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AIM: The plant species reported here are traditionally used in the 'Puna' or 'Altiplano' of Argentina for ailments related to bacterial infections. The aim of this study was to evaluate their antimicrobial properties against a panel of sensitive and multi-resistant gram-positive and gram-negative bacteria. MATERIALS AND METHODS: The antimicrobial activity of tinctures and aqueous extracts (Baccharis boliviensis, Chiliotrichiopsis keidelii, Chuquiraga atacamensis, Fabiana bryoides, Fabiana densa, Fabiana punensis, Frankenia triandra, Parastrephia lucida, Parastrephia lepidophylla, Parastrephia phyliciformis, Tetraglochin cristatum) was determined using the agar macrodilution and broth microdilution methods recommended by the Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS). The antibiotic resistant clinical strains were isolated from nosocomial infection in human lesions of skin and soft parts. RESULTS: The ethanolic extracts of 11 plant species inhibited the growth of one or more of the following strains: Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter cloacae, Morganella morganii, Pseudomonas aeruginosa. Ethanol extracts (tinctures) of aerial parts of Baccharis, Fabiana and Parastrephia showed the highest levels of antibacterial activity on methicillin, oxacillin and gentamicin resistant Staphylococcus with MIC values from 20 to 150 microg/ml. Baccharis boliviensis and Fabiana bryoides were more active than the other plant species on Enterococcus faecalis with different phenotype. The most interesting activity on multi-resistant gram-negative strains was obtained from Chuquiraga atacamensis. Parastrephia species showed activity against Enterobacter cloacae, Pseudomonas aeruginosa and Proteus mirabilis. The ethanolic extracts exhibited stronger activity and broader spectrum of action than aqueous extracts. The extracts were bactericidal in most cases. CONCLUSIONS: The presence of antibacterial activity in Puna plant extracts against multi-resistant bacteria give support to their traditional use for treating conditions associated with microorganisms in humans and animals and consequently seems promising for the treatment of multi-resistant bacteria. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: Jérôme Rivory, Louis-Jean Masgnaux, Mathieu Pioche are co-founders of the ATRACT devices and co. Nothing to declare for the other authors.

Background and study aims  White bile is defined as a colorless fluid occasionally found in the biliary tract of patients with bile duct obstruction. Its significance is not clearly established. Our objective was to analyze the prognostic value of white bile in a series of patients with biliary obstruction due to biliary or pancreatic cancer. Patients and methods  The study was conducted on a series of consecutive patients with malignant obstructive jaundice. They all underwent endoscopic retrograde cholangiopancreatography with collection of bile and biliary stent insertion. White bile was defined as bile duct fluid with bilirubin level < 20 µmol/L. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS). Results  Seventy-three patients were included (32 pancreatic cancers, 41 bile duct cancers). Thirty-nine (53.4 %) had white bile. The mean bile duct bilirubin level in this group was 4.2 ± 5.9 µmol/L vs 991 ± 1039 µmol/L in patients with colored bile (P < 0.0001). In the group of 54 patients not eligible for surgery, the multivariate analysis demonstrated an association between the presence of white bile and reduced OS (HR 2.3, 95 %CI 1.1-4.7; P = 0.02). Other factors independently associated with OS were metastatic extension (HR 2.8, 95 %CI 1.4-5.7) and serum total bilirubin (HR 1.003, 95 %CI 1.001-1.006). There was a significant inverse correlation between serum and bile duct bilirubin levels (r = -0.43, P = 0.0001). Conclusion  White bile in patients with inoperable malignant biliary obstruction is an independent factor of poor survival., Competing Interests: Competing interests The authors declare that they have no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)