Search

Cases of antibiotic-resistant Escherichia coli (E. coli) infections are becoming increasingly frequent and represent a major threat to our ability to treat cancer patients. The emergence of antimicrobial resistance threatens the treatment of E. coli infections. In this study, the antimicrobial profiles, virulent genes, and the frequency of extended-spectrum beta-lactamase (ESBL) gene carriage in fecal E. coli isolates from cancer patients at the Laquintinie Hospital in Douala (Cameroon) were determined. 507 participants were recruited from October 2021 to March 2023, of whom 307 (60.55%) had cancer and 200 (39.45%) did not. Two hundred and two E. coli were isolated from fecal samples of one hundred and fifteen cancer patients and 47 (87) noncancer patients using EMB LEVINE agar. The antimicrobial resistance profile of the isolates was determined using the Kirby–Bauer disk diffusion method. Virulence and resistance genes were detected by simplex polymerase chain reaction (PCR). E. coli showed significant rates of resistance to amoxicillin, cefotaxime, ceftazidime, piperacillin, tetracycline, and ciprofloxacin in cancer patients compared to noncancer patients. The rate of multidrug resistance (MDR) was significantly (p

Background: Pathogenic Escherichia coli is one of the most common causes of acute watery diarrhea among children and adults in the developing world. The severity of infection by this bacterium is a product of many factors, including virulence properties and antimicrobial resistance. This study aimed to determine the distribution of different virulence genes of E. coli isolates in hypertensive and non-hypertensive patients and their association with some selected beta-lactam resistance genes. Methods: At the Douala Laquintinie Hospital, 518 fecal samples were collected from both hypertensive and non-hypertensive patients with enteric infections. E. coli was isolated on eosin-methylene blue agar (EMB) and identified by the Api 20 E Galery. The virulence genes and extended-spectrum β-lactamase-producing (ESBL) E. coli genes were detected by simplex polymerase chain reaction (PCR), while antimicrobial susceptibility was tested by the Kirby-Bauer agar disc diffusion method. Results: The prevalence of enteric infection due to diarrheagenic E. coli (n = 204) was found to be 39.38 % in the general population (n = 518). There were 55 enterovirulent E. coli isolates identified. According to hypertension (HTN), enteropathogenic E. coli (EPEC) isolates were more isolated in hypertensive patients (77.78 %) than in non-hypertensive patients (22.22 %), while enteroaggregative E. coli (EAEC) were the most frequent in non-hypertensive patients (58.33 %). EPEC, EAEC, enterotoxigenic E. coli (ETEC), and Shiga toxin-producing E. coli (STEC) isolates showed higher rates of resistance to amoxicillin (AMO) (90.48 %; 100.00 %; 100.00 %; 100.00 % vs 83.33 %; 85.71 %; 75.00 %; 50.00 %) and SXT (71.43 %; 80.00 %; 75.00 %; 75.00 % vs 0.00 %; 28.57 %; 50.00 %; 25.00 %) in hypertensive patients compared to non-hypertensive patients. The prevalence of ESBL-producing (ESBL-P) E. coli was 87.27 %. The resistance genes blaTEM (64.71 % vs 52.38 %) and blaOXA (23.53 % vs 9.52 %) were more frequently detected in hypertensive patients than in non-hypertensive patients. The high resistance to AMO was correlated with the presence of the blaCTX-M gene (OR: 5.52; 95 % CI: 0.61–49.39; p = 0.093). Conclusion: This study reveals the high burden of the typical EPEC, EAEC, and ESBL-P E. coli and confirmed the high occurrence of blaCTX-M and blaTEM among ESBL-producing E. coli in hypertensive patients. The study suggests that measures need to be taken to reduce the harmfulness of enterovirulent E. coli and the resistance of enterovirulent E. coli in hypertensive patients.

