METHOD OF CHINESE HERBAL MEDICINE EXTRACT USED FOR TREATING MULTIPLE DISEASES CAUSED BY DRUG RESISTANT BACTERIA INFECTION

Information

  • Patent Application
  • 20220023369
  • Publication Number
    20220023369
  • Date Filed
    October 06, 2021
    3 years ago
  • Date Published
    January 27, 2022
    2 years ago
Abstract
Disclosed is a new drug application of a Pithecellobium clypearia Benth Extract (EA), and particularly is a method of the EA used for treating multiple diseases caused by drug resistant bacteria infection. Related drug resistant bacteria include a Multi-Drug Resistant (MDR) Acinetobacter baumannii (MDRAB), an MDR Pseudomonas aeruginosa (MDRPA), an Extended-Spectrum Beta-Lactamase (ESBL) producing Escherichia coli (ECO) and an ESBL-producing Klebsiella pneumonia (KPN).
Description
TECHNICAL FIELD

The present disclosure relates to a new drug application of a Pithecellobium Clypearia Benth Extract (EA), and particularly, to a method of the EA used for treating multiple diseases caused by drug resistant bacteria infection.


BACKGROUND

The twenty-first century is an age of Multi-Drug Resistant (MDR) bacteria. After 60 years of clinical use of an antibiotic, more and more hospital infections and infections with the MDR bacteria have become a major challenge to clinical antibacterial treatment at present. Since a first case of clinical Methicillin-Resistant Staphylococcus Aureus (MRSA) infected patient was reported by Jerons in 1961, the MRSA infections have gradually spread all over the world till now. In 2011, China Bacterial Resistance Surveillance in clinic showed that, in distribution of main drug resistant bacteria, Escherichia coli and Klebsiella pneumonia produced Extended-Spectrum Beta-Lactamase (ESBL) strains respectively were 50.7% and 38.5%, and the transition and current status of the drug resistance thereof are highly concerned. In addition, according to an annual report 2010 from a Drug Resistance Surveillance Cooperating Group of Ministry of Health, pathogenic bacteria separated by Acinetobacter baumannii and Pseudomonas aeruginosa in a hospital ICU ranked the top, and the drug resistance rates of the Acinetobacter baumannii to imipenem (IMP) and meropenem respectively were up to 60.4% and 61.4%. To sum up, in various MRSA and ESBL produced bacteria, the clinical occupied rates of the MDR Acinetobacter baumannii (MDRAB) and Pseudomonas aeruginosa (MDRPA) have been growing every year. Under the pressure that the drug resistance rates are rising continuously, the antibiotic treatment is facing an enormous challenge. In order to prevent further deterioration of a bacterial drug resistant phenomenon, experts and scholars are sparing no effort to discover a new method for inhibiting bacterial growth and treating a bacteria-induced disease. A research has been reported and proved that traditional Chinese herbal medicines such as Coptis chinensis, Scutellaria baicalensis and Forsythia suspensa have a certain inhibition effect to different drug resistant bacteria. The key to further research the Chinese herbal medicine to inhibit the growth of the drug resistant bacteria is to discover a new Chinese herbal medicine with a stronger bactericidal capacity and a wider drug resistant inhibitory spectrum.


With Pithecellobium bigemimum (L.) Benth as a scientific name, the Pithecellobium clypearia Benth is dry young branches and leaves of mimosa Pithecellobium plant that is the Pithecellobium clypearia Benth. It is cold, tastes bitter and has the effects of clearing away heat and toxic materials, astringing dampness and healing sore. It is a unique southern medicinal material for treating multiple heat toxin symptoms.


Currently, there has disclosed in a literature that the Pithecellobium clypearia Benth and an extract thereof have an antiviral effect, but lacks a research in an effect of the Pithecellobium clypearia Benth and the extract thereof in aspect of anti-drug resistant bacteria.


SUMMARY

In order to overcome the above defects, the present disclosure discloses an application of an EA in preparing a drug resistant bacteria resistant drug and in an aspect of a sensibilization effect by using with a similar antibiotic thereof, specifically:


1. a method of the EA used for treating disease caused by an MDRAB resistant infection, in which the EA is used with an antibiotic IMP or Tetracycline (TE) or Polymycin B (POLB) or Ceftazidime (CAZ) or Levofloxacin (LVX) and all show an obvious sensibilization effect;


2. a method of the EA used for treating disease caused by an MDRPA resistant infection, in which the EA is used with an antibiotic LVX or IMP or Amikacin (AMK) or CAZ or Cefoperazone (CFP) and all show an obvious sensibilization effect;


3. a method of the EA used for treating disease caused by an ESBL-producing Escherichia coli (ECO) resistant infection, in which the EA is used with an antibiotic AMK or Compound Sulfamethoxazole (SXT) and all show an obvious sensibilization effect;


4. a method of the EA used for treating disease caused by an ESBL-producing Klebsiella pneumonia (KPN) resistant infection, in which the EA shows an obvious inhibitory effect to the ESBL-producing KPN.


The EA preferably is a Pithecellobium clypearia Benth water extract or a Pithecellobium clypearia Benth ethanol extract.


A method for preparing the EA is as follows: extracting Pithecellobium clypearia Benth coarse powder with water or an ethanol aqueous solution having a concentration of 10%-95% by a volume ratio, and then extracting an obtained extracting solution with ethyl acetate, in which the obtained extract is a final product. The ethanol aqueous solution preferably is an ethanol aqueous solution having the concentration of 60% by the volume ratio.


In the present disclosure, the drug includes a human drug or an animal drug, or a soil treatment drug or preparation.


The present disclosure achieves the following beneficial effects.


The present disclosure first discloses the antibacterial effect of the EA to the MDRAB, the MDRPA, the ESBL-producing ECO and the ESBL-producing KPN and the sensibilization effect by using with the antibiotics thereof.


