Effect Of Galbanic Acid, A Sesquiterpene Coumarin From Ferula Szowitsiana, As An Inhibitor Of Efflux Mechanism In Resistant Clinical Isolates Of Staphylococcus Aureus

Galbanic acid, a sesquiterpene coumarin from Ferula szowitsiana roots, was investigated for its potentiating effect on the antimicrobial activity of antibiotics as well as ethidium bromide, in 6 multidrug resistance (MDR) clinical isolates of Staphylococcus aureus. Galbanic acid had inhibitory effect on none of the isolated bacteria tested (up to 800 μg /ml). The MIC range of ciprofloxacin, tetracycline and ethidium bromide, against all tested S. aureus were 10-80, 10-80 and 4-16 μg/ml, respectively. These were reduced to ≤2.5-5, 2.5-5 and 0.5-2 μg/ml in the presence of galbanic acid (300 μg /ml) or verapamil (100 μg /ml). The rate of ethidium bromide (2 μg /ml) accumulation in clinical isolates was enhanced with galbanic acid (300 μg /ml). There is also a decrease in loss of ethidium bromide from bacteria in the presence of galbanic acid. Similar results were obtained when verapamil (100 μg /ml) was used as an efflux pump inhibitor. Galbanic acid, like verapamil, a typical inhibitor of efflux pump, reduced the MIC of ethidium bromide and tested antibiotics. Since efflux is the only known reported mechanism for ethidium bromide resistance, the reduction in ethidium bromide MIC and enhanced accumulation as well as decreased efflux of ethidium bromide in the presence of galbanic acid, can be attributed to this efflux inhibitory properties.