Abstract Background Bauhinia thonningii is a plant traditionally used against many human diseases such as gastric ulcers, fever, inflammations, coughs, dysentery, diarrhea, and malaria. In the present investigation, the cytotoxicity of methanol extract of Bauhinia thonningii leaves (BTL), fractions and the isolated phytoconstituents was determined in a panel of 9 human cancer cell lines including drug sensitive and multidrug-resistant (MDR) phenotypes. The acute and sub-chronic oral toxicity of BTL was investigated as well. Methods Compounds were isolated using chromatographic techniques while their chemical structures were determined using spectroscopic methods. The resazurin reduction assay (RRA) was used to evaluate the cytotoxicity of samples, propidium iodide (PI) for apoptosis, 5,5′,6,6′-tetrachloro-1,1′,3,3′-tetraethylbenzimidazolylcarbocyanine iodide (JC-1) staining for mitochondrial membrane potential (MMP) analysis, 2´,7´-dichlorodihydrofluoresceine diacetate (H2DCFH-DA) staining for the quantification of reactive oxygen species (ROS), whereas Caspase Glo assays were combined by means of flow cytometry. Furthermore, the toxicological investigations were performed as recommended by the Organization for Economic Cooperation and Development (OECD). Results The botanicals as well as 6-C-methylquercetin-3,7-dimethyl ether (2), quercetin-3-O-L-rhamnopyranoside (5), quercetin-3-O-β-glucopyranoside (6), 6,8-C-dimethylkaempferol 3,7-dimethyl ether (7), and 6,8-C-dimethylkaempferol-3-methyl ether (8) had promising cytotoxic effects in the 9 tested cancer cell lines. The IC50 values below 20 µg/mL (botanicals) or 10 µM (compounds) on at least 1/9 tested cancer cell lines were considered. The best cytotoxic effects with IC50 values below 5 µM were achieved with compounds 7 against CEM/ADR5000 leukemia cells (2.86 µM) and MDA-MB-231-pcDNA breast adenocarcinoma cells (1.93 µM) as well as 8 against CCRF-CEM leukemia cells (3.03 µM), CEM/ADR5000 cells (2.42 µM), MDA-MB-231-pcDNA (2.34 µM), and HCT116 p53 −/− cells (3.41 µM). BTL and compound 8 induced apoptotic cell death in CCRF-CEM cells through caspase activation, alteration of MMP, and increased ROS production. BTL did not cause any adverse effects in rats after a single administration at 5000 mg/kg or a repeated dose of 250 mg/kg body weight (b. w.). Conclusion Bauhinia thonningii and its constituents are sources of cytotoxic drugs that deserve more in-depth studies to develop novel antiproliferative phytomedicine to fight cancer including resistant phenotypes.

Malarial and bacterial coinfections in low-income countries are a serious cause of morbidity and mortality, necessitating coadministration of antibiotics and antimalarials. This study investigated the relationship between malaria infection and bacterial drug resistance in malaria and nonmalaria patients on consultation at the Dschang Regional Hospital. A follow-up study was carried out from October 2020 to December 2021 on 127 malaria and 174 nonmalaria patients having enteric infections. Clinical and haematological parameters were measured using standard methods. CD4 and CD8 cells were determined using flow cytometry. Enteric bacteria pathogens were isolated from stool, and antimicrobial and antimalarial profiles were determined using agar diffusion and microdilution methods, respectively. Significant reduction of RBCs, WBCs, CD4, CD8, granulocytes, monocytes and platelets was seen in coinfected patients compared to monoinfected participants (p≤0.0491). E. coli was the main pathogenic bacteria isolated from the digestive tract of coinfected patients (40.63%) and monoinfected patients (59.37%). E. coli showed a high level of resistance to AMX (57.69%) and CDA (61.54%) in coinfected patients compared to 55.26% and 41.67%, respectively, in monoinfected patients. Quinine (53[50.00%]; 6[42.86%]) presented a minimal inhibitory concentration (MIC) of 32 μg/mL on the bacteria isolates from coinfected and monoinfected patients, respectively, while Artemether 89 (83.96%), Maloxine 5 (3.94%) and Surquina 250 (39.37%) presented a MIC of 64 μg/mL on bacterial isolates of coinfected and monoinfected patients. E. coli showed high resistance against AKI (45.93%), AMX (43.75%) and ERY (59.37%) in malaria patients who were under antimalarial drugs compared to malaria patients who were not under malaria drugs (29.68%, 34.37% and 32.81%, respectively). This study highlights that antimalarial drugs might certainly have an influence on the acquisition and emergence of bacterial resistance in the case of malaria bacterial coinfection, and therefore, adequate management and planning effective control programmes might certainly go a long way to reduce the rate of morbidity and mortality.