A test proves that the EA by using with the IMP or the TE or the POLB or the CAZ or the LVX has a synergistic effect to the MDRA resistance, and compared with the single use, the usage of the antibiotic is reduced by 50%-87%.


The EA by using with the LVX or the IMP or the AMK or the CAZ or the CFP has a synergistic effect to the MDRPA resistance, and compared with the single use, the usage of the antibiotic is reduced by 50%-99.2%.


The EA by using with the AMK or the SXT has a synergistic effect to the ESBL-producing ECO, and compared with the single use, the usage of the antibiotic is reduced by 75%-99.3%.


The EA in the present disclosure can be taken as a natural antibacterial drug for the above drug resistant bacteria or a sensitizer similar to the antibiotic, and is applied to treatment of a disease caused by the above bacteria. The present disclosure provides a new way and a replacement drug to solve the drug resistant problem of the antibiotics, and is applied to the human drug, other animal drugs and soil remediation of corresponding infectious bacteria. It is a natural plant extract and has no side effect, and the extracting method is simple and environment-friendly.







DETAILED DESCRIPTION OF THE EMBODIMENTS

The EA to resist the drug resistant bacteria and the pharmacological actions of the sensibilization effect to similar antibiotics will be further described with the reference to the following implementation solutions.


Preparation of the EA: the Pithecellobium clypearia Benth is provided by Guangzhou Huacheng Pharmaceutical Factory. An appropriate amount of Pithecellobium clypearia Benth medicinal materials are taken and are crushed into coarse powder; the coarse powder is reflowed for two times with water or with a 10%-95% ethanol aqueous solution, each time for 2 h, and is filtered; filtrates are merged and are condensed to obtain an extractum (namely, the Pithecellobium clypearia Benth water or ethanol extract); after being taken and suspended in the water, the extractum is extracted with ethyl acetate for three times, and ethyl acetate extracting solutions are merged and are condensed to obtain an ethyl acetate extract. The extract obtained by reflowing with a 10% ethanol aqueous solution is referred to as a Pithecellobium clypearia Benth 10% ethanol extract, and the extract obtained by reflowing with other concentrations of ethanol aqueous solutions are by that analogy.


Strains: test strains in the present disclosure all are provided by the Clinical Microbiology Lab of Department of Lab Medicine at First Affiliated Hospital of Sun Yat-Sen University and the drug resistance is tested and confirmed by the same.



Mycoplasma Hominis (MH) broth culture medium: 2.1 g of MH broth dry powder (British OXOID LTD.) is taken and a volume is fixed to 100 ml; the pH is adjusted to 7.0 with NAOH; and the culture medium is sterilized at a high pressure and is placed into a refrigerator at 4° C. for later use.


Determination methods of a Minimal Inhibitory Concentration (MIC) and a Minimum Bactericidal Concentration (MBC) of a test product: the MIC and the MBC of the Pithecellobium clypearia Benth water or ethanol extract to the MDRAB are determined by a microdilution broth method. And it is operated by referring to the microdilution broth method recommended by National Committee for Clinical Laboratory Standards (NCCLS).


Test methods of the sensibilization effects of the test product to similar antibiotics: it is operated by referring to a checkerboard assay recommended by NCCLS.


I. Inhibitory and Bactericidal Tests of MDRA Resistance of the EA and Test of the Sensibilization Effect by Respectively Using with the IMP or the TE or the POLB or the CAZ or the LVX


Embodiment 1

1. Test Method


1) MIC Determination


The EA, the IMP, the TE, the POLB, the CAZ and the LVX are respectively diluted in the MH broth culture medium by a series of ratios, with each pore for 50 μl; the inoculant bacteria are adjusted to 1.0*106 CFU/ml and 50 μl of a bacteria solution is added to each pore; the culture is at 35° C. and for 24 h; and the concentration, at which no precipitate occurs, of a minimum antibacterial drug is the MIC.


2) MBC Determination


A spread plate count method is adopted. 50 μl of bacterial suspension is absorbed from a pore for sterile growth in item 1) to a blood plate, is uniformly coated and is cultured for 24 h at 35° C. Bacterial colonies are counted, and the concentration, at which the initial number of experimental viable bacteria is reduced by 99.9% or more, of the minimum antibacterial drug is the MBC.


By determining the MIC and the MBC of the drug and making statistics of the data to obtain MIC50, MIC90, MBC50 and MBC90, the effect of the MDRA resistance of the drug is evaluated.


3) Checkerboard Assay


The checkerboard assay is performed in a 96-pore sterile culture plate. The EA, the IMP, the TE, the POLB and the CAZ are respectively diluted into a series of concentrations in a doubling manner in the MH broth culture medium, and two drugs are combined respectively at ¼MIC to 4MIC; 25 μl of A drug and 25 μl of B drug are respectively added to each pore, the concentration of the bacterial suspension is adjusted to 1.0*106 CFU/ml, 50 μl of the bacteria solution is inoculated to each pore and is cultured for 24 h at 35° C.; and then, the MIC to the MDRAB after the A drug is used with the B drug is observed.


Calculation of a Fractional Inhibitory Concentration (FIC): FIC=S20b combined-use MIC/S20b single-use MIC+antibiotic combined-use MIC/antibiotic single-use MIC. By calculating the FIC, the combined antibacterial interaction between the EA and the antibiotic is evaluated, with synergistic effect for FIC≤0.5, additive effect for 0.5<FIC≤1, indifferent effect for 1<FIC≤2 and antagonistic effect for FIC >2. According to a sterile growth pore, the optimum concentration ratio between the EA and the antibiotic is founded out. At last, the effect of the EA to strengthen the efficacy of the antibiotic is evaluated.


The test products in the embodiment include: the Pithecellobium clypearia Benth water extract, the Pithecellobium clypearia Benth 10% ethanol extract, the Pithecellobium clypearia Benth 60% ethanol extract and the Pithecellobium clypearia Benth 95% ethanol extract.


