Study Effect of the Aqueous and Alcoholic Extracts of Radish and Ginger on the Gram Negative Bacteria that Cause Urinary Tract Infection in Balad City

Urinary Tract Infections (UTIs) are common and significant health problems in both developing and developed countries, with a majority of cases being caused by bacterial pathogens, particularly among women, children, and individuals with kidney failure. It is estimated that approximately 250 million people are infected with viral tract infections each year. UTIs are a major medical issue worldwide, with Iraq reporting a staggering 23% incidence of bacterial infections, which is the highest in the world [1, 2]. UTIs predominantly affect females and are particularly concerning for children [3]. The most common cause of UTIs is Escherichia coli, which accounts for 90% of cases and originates from the human intestine. Other Gram-negative bacterial pathogens in the Enterobacteriaceae family, such as Proteus spp., Klebsiella spp., and Pseudomonas spp., as well as Enterococcus spp. and Gram-positive Staphylococcus aureus and Staphylococcus spp., can also cause UTIs [3].

Treatment of UTIs:

Although antibiotics have been a critical treatment option for UTIs, their effectiveness has been compromised due to the emergence of antibiotic-resistant bacteria. This resistance occurs due to the random increase in the use of antibiotics and the presence of plasmids responsible for this resistance, which can transfer between bacteria [4]. As a result, there is a growing interest in exploring alternative treatments for UTIs, particularly since antibiotics can cause side effects. One such alternative is the use of medicinal plants and herbs, which have been used for centuries in traditional medicine to prevent and treat various diseases. Historical texts from civilizations such as Assyrian, Greek, Pharaonic, Indian, and Chinese describe the use of medicinal plants and herbs for various ailments [5].

The research gap in this study is the need for new antibiotics to combat bacterial infections, specifically UTIs and auditory system infections. While previous research has explored the potential of natural plant extracts as alternatives to synthetic antibiotics, there is a lack of research investigating the inhibitory effects of radish and ginger extracts on bacterial species commonly found in these types of infections. The specific research gap addressed by this study is the need to evaluate the inhibitory effect of aqueous and alcoholic extracts of radish and ginger against bacterial species isolated from UTIs and auditory system infections. The study also aims to determine the synergistic effects of the extracts and their potential as alternatives to antibiotics that are losing their effectiveness due to bacterial resistance [6].

To achieve these goals, the paper is structured as follows: first, a literature review is presented, outlining the previous research on the use of medicinal plants and herbs in the treatment of bacterial infections. Next, the methodology section details the procedures used to isolate the bacterial species and prepare the plant extracts, as well as the methods used to test their inhibitory effects. The results section presents the findings of the study, including the inhibitory effects of the plant extracts and their synergistic effects. Finally, the discussion and conclusion sections provide an interpretation of the results and their implications for future research in this area.

100 urine samples were collected for patients with acute and chronic urinary tract infection, 40 infected samples were obtained, and the ages of the infected ranged between (10-60) years and for both gender, where the infection in females was higher than males as shown in Table 1.

As 100 bacterial isolates were obtained, it was distributed between males and females according to ages, where it was 25 cases in females 55.5%, and 15 isolates in males with ratio 27.3%, where there was a significant difference between males and females, as shown in Table 2 whereas 60 sample uninfected.

The results in Figure 1 show that E. coli bacteria were the most isolated with 30% and P. aeruginosa, K.pnemoniae, S.marcescens and P. mirabilis with isolation rates (13%, 20%, 12%, 15%) respectively, while we find that C. freundii bacteria occupies the last place of isolation rates, as it is isolated by 10%.

Table 1. The relationship between bacterial infection and gens

Table 2. Number of bacterial infections according to age groups

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Figure 1. Bacterial isolates

The results in Table 3 showed the numbers and percentages of susceptible isolates and antibiotic resistance included in the study by the method of diffusion in pits. The current study showed that there are isolates that bear the characteristic of multiple antibiotic resistance, and the variation in the sensitivity of bacterial isolates to antibiotics may be due to several factors that may affect the results of the examination including, the thickness of the culture media, the pH of the culture medium, the size of the vaccine used, the content of the antibiotic tablet, age Antagonist content and antagonist disc storage method, in which sensitivity to bacterial isolates was compared with what was reported by the study [13].

Through Table 3 it was found that the reason for the emergence of isolates of P. mirabilis bacteria resistant to many of the antibiotics used in this study to the presence of mutations or the presence of plasmids that bear the resistance characteristics of many antibiotics combined, which play an important role in the spread of the phenomenon. Multiple antibiotic resistance is highly common among bacteria, in addition to this bacterial type having the ability to form biofilm that plays an important role in antibiotic resistance [14]. While the cause of K.pneumoniae resistance to many antibiotics is due to the possession of this preservative bacterium, there are also many mechanisms that make it resistant to antibiotics, and the most important of these mechanisms is its production of beta-lactase enzymes, as studies have shown that it has many types of these enzymes that destroy a wide range of antibiotics Beta-lactam [15].