Background. Opportunistic infections are the second cause of death among cancer patients. This study aimed at determining the antimicrobial profile and the prevalence of extended-spectrum beta-lactamase (ESBL)-gene carriage of Pseudomonas aeruginosa isolates among cancer patients at the Douala Laquintinie Hospital, Littoral Region of Cameroon. Between October 2021 and March 2023, 507 study participants were recruited among whom 307 (60.55%) were cancer patients, compared to 200 (39.45%) noncancer patients. Fifty-eight P. aeruginosa isolates were isolated from fecal samples of forty-five cancer patients and thirteen noncancer patients using Cetrimide agar. The antimicrobial resistance profile of the isolates was determined using the Kirby–Bauer disk diffusion method. The polymerase chain reaction was used to detect the presence of extended-spectrum beta-lactamase genes among P. aeruginosa isolates. P. aeruginosa showed significant resistance rates in cancer patients compared to noncancer patients to imipenem, cefotaxime, and ceftazidime, piperacillin-tazobactam, ticarcillin-clavulanic acid, and ciprofloxacin. The multidrug resistance (MDR) rate was significantly (p

Patients with cancer have weakened immune systems, making them more vulnerable to infections. This study was carried out to determine the bacterial origins of enteric disorders in cancer patients and noncancer patients at the Oncology Department of Laquintinie Hospital in Douala. A cross-sectional study was conducted from October 2021 to March 2023. Stool samples from 307 cancer patients with enteric disorders and 200 noncancer patients with enteric disorders were examined to diagnose the presence of bacteria using various techniques. Among all participants in this study, 62.13% were female and 37.87% were male. The average age of the participants was 46.38 ± 15.81 years, with a minimum age of 10 years and a maximum age of 84 years. The average age of participants was significantly higher (p

Abstract Background The rise of multidrug-resistant (MDR) bacteria is a real public health problem worldwide and is responsible for the increase in hospital infections. Donella welwitschii is a liana or shrub belonging to the family Sapotaceae and traditionally used to cure coughs. Objective This study was conducted with the objective to validate the medicinal properties of this plant, the aerial part was studied for its phytochemical composition using column and PTLC chromatography and exploring its antibacterial and antibiotic-modifying activity as well as those of its phytochemicals. Methods The structures of the compounds were elucidated from their physical and spectroscopic data in conjunction with literature. The antibacterial activity of the isolated metabolites was performed toward a panel of MDR Gram negative and Gram-positive bacteria. The broth micro-dilution method was used to determine antibacterial activities, efflux pump effect using the efflux pump inhibitor (EPI) (phenylalanine-arginine-ß-naphthylamide (PAβN)), as well as the modulating activity of antibiotics. Monitoring the acidification of the bacterial growth medium was used to study the effects of the samples on the bacterial proton-ATPase pumps and cellular ATP production. Results Eleven compounds were isolated including pentacyclic triterpenes, C-glucosyl benzophenones. With a MIC value