The MDRABs are numbered as A1-A20.


2. Test results


2.1 In-vitro inhibitory test results of the Pithecellobium clypearia Benth water extract and the five antibiotics (the IMP, the TE, the POLB, the CAZ and LVX) to the MDRABs are shown in table A1.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth water extract to the MDRABs are shown in table A2.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth water extract and the five antibiotics to the MDRABs is shown in table A3.


The statistic analysis on MBC50 and MBC90 of the Pithecellobium clypearia Benth water extract to the MDRABs is shown in table A4.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth water extract and the five antibiotics and distribution statistical results of the FIC values are shown in table A5 and table A6.


The sensibilization effects of the Pithecellobium clypearia Benth water extract to the five antibiotics and the MIC50 and MIC90 after combined use are shown in tables A7-A12.









TABLE A1







In-vitro inhibitory test results of the Pithecellobium clypearia Benth


water extract and the five antibiotics to the MDRABs









MIC (μg/ml)













Strain No.
EA
IMP
TE
LVX
CAZ
POLB
















 A1
600
1
2
0.5
128
8


 A2
600
32
256
16
512
2


 A3
600
32
256
4
512
2


 A4
600
8
8
0.5
256
2


 A5
600
32
32
4
64
4


 A6
600
32
256
8
>512
8


 A7
600
32
512
8
>512
4


 A8
600
32
256
4
512
8


 A9
600
32
256
4
512
1


A10
600
16
128
32
512
32


A11
600
32
256
4
512
16


A12
600
32
512
32
512
2


A13
600
32
512
32
256
2


A14
600
32
256
16
512
0.5


A15
1200
32
>512
32
256
2


A16
600
32
512
8
512
4


A17
600
16
512
16
256
64


A18
600
32
512
8
512
4


A19
600
32
512
16
256
4


A20
600
32
256
16
512
2


ATCC27853
300
1
8
1
4
1
















TABLE A2







In-vitro bactericidal test results of the Pithecellobium


clypearia Benth water extract to the MDRABs










Strain No.
MBC (μg/ml)







A1 
1200



A2 
1200



A3 
1200



A4 
1200



A5 
1200



A6 
1200



A7 
1200



A8 
1200



A9 
1200



A10
1200



A11
1200



A12
1200



A13
1200



A14
1200



A15
2400



A16
1200



A17
1200



A18
1200



A19
1200



A20
1200

















TABLE A3







Statistical results on in-vitro inhibitory MIC50 and MIC90 of the


Pithecellobium clypearia Benth water extract and the antibiotics


to the MDRABs









MIC (μg/ml)










Drug
Range
MIC50
MIC90





EA
600-1200
600
600


IMP
 1-32
 32
 32


TE
 2-512
256
512


POLB
 0.5-64
 4
 16


CAZ
 64-512
512
512


LVX
 0.5-32
 8
 32
















TABLE A4







Bactericidal MIC50 and MIC90 of the Pithecellobium clypearia


Benth water extract to the MDRABs









MBC (μg/ml)










Drug
Range
MBC50
MBC90





EA
1200-2400
1200
1200
















TABLE A5







FIC values of the combined drug sensitive test of the


Pithecellobium clypearia Benth water extract and the


five antibiotics








Strain
FIC












No.
EA + IMP
EA + TE
EA + POLB
EA + CAZ
EA + LVX





A1
1
1
1.5
0.75
0.625


A2
1
1
1
1
1.5


A3
1
0.75
1.25
0.75
0.375


A4
0.625
0.75
0.5
0.625
0.375


A5
1.5
0.375
0.375
1
0.5


A6
1
0.5
0.5
1
1


A7
1
1
0.75
1
1


A8
1
1
1.007813
1
1.25


A9
1.5
0.75
1.0625
0.375
0.265625


A10
1
1.5
0.5
1
0.75


A11
1.25
0.75
0.5
1
1


A12
1
0.75
1.03125
0.5
0.5625


A13
1.5
0.5
1.5
1
0.75


A14
0.375
0.375
0.625
0.375
1


A15
0.375
0.3125
0.53125
1
0.501953


A16
0.5
0.625
0.515625
1.125
0.5


A17
0.375
1.25
1.03125
0.625
1


A18
0.375
0.75
1.5
1
0.375


A19
0.5
0.375
1
1
1


A20
0.5
0.5
1
0.375
0.5
















TABLE A6







Distribution statistics of the FIC values of the combined drug


sensitive test of the Pithecellobium clypearia Benth water


extract and the five antibiotics













EA +
EA +
EA +
EA +
EA +


FIC − Range
IMP
TE
POLB
CAZ
LVX





FIC ≤ 0.5
35%
35%
25%
20%
35%


0.5 <FIC ≤ 1
45%
55%
35%
75%
55%


1 < FIC ≤ 2
20%
10%
40%
 5%
10%


FIC > 2





















TABLE A7







Sensibilization effect of the Pithecellobium clypearia Benth


water extract to the IMP and MIC after combined use












EA single-
EA combined-
IMP single-
IMP combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)





A1
 600
300
 1
0.5


A2
 600
300
32
16


A3
 600
300
32
16


A4
 600
300
 8
1


A5
 600
600
32
16


A6
 600
300
32
16


A7
 600
300
32
16


A8
 600
300
32
16


A9
 600
600
32
16


A10
 600
300
16
8


A11
 600
600
32
8


A12
 600
300
32
16


A13
 600
600
32
16


A14
 600
150
32
4


A15
1200
300
32
4


A16
 600
150
32
8


A17
 600
150
16
2


A18
 600
 75
32
8


A19
 600
150
32
8


A20
 600
150
32
8
















TABLE A8







Sensibilization effect of the Pithecellobium clypearia Benth


water extract to the TE and MIC after combined use












EA single-
EA combined-
TE single-
TE combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)





