As bacteria are becoming more resistant to commonly used antibiotics, alternative therapies are being sought. whISOBAX (WH) is a witch hazel extract that is highly stable (tested up to 2 months in 37 °C) and contains a high phenolic content, where 75% of it is hamamelitannin and traces of gallic acid. Phenolic compounds like gallic acid are known to inhibit bacterial growth, while hamamelitannin is known to inhibit staphylococcal pathogenesis (biofilm formation and toxin production). WH was tested in vitro for its antibacterial activity against clinically relevant Gram-positive and Gram-negative bacteria, and its synergy with antibiotics determined using checkerboard assays followed by isobologram analysis. WH was also tested for its ability to suppress staphylococcal pathogenesis, which is the cause of a myriad of resistant infections. Here we show that WH inhibits the growth of all bacteria tested, with variable efficacy levels. The most WH-sensitive bacteria tested were Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis, followed by Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Streptococcus agalactiae and Streptococcus pneumoniae. Furthermore, WH was shown on S. aureus to be synergistic to linezolid and chloramphenicol and cumulative to vancomycin and amikacin. The effect of WH was tested on staphylococcal pathogenesis and shown here to inhibit biofilm formation (tested on S. epidermidis) and toxin production (tested on S. aureus Enterotoxin A (SEA)). Toxin inhibition was also evident in the presence of subinhibitory concentrations of ciprofloxacin that induces pathogenesis. Put together, our study indicates that WH is very effective in inhibiting the growth of multiple types of bacteria, is synergistic to antibiotics, and is also effective against staphylococcal pathogenesis, often the cause of persistent infections. Our study thus suggests the benefits of using WH to combat various types of bacterial infections, especially those that involve resistant persistent bacterial pathogens.

中文翻译：

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whISOBAXTM抑制细菌发病机理并增强抗生素作用。

随着细菌对常用抗生素的抵抗力越来越强，正在寻找替代疗法。whISOBAX（WH）是一种金缕梅提取物，具有很高的稳定性（在37°C下经过2个月的测试），酚含量高，其中75％是金缕梅宁和微量没食子酸。已知诸如没食子酸的酚类化合物可抑制细菌生长，而金缕梅则可抑制葡萄球菌致病（生物膜形成和毒素产生）。WH已在体外测试了其对临床相关革兰氏阳性和革兰氏阴性细菌的抗菌活性，并通过棋盘检测和等效线图分析确定了其与抗生素的协同作用。还测试了WH抑制葡萄球菌致病性的能力，这是无数抗药性感染的原因。在这里，我们显示WH以可变的功效水平抑制所有测试细菌的生长。对WH敏感度最高的细菌是表皮葡萄球菌，金黄色葡萄球菌，粪肠球菌和粪肠球菌，其次是鲍曼不动杆菌，肺炎克雷伯菌，大肠埃希氏菌，铜绿假单胞菌，无乳链球菌和链球菌。此外，WH在金黄色葡萄球菌上显示出与利奈唑胺和氯霉素的协同作用，并与万古霉素和丁胺卡那霉素发生累积。测试了WH对葡萄球菌发病机理的影响，并在此处显示了其抑制生物膜形成（对表皮葡萄球菌进行了测试）和毒素产生（对金黄色葡萄球菌肠毒素A（SEA）进行了测试）的作用。在亚抑菌浓度的环丙沙星诱导发病机理中，毒素的抑制作用也很明显。综上所述，我们的研究表明WH在抑制多种细菌的生长方面非常有效，与抗生素具有协同作用，还可以有效预防葡萄球菌的发病，而葡萄球菌的发病通常是持续感染的原因。因此，我们的研究表明，使用WH对抗各种类型的细菌感染（尤其是那些涉及耐药性持久性细菌病原体的细菌感染）的益处。