Abstract Background Tetrapleura tetraptera is a medicinal spice traditionally used to treat cancer, diabetes, and several other ailments. This study analyzed the cytotoxicity of the dichloromethane methanol extract of T. tetraptera fruits (TTF) and its constituents. The toxicity profile of the TTF extract was also evaluated in rats. Methods The Cytotoxicity of this extract was evaluated using the resazurin reduction assay (RRA). Acute and sub-chronic toxicity studies were performed according to the protocol described by the Organisation for Economic Cooperation, and Development (OECD). Hematological, serum, and urine biochemical parameters, as well as histological sections of the liver and kidney, were also evaluated based on standard methods. Results The TTF extract, compound 5, and the reference drug doxorubicin were active in all 9 tested cancer cell lines. The recorded IC50 ranged from 18.32 μM (against B16-F1 murine melanoma cells) to 36.18 μM (against SKMel-505 BRAF wildtype melanoma cells) for TTF, from 10.02 μM (towards MaMel-80a BRAF-V600E homozygous mutant melanoma cells) to 31.73 μM (against SKMel-28 BRAF-V600E homozygous mutant melanoma cells) for compound 5, and from 0.22 μM (against B16-F1 cells) to 9.39 μM (against SKMel-505 cells) for doxorubicin. The study of acute toxicity test showed that the lethal dose (LD50) of this extract was greater than 5000 mg/kg body weight. In the sub-chronic toxicity studies, variations were observed in some biochemical parameters, especially at higher doses. Conclusion TTF and its most active compound (5) are found to be potential cytotoxic agents, meanwhile, TTF was safe when given a single oral dose of 5000 mg/kg. However, caution is necessary in case of prolonged oral administration due to potential alterations of renal function at high doses (> 1000 mg/kg).

Malarial and bacterial coinfections in low‐income countries are a serious cause of morbidity and mortality, necessitating coadministration of antibiotics and antimalarials. This study investigated the relationship between malaria infection and bacterial drug resistance in malaria and nonmalaria patients on consultation at the Dschang Regional Hospital. A follow‐up study was carried out from October 2020 to December 2021 on 127 malaria and 174 nonmalaria patients having enteric infections. Clinical and haematological parameters were measured using standard methods. CD4 and CD8 cells were determined using flow cytometry. Enteric bacteria pathogens were isolated from stool, and antimicrobial and antimalarial profiles were determined using agar diffusion and microdilution methods, respectively. Significant reduction of RBCs, WBCs, CD4, CD8, granulocytes, monocytes and platelets was seen in coinfected patients compared to monoinfected participants (p ≤ 0.0491). E. coli was the main pathogenic bacteria isolated from the digestive tract of coinfected patients (40.63%) and monoinfected patients (59.37%). E. coli showed a high level of resistance to AMX (57.69%) and CDA (61.54%) in coinfected patients compared to 55.26% and 41.67%, respectively, in monoinfected patients. Quinine (53[50.00%]; 6[42.86%]) presented a minimal inhibitory concentration (MIC) of 32 μg/mL on the bacteria isolates from coinfected and monoinfected patients, respectively, while Artemether 89 (83.96%), Maloxine 5 (3.94%) and Surquina 250 (39.37%) presented a MIC of 64 μg/mL on bacterial isolates of coinfected and monoinfected patients. E. coli showed high resistance against AKI (45.93%), AMX (43.75%) and ERY (59.37%) in malaria patients who were under antimalarial drugs compared to malaria patients who were not under malaria drugs (29.68%, 34.37% and 32.81%, respectively). This study highlights that antimalarial drugs might certainly have an influence on the acquisition and emergence of bacterial resistance in the case of malaria bacterial coinfection, and therefore, adequate management and planning effective control programmes might certainly go a long way to reduce the rate of morbidity and mortality. [ABSTRACT FROM AUTHOR]