A1
 600
300
  2
 1


A2
 600
300
 256
128


A3
 600
300
 256
 64


A4
 600
300
  8
 2


A5
 600
150
 32
 4


A6
 600
150
 256
 64


A7
 600
300
 512
256


A8
 600
300
 256
128


A9
 600
300
 256
 64


A10
 600
600
 128
 64


A11
 600
300
 256
 64


A12
 600
150
 512
256


A13
 600
150
 512
128


A14
 600
150
 256
 32


A15
1200
300
1024
 64


A16
 600
300
 512
 64


A17
 600
600
 512
128


A18
 600
300
 512
128


A19
 600
150
 512
 64


A20
 600
150
 256
 64
















TABLE A9







Sensibilization effect of the Pithecellobium clypearia Benth


water extract to the POLB and MIC after combined use













EA
POLB
POLB



EA single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)





A1
 600
600
 8
4


A2
 600
300
 2
1


A3
 600
600
 2
0.5


A4
 600
150
 2
0.5


A5
 600
150
 4
0.5


A6
 600
150
 8
2


A7
 600
300
 4
1


A8
 600
600
 8
0.0625


A9
 600
600
 1
0.0625


A10
 600
150
32
8


A11
 600
150
16
4


A12
 600
600
 2
0.0625


A13
 600
600
 2
1


A14
 600
300
 0.5
0.0625


A15
1200
600
 2
0.0625


A16
 600
300
 4
0.0625


A17
 600
600
64
2


A18
 600
600
 4
2


A19
 600
300
 4
2


A20
 600
300
 2
1
















TABLE A10







Sensibilization effect of the Pithecellobium clypearia Benth


water extract to the CAZ and MIC after combined use













EA
CAZ
CAZ



EA single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)





A1
 600
150
 128
 64


A2
 600
300
 512
256


A3
 600
150
 512
256


A4
 600
300
 256
 32


A5
 600
300
 64
 32


A6
 600
300
1024
512


A7
 600
300
1024
512


A8
 600
300
 512
256


A9
 600
150
 512
 64


A10
 600
300
 512
256


A11
 600
300
 512
256


A12
 600
150
 512
128


A13
 600
300
 256
128


A14
 600
150
 512
 64


A15
1200
600
 256
128


A16
 600
600
 512
 64


A17
 600
300
 256
 32


A18
 600
300
 512
256


A19
 600
300
 256
128


A20
 600
150
 512
 64
















TABLE A11







Sensibilization effect of the Pithecellobium clypearia Benth


water extract to the LVX and MIC after combined use













EA
LVX
LVX



EA single-
combined-
single-use
combined-


Strain
use MIC
use MIC
MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)





A1
 600
300
 0.5
 0.0625


A2
 600
300
16
16


A3
 600
150
16
 2


A4
 600
150
 0.5
 0.0625


A5
 600
150
 4
 1


A6
 600
300
 8
 4


A7
 600
300
 8
 4


A8
 600
150
 4
 4


A9
 600
150
 4
 0.0625


A10
 600
300
32
 8


A11
 600
300
 4
 2


A12
 600
300
32
 2


A13
 600
300
32
 8


A14
 600
300
16
 8


A15
1200
600
32
 0.0625


A16
 600
150
 8
 2


A17
 600
300
16
 8


A18
 600
150
 8
 1


A19
 600
300
16
 8


A20
 600
150
16
 4
















TABLE A12







MIC50 and MIC90 of the five antibiotics after combined use








Combined
Antibiotic (μg/ml)









drug
MIC50 after combined use
MIC90 after combined use





EA + IMP
 8
 16


EA + TE
 64
128


EA + POLB
 1
 4


EA + CAZ
128
256


EA + LVX
 2
 8









With the single use of the Pithecellobium clypearia Benth water extract to the MDRABs, the MIC50 is 600 μg/ml, the MIC90 is 600 μg/ml, the MBC50 is 1200 μg/ml, and the MBC90 is 1200 μg/ml.


It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth water extract and the IMP that the two drugs have the synergistic effect or partial synergistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the concentration of the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC50 of the IMP is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 16 μg/ml and is reduced by 50%.


It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth water extract and the TE to the 20 MDRABs that the two drugs have the synergistic effect or partial synergistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC50 of the TE is reduced from single-use 256 μg/ml to 64 μg/ml and is reduced by 75%; and the MIC90 is reduced from 512 μg/ml to 128 μg/ml and is reduced by 75%.


For the 20 MDRABs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the POLB that the two drugs have no antagonistic effect, wherein 25% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC50 of the POLB is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC90 is reduced from 16 μg/ml to 4 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the CAZ to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC50 of the CAZ is reduced from single-use 512 μg/ml to 128 μg/ml and is reduced by 75%; and the MIC90 is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the LVX to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRAB, when the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC50 of the LVX is reduced from single-use 8 μg/ml to 2 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.


2.2. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics (the IMP, the TE, the POLB, the CAZ and the LVX) to the MDRABs are shown in table A13.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 10% ethanol extract to the MDRABs are shown in table A14.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics to the MDRABs is shown in table A15.


The statistic analysis on MBC50 and MBC90 of the EA to the MDRABs is shown in table A16.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table A17 and table A18.


The sensibilization effects of the Pithecellobium clypearia Benth 10% ethanol extract to the five antibiotics and the MIC50 and MIC90 after combined use are shown in tables A19-A24.