Studies have indicated that the cause of resistance of S. marcescens bacteria may be due to the containment of the outer membrane of its strains on a large amount of fats and stable fats, as well as the containment of its strains on the resistance plasmids. As the resistance of these bacteria to antibiotics contributes to the increase in the incidence of hospital infection due to their possession of the plasmids that encode them (R-Plasmids) and resistance factors (R-Factors), as they have been shown to transmit the resistance characteristic and produce enzymes (beta-Lactamase) in particular, and it has been diagnosed. More than one type of broad-spectrum beta-lactamase is in isolation of one of them, and conjugation is considered one of the methods for transmitting the resistance trait.

Also, the high resistance shown by isolates of Ps. aeruginosa for most of the antibiotics used in the current study is due to the fact that these bacteria possess many antibiotic resistance mechanisms, and among these mechanisms the outer wall contains a special protein that is characterized by its high ability to release various antibiotics into the outside of the bacterial cell with the same speed of entry and this thing makes the concentration of the antibiotic Inside the bacterial cell is insufficient to eliminate it, and the reason for its resistance to antibiotics may be due to the presence of the resistance plasmid R-plasmid, which gives it the characteristic of resistance to many antibiotics [16].

Table 3. Sensitivity of bacterial species to antibiotics in patients with urinary tract infection

S: Sensitive, I: Intermediate, and R: Resistance

Table 4. Inhibitor diameter

Table 4 showed the effectiveness of plant extracts on bacterial isolates isolated from the urinary tract, where the effectiveness of plant extracts was tested by the method of diffusion from pits according to what was mentioned in the materials and methods of work by testing all the diagnosed bacterial isolates under the study where it showed different efficacy towards plant extracts and concentrations (100, 50 and 25.10 mg / ml).

Table 4 shows rate inhibitor diameter and selected (3) bacterial isolate from all type, which excel resistant for large antibiotic to conduct experiment hot extraction them and record inhibition rate.

The mechanisms of inhibiting plant extracts towards bacteria can be explained, according to one of the researchers, by inhibiting the formation of the cell wall of the microorganism or by inhibiting the synthesis of some basic proteins in it and the formation of complexes with the cell wall that impede the regularity of permeability, and inhibit some enzymes that have an important metabolic role in growth and reproduction, and the rupture of cellular membranes [17].

The study of the effect of the (hot) aqueous and alcoholic plant extracts of the fruits of the Zingiber plant on the bacterial species isolated from urinary tract infections was conducted by the method of spreading from pits, which is characterized by its ease and efficiency [18]. Where 3 bacterial isolates of each type were selected and characterized by their great resistance to antibiotics to conduct the extracts experiment on them, and then recorded their inhibition rate and it was measured in units (mm). One of the studies indicated that the ginger plant consists of different components according to the type of solvent, as it showed that the aqueous extract of ginger contains flavonoids, amino acids, carbohydrates and glycosides with the absence of both sterols, tannins, phenols, terpenes, alkaloids, lecnins and soaps, while the alcoholic extract of ginger has indicated that it contains the same study. Flavonoids, amino acids, carbohydrates, alkaloids, and glycosides, with low amounts of phenols and tannins, and the absence of terpenes, lignins, and saponins.

The effect of (hot) aqueous and alcoholic plant extracts of the radish plant Raphanus on the bacterial species isolated from urinary tract infections was studied by the method of spreading from pits, which is characterized by its ease and efficiency. Where it selected (3) bacterial isolates of each type, which was characterized by its great resistance to antibiotic, to conduct the experimental extracts on them, then recorded the rate of inhibition for them and it was measured in units (mm). Our current study showed that this plant extract has a differential effect on bacterial isolates, and this depends on the type of extract, the amount of concentration used and the type of microorganism.

Radish is an annual plant that has tuberous, wedge-shaped or spherical roots depending on the variety, and the medicinal part in it (seeds, leaves, and roots), and the active ingredients in radish are starch, sugar, Raphaiol, Raphanin, Reticol and Sinapine, the compound Raphaiol is from Alkaloids, which are the most important medicinal substances in plants, and from the chemical view are complex organic chemicals, and the roots and leaves of radish have an effective effect on the body's resistance to bacteria [19-24].

In conclusion, the study found that bacterial isolates from urinary tract infections showed various degrees of resistance to antibiotics, with some exhibiting multi-drug resistance. The emergence of antibiotic resistance was attributed to several factors, including the thickness and pH of the culture media, size of the vaccine used, age of the antagonist content, and antagonist disc storage method. Additionally, bacterial strains had inherent mechanisms for antibiotic resistance, such as the possession of plasmids or beta-lactase enzymes.

The study also found that plant extracts from ginger and radish showed varying degrees of effectiveness against the bacterial isolates, with an inhibitory effect depending on the type of extract and the concentration used. The extracts' inhibitory mechanisms may be due to the inhibition of cell wall formation, the synthesis of basic proteins, the formation of complexes with the cell wall, inhibition of enzymes, or rupture of cellular membranes. The study's findings are rich in the understanding of bacterial resistance mechanisms and the potential for plant extracts as alternative treatments for urinary tract infections.

Compared to previous studies, this study's contribution lies in its focus on urinary tract infections and its comprehensive evaluation of bacterial isolates' resistance to antibiotics and plant extracts' effectiveness. The study's findings can aid in developing better strategies for the treatment of urinary tract infections and in reducing the incidence of antibiotic resistance.