In this chapter, the traditional uses, the phytochemistry, and the cytotoxic potential of Albizia adianthifolia (Schum.) (Fabaceae) have been provided. The plant is traditionally used to treat sexually transmitted infections, gastrointestinal tract disorders, headaches, neurodegenerative diseases, diabetes, respiratory disorders, injuries, pain, and female fertility problems. Several pharmacological studies have demonstrated the activity of botanicals from different parts of this plant against human cancer cell lines. Phytochemical studies of the plant revealed 26 compounds belonging to terpenoids, phenolics, and alkaloids. Their cytotoxicity in cancer cell lines has been reported. Botanicals and phytochemicals from A. adianthifolia are potential sources of cytotoxic drugs to fight cancers including the refractory phenotypes. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to investigate the immunological and bacterial profiles in pregnant women of Bafang-Cameroon. Methods Stool and midstream urine were cultured using specific culture media. The disk diffusion method was used for the antimicrobial susceptibility test. T-cell lymphocyte counts (CD3, CD4 and CD8), white blood cell counts, sensitive C-reactive protein, and interleukin-6, were measured by flow cytometry, optical detection, and the enzyme-linked immunosorbent assay solid phase direct sandwich method. Results Out of 700 participants, 71.43% were pregnant, and 28.57% were non-pregnant women. The mean age was 29.40 ± 8.27 and 27.41 ± 6.55 years in non-pregnant and pregnant women, respectively. CD4 T-cells were not significantly lower in pregnant women compared with non-pregnant women. There were 43.65% and 56.35% bacteria isolates obtained from urine and stool samples, respectively. Bacteria were mostly isolated in patients with a CD4 T-cell count between 461 and 806 cells/μL. Isolates of Klebsiella pneumoniae and Enterobacter aerogenes showed 100% resistance in non-pregnant women, however all isolated bacteria were shown to be multidrug resistant in pregnant women. Salmonella sp. (24.3%) and Escherichia coli (21.51%) showed an increase in multidrug resistant phenotypes in pregnant women. Conclusion This study demonstrated that routine bacteriological analysis during pregnancy is necessary for their follow-up care.

Abstract Background The cytotoxicity of the root’s methanol extract of Imperata cylindrica (ICR). was previously reported in a panel of human cancer cell lines, including multi-drug resistant phenotypes. The aim of this study was to assess the acute and sub-chronic oral toxicity of methanol root extract of Imperata cylindrica. Methods The acute toxicity was carried out according to the experimental protocol of OECD. The plant extract was administered orally to female rats at a single dose of 5000 mg/kg for 14 days and the animals were observed for any behavioral changes or mortality. For sub-chronic toxicity study, ICR was orally administered daily to male and female rats at different doses (250, 500 and 1000 mg/kg per b.w.) for 30 days. During these treatment days the animals were observed for any appearance of toxicity symptoms; following the treatment period, animals were sacrificed for hematological, biochemical and histopathology analysis. Results From the results of the acute oral toxicity assay, ICR was found to be non-toxic at the dose of 5000 mg/kg b.w. During the period of sub-chronic toxicity test, observation of signs, behavior and health status of the animals showed no abnormality in the groups of animals treated with ICR as compared to the controls. Significant variation of the relative body weights of heart and kidney were observed at dose a 1000 mg/kg b.w. Significant decrease of aspartate aminotransferase, creatinine level, low density lipoprotein concentration, triglyceride and total cholesterol were observed. In males, we noticed a significant decrease of the level of granulocytes with an increase of lymphocytes and mean corpuscular hemoglobin concentration levels. Histological examinations performed on kidney and liver showed a normal kidney architecture and liver also presented a normal hepatic architecture with slight degeneration at a dose 1000 mg/kg b.w. Conclusion ICR is safe for acute oral administration; however, for long-term oral administration, safety measures should be taken. Thus, oral sub-chronic exposure of ICR at lower doses are recommended while higher doses around 1000 mg/kg b.w. should be discouraged.