TABLE A13







In-vitro inhibitory test results of the Pithecellobium clypearia Benth


10% ethanol extract and the five antibiotics to the MDRABs









MIC (μg/ml)













Strain No.
EA
IMP
TE
LVX
CAZ
POLB
















 A1
600
1
2
0.5
128
8


 A2
600
32
256
16
512
2


 A3
600
32
256
4
512
2


 A4
600
8
8
0.5
256
2


 A5
600
32
32
4
64
4


 A6
600
32
256
8
>512
8


 A7
600
32
512
8
>512
4


 A8
600
32
256
4
512
8


 A9
600
32
256
4
512
1


A10
600
16
128
32
512
32


A11
600
32
256
4
512
16


A12
600
32
512
32
512
2


A13
600
32
512
32
256
2


A14
600
32
256
16
512
0.5


A15
600
32
>512
32
256
2


A16
600
32
512
8
512
4


A17
600
16
512
16
256
64


A18
600
32
512
8
512
4


A19
600
32
512
16
256
4


A20
600
32
256
16
512
2


ATCC27853
300
1
8
1
4
1
















TABLE A14







In-vitro bactericidal test results of the Pithecellobium clypearia


Benth 10% ethanol extract to the MDRABs








Strain No.
MBC (μg/ml)





A1
1200


A2
1200


A3
1200


A4
1200


A5
1200


A6
1200


A7
1200


A8
1200


A9
1200


A10
1200


A11
1200


A12
1200


A13
1200


A14
1200


A15
1200


A16
1200


A17
1200


A18
1200


A19
1200


A20
1200
















TABLE A15







Statistical results on in-vitro inhibitory MIC50 and MIC90 of the


Pithecellobium clypearia Benth 10% ethanol extract and the


antibiotics to the MDRABs









MIC (μg/ml)










Drug
Range
MIC50
MIC90





EA
600
600
600


IMP
 1-32
 32
 32


TE
 2-512
256
512


POLB
 0.5-64
 4
 16


CAZ
 64-512
512
512


LVX
 0.5-32
 8
 32
















TABLE A16







bactericidal MBC50 and MBC90 of the Pithecellobium clypearia


Benth 10% ethanol extract to the MDRABs









MBC (μg/ml)










Drug
Range
MBC50
MBC90





EA
1200
1200
1200
















TABLE A17







FIC values of the combined drug sensitive test of the


Pithecellobium clypearia Benth 10% ethanol extract


and the five antibiotics









FIC












Strain


EA +




No.
EA + IMP
EA + TE
POLB
EA + CAZ
EA + LVX





A1
1
1
1
1
0.625


A2
0.75
0.75
1
1
1


A3
0.75
0.75
1
1
0.625


A4
1.5
0.5
1
0.5
0.625


A5
0.5
0.375
0.75
1
1


A6
0.625
0.75
0.375
1
1


A7
0.5
0.5
0.375
1
1


A8
1
0.5
0.507813
0.75
1


A9
0.375
0.375
0.5625
0.75
0.265625


A10
0.75
0.75
0.375
1
0.75


A11
0.5
0.5
1
0.75
1


A12
0.5
0.5
1
0.75
0.75


A13
0.5
1
1
1
0.75


A14
1
1
0.625
0.375
1


A15
0.75
0.625
1
1
1


A16
0.5
1
0.75
0.5
0.75


A17
0.75
0.375
0.75
0.5
0.5


A18
1
0.5
0.75
1
1


A19
0.5
1
0.75
0.5
0.375


A20
0.5
1.5
1
0.5
0.5
















TABLE A18







Distribution statistics of the FIC values of the combined drug


sensitive test of the Pithecellobium clypearia Benth 10%


ethanol extract and the five antibiotics















EA +

EA +


FIC Range
EA + IMP
EA + TE
POLB
EA + CAZ
LVX





FIC ≤ 0.5
45%
45%
15%
30%
20%


0.5 < FIC ≤ 1
50%
50%
85%
70%
80%


1 < FIC ≤ 2
 5%
 5%





FIC > 2





















TABLE A19







Sensibilization effect of the Pithecellobium


clypearia Benth 10% ethanol extract to


the IMP and MIC after combined use












EA
EA
IMP
IMP



single-
combined-
single-use
combined-


Strain
use MIC
use MIC
MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
600
300
1
0.5


