICI values. This study demonstrated that the aqueous extract ofP. guineensecombined with beta lactamics antimicrobials, fluoroquinolones, and carbapenems, acts synergistically by inhibiting MRSA strains.