Patients with cancer have weakened immune systems, making them more vulnerable to infections. This study was carried out to determine the bacterial origins of enteric disorders in cancer patients and noncancer patients at the Oncology Department of Laquintinie Hospital in Douala. A cross‐sectional study was conducted from October 2021 to March 2023. Stool samples from 307 cancer patients with enteric disorders and 200 noncancer patients with enteric disorders were examined to diagnose the presence of bacteria using various techniques. Among all participants in this study, 62.13% were female and 37.87% were male. The average age of the participants was 46.38 ± 15.81 years, with a minimum age of 10 years and a maximum age of 84 years. The average age of participants was significantly higher (p < 0.000) in cancer patients (49.54 ± 14.65 years) compared to noncancer patients (41.53 ± 16.33 years). Proteus mirabilis, Proteus vulgaris, Salmonella typhi, Enterobacter cloacae, Klebsiella pneumoniae, Yersinia intemedia, and Klebsiella oxytoca were more frequently isolated in cancer patients than in noncancer patients, with the respective percentages of 56.25% versus 43.75%, 50.00% versus 50.00%, 61.66% versus 38.34%, 66.66% versus 33.34%, 72.22% versus 27.78%, 80.00 versus 20.00%, and 100% versus 0.00%. Most isolates were sensitive to imipenem (IMP), gentamicin (GEN), and amikacin (AMK). Proteus vulgaris, the most prevalent isolate, showed significantly high resistance (with p < 0.05) in cancer patients compared to noncancer patients at amoxicillin/clavuranic acid (AMC) (89.13% versus 41.30%), ceftriaxone (CTR) (63.04% versus 39.13%), ciprofloxacin (CIP) (65.22% versus 34.18%), and tetracycline (TET) (93.48% versus 63.04%). Multidrug resistance was observed in cancer patients compared to noncancer patients for Klebsiella pneumoniae (85.00% versus 60.00%), Salmonella typhi (84.62% versus 60.00%), and Klebsiella oxytoca (86.49% versus 43.48%). The increase in the number of Gram‐negative infections among cancer patients, as shown in the present study, highlights the need for broad‐spectrum therapy and effective planning of control programs to reduce bacterial diseases among cancer patients. [ABSTRACT FROM AUTHOR]

Globally, the highest incidence of cervical cancer is seen in Sub-Saharan Africa. Plants have long been recognized as a fascinating source of anti-tumor medications. The present chapter aimed at compiling information on African medicinal plants and the phytochemicals they produce that have been reported for their anticancer properties and modes of action against cervical malignancies. Based on the established cutoff points for the classification of anticancer activity of natural products, 55 anti-cervical cancer plants were identified from eleven African countries. The most active African botanicals against cervical cancer are Rosmarinus officinalis, Sarcocephalus pobeguinii, Acokanthera schimperi, Kalanchoe petitiana, and Euphorbia schimperiana. Among the identified compounds from African medicinal plants, the most active against cervical cancer lines are diterpenoids ent-trachyloban-3β-ol (1) and ent-trachyloban-3-one (3). The potent cytotoxic botanicals and phytochemicals identified are potential sources of anti-tumor drugs against cancer and should be further explored to develop herbal medicine and pharmaceuticals to tackle cervical cancer. [ABSTRACT FROM AUTHOR]

Invasive melanoma accounts for only 1% of skin cancer diagnosed but causes most fatalities. It is the most prevalent malignancy diagnosed in the United States. Scientific databases like Pubmed, ScienceDirect, Scopus, and Google Scholar were used to retrieve information on the cytotoxic activity of botanicals and phytochemicals from the flora of Africa toward drug-sensitive and multidrug-resistant (MDR) melanoma cancer cells. This information was further compiled. As a result, botanicals from Piper capense and Callicarpa longissimi as well as 8,8-bis-(dihydroconiferyl)-diferulate (1), licarin A (2), and soyauxinium chloride (3) were the more suitable samples that could be helpful to combat the multidrug resistance of melanoma cell lines. Extensive preclinical and clinical studies on these natural products are required, to develop novel anti-melanoma drugs. [ABSTRACT FROM AUTHOR]