A2 
600
300
32
8


A3 
600
300
32
8


A4 
600
300
8
8


A5 
600
150
32
8


A6 
600
300
32
4


A7 
600
150
32
8


A8 
600
300
32
16


A9 
600
75
32
8


A10
600
150
16
8


A11
600
150
32
8


A12
600
150
32
8


A13
600
150
32
8


A14
600
300
32
16


A15
600
300
32
8


A16
600
150
32
8


A17
600
300
16
4


A18
600
300
32
16


A19
600
150
32
8


A20
600
150
32
8
















TABLE A20







Sensibilization effect of the Pithecellobium


clypearia Benth 10% ethanol extract to


the TE and MIC after combined use












EA
EA
TE
TE



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
600
300
2
1


A2 
600
300
256
64


A3 
600
300
256
64


A4 
600
150
8
2


A5 
600
150
32
4


A6 
600
300
256
64


A7 
600
150
512
128


A8 
600
150
256
64


A9 
600
150
256
32


A10
600
300
128
32


A11
600
150
256
64


A12
600
150
512
128


A13
600
300
512
256


A14
600
300
256
128


A15
600
300
1024
128


A16
600
300
512
256


A17
600
150
512
64


A18
600
150
512
128


A19
600
300
512
256


A20
600
300
256
256
















TABLE A21







Sensibilization effect of the Pithecellobium


clypearia Benth 10% ethanol extract to the


POLB and MIC after combined use












EA
EA
POLB
POLB



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
600
300
8
4


A2 
600
300
2
1


A3 
600
300
2
1


A4 
600
300
2
1


A5 
600
300
4
1


A6 
600
150
8
1


A7 
600
75
4
1


A8 
600
300
8
0.0625


A9 
600
300
1
0.0625


A10
600
150
32
4


A11
600
300
16
8


A12
600
300
2
1


A13
600
300
2
1


A14
600
300
0.5
0.0625


A15
600
300
2
1


A16
600
300
4
1


A17
600
300
64
16


A18
600
300
4
1


A19
600
300
4
1


A20
600
300
2
1
















TABLE A22







Sensibilization effect of the Pithecellobium


clypearia Benth 10% ethanol extract to the


CAZ and MIC after combined use












EA
EA
CAZ
CAZ



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
600
300
128
64


A2 
600
300
512
256


A3 
600
300
512
256


A4 
600
150
256
64


A5 
600
300
64
32


A6 
600
300
1024
512


A7 
600
300
1024
512


A8 
600
150
512
256


A9 
600
300
512
128


A10
600
300
512
256


A11
600
300
512
128


A12
600
300
512
128


A13
600
300
256
128


A14
600
150
512
64


A15
600
300
256
128


A16
600
150
512
128


A17
600
150
256
64


A18
600
300
512
256


A19
600
150
256
64


A20
600
150
512
128
















TABLE A23







Sensibilization effect of the Pithecellobium


clypearia Benth 10% ethanol extract to


the LVX and MIC after combined use












EA
EA
LVX
LVX



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
600
300
0.5
0.0625


A2 
600
300
16
8


A3 
600
300
16
2


A4 
600
300
0.5
0.0625


A5 
600
300
4
2


A6 
600
300
8
4


A7 
600
300
8
4


A8 
600
300
4
2


A9 
600
150
4
0.0625


A10
600
300
32
8


A11
600
300
4
2


A12
600
300
32
8


A13
600
300
32
8


A14
600
300
16
8


A15
600
300
32
16


A16
600
150
8
4


A17
600
150
16
4


A18
600
300
8
4


A19
600
150
16
2


A20
600
150
16
4
















TABLE A24







MIC50 and MIC90 of the five antibiotics


after combined use









Antibiotic (μg/ml)









Combined
MIC50 after
MIC90 after


drug
combined use
combined use












EA + IMP
8
16


EA + TE
64
256


EA + POLB
1
4


EA + CAZ
128
256


EA + LVX
4
8









With the single use of the Pithecellobium clypearia Benth 10% ethanol extract to the MDRABs, the MIC50 is 600 μg/ml, the MIC90 is 600 μg/ml, the MBC50 is 1200 μg/ml, and the MBC90 is 1200 μg/ml.


It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the IMP that the two drugs have the synergistic effect or partial synergistic effect, wherein 45% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC50 of the IMP is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 16 μg/ml and is reduced by 50%.


It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the TE to the 20 MDRABs that the two drugs have the synergistic effect or partial synergistic effect, wherein 45% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC50 of the TE is reduced from single-use 256 μg/ml to 64 μg/ml and is reduced by 75%; and the MIC90 is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.


For the 20 MDRABs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the POLB that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the POLB is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC90 is reduced from 16 μg/ml to 4 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the CAZ to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 30% with FIC≤0.5 have the synergistic effect. When an ethyl acetate extract of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC50 of the CAZ is reduced from single-use 512 μg/ml to 128 μg/ml and is reduced by 75%; and the MIC90 is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the LVX to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 25% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the LVX is reduced from single-use 8 μg/ml to 4 μg/ml and is reduced by 50%; and the MIC90 is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.


2.3. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics (the IMP, the TE, the POLB, the CAZ and the LVX) to the MDRABs are shown in table A25.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 60% ethanol extract to the MDRABs are shown in table A26.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics to the MDRABs is shown in table A27.


The statistic analysis on MBC50 and MBC90 of the EA to the MDRABs is shown in table A28.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table A29 and table A30.


The sensibilization effects of the Pithecellobium clypearia Benth 60% ethanol extract to the five antibiotics and the MIC50 and MIC90 after combined use are shown in tables A31-A36.









TABLE A25







In-vitro inhibitory test results of the Pithecellobium clypearia Benth


60% ethanol extract and the five antibiotics to the MDRABs









MIC (μg/ml)













Strain No.
EA
IMP
TE
LVX
CAZ
POLB
















 A1
300
1
2
0.5
128
8


 A2
300
32
256
16
512
2


 A3
600
32
256
4
512
2


 A4
600
8
8
0.5
256
2


 A5
300
32
32
4
64
4


 A6
300
32
256
8
>512
8


 A7
300
32
512
8
>512
4


 A8
300
32
256
4
512
8


 A9
600
32
256
4
512
1


A10
300
16
128
32
512
32


A11
600
32
256
4
512
16


A12
300
32
512
32
512
2


A13
300
32
512
32
256
2


A14
600
32
256
16
512
0.5


A15
600
32
>512
32
256
2


A16
300
32
512
8
512
4


A17
300
16
512
16
256
64


A18
300
32
512
8
512
4


A19
300
32
512
16
256
4


A20
300
32
256
16
512
2


ATCC27853
300
1
8
1
4
1
















TABLE A26







In-vitro bactericidal test results of the


Pithecellobium clypearia Benth


60% ethanol extract to the MDRABs










Strain No.
MBC (μg/ml)














A1 
600



A2 
600



A3 
1200



A4 
1200



A5 
600



A6 
600



A7 
600



A8 
1200



A9 
600



A10
600



A11
600



A12
600



A13
600



A14
1200



A15
1200



A16
1200



A17
600



A18
600



A19
600



A20
600

















TABLE A27







Statistics on in-vitro inhibitory MIC50 and


MIC90 of the Pithecellobium clypearia Benth 60%


ethanol extract and the antibiotics to the MDRABs











MIC (μg/ml)












Drug
Range
MIC50
MIC90
















EA
300-600
300
600



IMP
 1-32
32
32



TE
 2-512
256
512



POLB
0.5-64 
4
16



CAZ
 64-512
512
512



LVX
0.5-32 
8
32

















TABLE A28







Bactericidal MBC50 and MIC90 of the Pithecellobium


clypearia Benth 60% ethanol extract to the MDRABs











MBC (μg/ml)












