Synergistic Effect of Ficus Religiosa Extract and Ciprofloxacin on Growth and Biofilm Formation of Escherichia coli Isolated from Clinical Samples

Abstract

This study aimed to reveal the effect of total flavonoids and crude extract of ficus religiosa on biofilm inhibition and to evaluate the synergistic activity of crude and flavonoids with Ciprofloxacin (CIP) as a biofilm antagonist of clinically isolated E. coli. Crude extraction was accomplished using 80% methanol and flavonoid extraction accomplished using 100% methanol. 119 clinical urine and stool samples were collected from patients at Medical City Hospital. The Vitik 2 assay identified 76 of them as E. coli and only 46 isolates were able to produce biofilm when grown in congo red agar and microtiter plates. Molecular detection was carried out for the availability of genes responsible for biofilm formation in bacterial isolates The bacterial isolates were selected according to their ability to form biofilm and their resistance to antibiotics. The results showed that 21 (70%) isolates possess the fimH gene and 17 (56.6%) isolates possess the pap for E. coli. The results showed that the crude extract was more effective than flavonoids in inhibiting biofilm production at a concentration of 512 µg /ml. The results also showed that the mixture of Ciprofloxacin (8 µg /ml) and the crude extract (128 µg /ml) against biofilm formation of E. coli where the percentage of biofilm inhibition was (88%). The flavonoids with Ciprofloxacin against E. coli were (128 µg/ml) and (8 µg/ml), respectively, where the inhibition ratio was (81.1%). At low levels, this showed synergistic efficacy against bacterial biofilm formation. These results show that this drug can be used to fight E. coli biofilms well as as an antibacterial drug in the future.