Glioblastoma (GBM) is the most common and most aggressive primary brain tumor. In this document, data on the cytotoxicity of plant products from the flora of Africa against drug sensitive and multidrug-resistant (MDR) GBM cell lines were collected from various scientific databases including PubMed, ScienceDirect, Scopus, Web of Science, and Scholar Google. As a result, the cytotoxicity of 42 botanicals and 112 cytotoxic phytochemicals are reported. They were further compiled and ranked following rationally established cut-off values for cytotoxic products from natural sources, to identify the potential phytomedicine. The crude extracts from Vepris soyauxii, Albizia adianthifolia, Curcuma longa, Piper capense, Anonidium mannii, and Uapaca togoensis were identified as the most suitable to combat the drug resistance GBM cells. Compounds identified as the most suitable to fight the multidrug resistance of GBM were isotetrandrine (5), aridanin (11), 7,7″-di-O-methylchamaejasmin (12), isoxanthochymol (13), and canniflavone (14), guieranone A (15), guttiferone E (16), isogarcinol (17), epunctanone (21), hydnocarpin (23), soyauxinium chloride (25), arborinine (27), 5,7-dihydroxy-4′-methoxy-6,8-diprenylisoflavone (28), licarin A (30) and B (31), and bidwillon A (32). These natural products deserve further investigations to produce novel naturally based medicine to combat glioblastoma, including the MDR phenotypes. [ABSTRACT FROM AUTHOR]

Despite the paucity of information on the relative frequency of cancers around the world and their socio-economic consequences in different regions, relatively little is known about the global burden of cancer and associated drug resistance. Although there is no reliable data on its incidence and evolution, with estimates varying according to the development index of the countries concerned, cancer is one of the main causes of death and disability in the world. Several treatments are available, but many treatment methods are ineffective because of resistance to anticancer drugs. Although previously thought to be rare in some communities, cancer, and drug-resistant cancer have recently been found to be common, and the situation has worsened since the HIV-AIDS pandemic about three decades ago. Drug resistance may be due to the activation of intrinsic (pre-existing) or acquired (drug-induced) mechanisms, and favors therapeutic failure, hence the need to understand the mechanisms underlying the development of drug resistance. The advanced stage of diagnosis and the unavailability/high cost of therapeutic agents result in a significant economic burden for the patient, his or her family, the community, and the country. This chapter of the book describes the incidence and burden of cancer, as well as global concerns about cancer drug resistance and resistance mechanisms, and finally provides updates on the global burden. [ABSTRACT FROM AUTHOR]

Bacterial multidrug resistance causes many therapeutic failures, making it more difficult to fight against bacterial diseases. This study aimed to investigate the antibacterial activity of extract, fractions, and phytochemicals from Plectranthus glandulosus (Lamiaceae) against multidrug-resistant (MDR) Gram-negative phenotypes expressing efflux pumps. The crude extract after extraction was subjected to column chromatography, and the structures of the isolated compounds were determined using spectrometric and spectroscopic techniques. Antibacterial assays of samples alone and in the presence of an efflux pump inhibitor (phenylalanine-arginine β-naphthylamide, PAβN) were carried out using the broth microdilution method. The phytochemical study of P. glandulosus plant extract afforded seven major fractions (A–G) which lead to the isolation of seventeen known compounds. The ethanol extract of P. glandulosus was not active at up to 1024 μg/mL, whereas its fractions showed MICs varying from 32 to 512 μg/mL on the studied bacteria. Fraction C of P. glandulosus showed the lowest MIC (32 μg/mL) on E. coli ATCC8739 strain. Fraction D presented the highest activity spectrum by inhibiting the growth of 90% (9/10) of the studied bacteria. The presence of PAβN has improved the activity of extract and all fractions. Overall, the tested phytochemicals showed low activity against the studied bacteria. The overall results obtained in this study show that some fractions from P. glandulosus, mainly fractions C and D, should be investigated more for their possible use to fight against MDR bacteria.