Drug
Range
MBC50
MBC90







EA
600-1200
600
1200

















TABLE A29







FIC values of the combined drug sensitive test


of the Pithecellobium clypearia Benth 60%


ethanol extract and the five antibiotics









FIC












Strain
EA +
EA +
EA +
EA +
EA +


No.
IMP
TE
POLB
CAZ
LVX















A1 
0.75
0.75
1.5
0.75
0.375


A2 
0.5
0.5
1.25
0.75
1.25


A3 
0.375
0.375
1
0.5
1.0040


A4 
0.1875
0.625
0.75
0.5
0.625


A5 
0.5
0.75
1
0.75
1.25


A6 
0.625
0.75
0.5
1
1


A7 
0.625
0.75
0.75
0.75
1


A8 
0.625
0.625
1.0080
0.75
1.25


A9 
0.375
0.375
0.5625
0.625
0.5156


A10
0.75
0.75
0.5
0.75
1.0020


A11
0.375
0.375
0.5
0.625
1.125


A12
0.3125
0.5
1.25
0.75
1.03125


A13
0.5
0.5
1.5
1
1.0020


A14
0.25
0.375
0.625
0.625
0.625


A15
0.375
0.3125
0.53125
0.75
0.5020


A16
0.5
0.5
1.0156
0.75
0.75


A17
0.625
1
1.03125
0.75
0.75


A18
0.5
0.625
1.125
0.75
0.75


A19
0.375
0.5
1.125
1
1


A20
0.5
0.625
1.25
1
1
















TABLE A30







Distribution statistics of the FIC values of the combined


drug sensitive test of the Pithecellobium clypearia Benth


60% ethanol extract and the five antibiotics













EA +

EA +
EA +
EA +


FIC Range
IMP
EA + TE
POLB
CAZ
LVX





FIC ≤ 0.5
70%
50%
15%
10%
 5%


0.5 < FIC ≤ 1
30%
50%
35%
85%
55%


1 < FIC ≤ 2


50%
 5%
40%


FIC > 2





















TABLE A31







Sensibilization effect of the Pithecellobium


clypearia Benth 60% ethanol extract


to the IMP and MIC after combined use












EA
EA
IMP
IMP



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
300
75
1
0.5


A2 
300
75
32
8


A3 
600
75
32
8


A4 
600
75
8
0.5


A5 
300
75
32
8


A6 
300
37.5
32
16


A7 
300
37.5
32
16


A8 
300
37.5
32
16


A9 
600
150
32
4


A10
300
75
16
8


A11
600
150
32
4


A12
300
18.75
32
8


A13
300
75
32
8


A14
600
75
32
4


A15
600
150
32
4


A16
300
75
32
8


A17
300
150
16
2


A18
300
75
32
8


A19
300
37.5
32
8


A20
300
75
32
8
















TABLE A32







Sensibilization effect of the Pithecellobium


clypearia Benth 60% ethanol extract


to the TE and MIC after combined use












EA
EA
TE
TE



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
300
75
2
1


A2 
300
75
256
64


A3 
600
150
256
32


A4 
600
300
8
1


A5 
300
150
32
8


A6 
300
75
256
128


A7 
300
150
512
128


A8 
300
150
256
32


A9 
600
150
256
32


A10
300
150
128
32


A11
600
150
256
32


A12
300
75
512
128


A13
300
75
512
128


A14
600
150
256
32


A15
600
150
1024
64


A16
300
75
512
128


A17
300
150
512
256


A18
300
150
512
64


A19
300
75
512
128


A20
300
150
256
32
















TABLE A33







Sensibilization effect of the Pithecellobium


clypearia Benth 60% ethanol extract to


the POLB and MIC after combined use












EA
EA
POLB
POLB



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
300
300
8
4


A2 
300
300
2
0.5


A3 
600
300
2
1


A4 
600
150
2
1


A5 
300
150
4
2


A6 
300
75
8
2


A7 
300
75
4
2


A8 
300
300
8
0.0625


A9 
600
300
1
0.0625


A10
300
75
32
8


A11
600
150
16
4


A12
300
300
2
0.5


A13
300
300
2
1


A14
600
300
0.5
0.0625


A15
600
300
2
0.0625


A16
300
300
4
0.0625


A17
300
300
64
2


A18
300
300
4
0.5


A19
300
300
4
0.5


A20
300
300
2
0.5
















TABLE A34







Sensibilization effect of the Pithecellobium


clypearia Benth 60% ethanol extract to


the CAZ and MIC after combined use












EA
EA
CAZ
CAZ



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














A1 
300
75
128
64


A2 
300
150
512
128


A3 
600
150
512
128


A4 
600
150
256
64


A5 
300
75
64
32


A6 
300
150
1024
512


A7 
300
150
1024
256


A8 
300
75
512
256


A9 
600
300
512
64


A10
300
150
512
128


A11
600
300
512
64


A12
300
150
512
128


A13
300
150
256
128


A14
600
75
512
256


A15
600
150
256
128


A16
300
150
512
128


A17
300
75
256
128


A18
300
150
512
128


A19
300
150
256
128


A20
300
150
512
256
















TABLE A35







Sensibilization effect of the Pithecellobium clypearia Benth 60%


ethanol extract to the LVX and MIC after combined use












EA
EA
LVX
LVX


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














A1
300
75
0.5
0.0625


A2
300
75
16
16


A3
300
300
16
0.0625


A4
600
300
0.5
0.0625


A5
300
75
4
4


A6
300
150
8
4


A7
300
150
8
4


A8
300
75
4
4


A9
600
300
4
0.0625


A10
300
300
32
0.0625


A11
600
75
4
4


A12
300
300
32
1


A13
300
300
32
0.0625


A14
600
75
16
8


A15
600
300
32
0.0625


A16
300
75
8
4


A17
300
150
16
4


A18
300
75
8
4


A19
300
150
16
8


A20
300
150
16
8
















TABLE A36







MIC50 and MIC90 of the five antibiotics after combined use









Antibiotic (μg/ml)









Combined drug
MIC50 after combined use
MIC90 after combined use












EA + IMP
8
16


EA + TE
32
128


EA + POLB
0.5
4


EA + CAZ
128
256


EA + LVX
4
8









With the single use of the Pithecellobium clypearia Benth 60% ethanol extract to the MDRABs, the MIC50 is 300 μg/ml, the MIC90 is 600 μg/ml, the MBC50 is 600 μg/ml, and the MBC90 is 1200 μg/ml.


It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the IMP that the two drugs have the synergistic effect or partial synergistic effect, wherein 70% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC50 of the IMP is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 16 μg/ml and is reduced by 50%.


It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the TE to the 20 MDRABs that the two drugs have the synergistic effect or partial synergistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC50 of the TE is reduced from single-use 256 μg/ml to 32 μg/ml and is reduced by 87.5%; and the MIC90 is reduced from 512 μg/ml to 128 μg/ml and is reduced by 75%.


For the 20 MDRABs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the POLB that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the POLB is reduced from single-use 4 μg/ml to 0.5 μg/ml and is reduced by 87.5%; and the MIC90 is reduced from 16 μg/ml to 4 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the CAZ to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 10% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC50 of the CAZ is reduced from single-use 512 μg/ml to 128 μg/ml and is reduced by 75%; and the MIC90 is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the LVX to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 5% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the LVX is reduced from single-use 8 μg/ml to 4 μg/ml and is reduced by 50%; and the MIC90 is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.


2.4. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics (the IMP, the TE, the POLB, the CAZ and the LVX) to the MDRABs are shown in table A37.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRABs are shown in table A38.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics to the MDRABs is shown in table A39.


The statistic analysis on MBC50 and MBC90 of the EA to the MDRABs is shown in table A40.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table A41 and table A42.


The sensibilization effects of the Pithecellobium clypearia Benth 95% ethanol extract to the five antibiotics and the MIC50 and MIC90 after combined use are shown in tables A43-A48.









TABLE A37







In-vitro inhibitory test results of the Pithecellobium clypearia Benth


95% ethanol extract and the five antibiotics to the MDRABs









MIC (μg/ml)













Strain No.
EA
IMP
TE
LVX
CAZ
POLB
















 A1
600
1
2
0.5
128
8


 A2
600
32
256
16
512
2


 A3
600
32
256
4
512
2


 A4
600
8
8
0.5
256
2


 A5
600
32
32
4
64
4


 A6
600
32
256
8
>512
8


 A7
600
32
512
8
>512
4


 A8
600
32
256
4
512
8


 A9
600
32
256
4
512
1


A10
600
16
128
32
512
32


A11
600
32
256
4
512
16


A12
600
32
512
32
512
2


A13
600
32
512
32
256
2


A14
600
32
256
16
512
0.5


A15
1200
32
>512
32
256
2


A16
600
32
512
8
512
4


A17
600
16
512
16
256
64


A18
600
32
512
8
512
4


A19
600
32
512
16
256
4


A20
600
32
256
16
512
2


ATCC27853
300
1
8
1
4
1
















TABLE A38







In-vitro bactericidal test results of the Pithecellobium clypearia Benth


95% ethanol extract to the MDRABs










Strain No.
MBC (μg/ml)







A1
1200



A2
1200



A3
1200



A4
1200



A5
1200



A6
1200



A7
1200



A8
1200



A9
1200



A10
1200



A11
1200



A12
1200



A13
1200



A14
1200



A15
1200



A16
1200



A17
1200



A18
1200



A19
1200



A20
1200

















TABLE A39







Statistical results on in-vitro inhibitory MIC50 and MIC90 of the


Pithecellobium clypearia Benth 95% ethanol extract and the


antibiotics to the MDRABs









MIC (μg/ml)










Drug
Range
MIC50
MIC90













EA
 600-1200
600
600


IMP
 1-32
32
32


TE
 2-512
256
512


POLB
0.5-64 
4
16


CAZ
 64-512
512
512


LVX
0.5-32 
8
32
















TABLE A40







Bactericidal MBC50 and MBC90 of the Pithecellobium clypearia Benth


95% ethanol extract to the MDRABs









MBC (μg/ml)










Drug
Range
MBC50
MBC90





EA
1200
1200
1200
















TABLE A41







FIC values of the combined drug sensitive test of the Pithecellobium


clypearia Benth 95% ethanol extract and the five antibiotics








Strain
FIC












No.
EA + IMP
EA + TE
EA + POLB
EA + CAZ
EA + LVX





A1
0.75
0.75
1
1
1


A2
0.5
0.5
0.75
0.75
1


A3
0.5
0.375
1
0.75
0.625


A4
0.3125
0.625
1
0.75
0.375


A5
0.75
0.5
1
1
1


A6
0.75
1
0.5
1
1


A7
0.75
0.75
0.75
0.5
1


A8
0.75
0.625
0.625
1
1


A9
0.375
0.625
0.75
1
0.515625


A10
0.75
0.75
0.5
1
0.3125


A11
0.375
0.625
0.5
0.625
1.5


A12
0.5
0.75
1
0.75
0.53125


A13
0.75
0.5
1
0.75
0.5625


A14
0.75
0.375
1
1
1


A15
0.75
0.3125
0.28125
0.75
0.3125


A16
0.5
0.75
0.515625
1
0.75


A17
0.375
0.75
0.5625
1
0.5


A18
0.5
0.75
0.75
0.5
1


A19
0.5
0.75
0.75
0.75
1


A20
0.5
0.625
0.75
1
0.75
















TABLE A42







Distribution statistics of the FIC values of the combined drug sensitive


test of the Pithecellobium clypearia


Benth 95% ethanol extract and the five antibiotics












FIC Range
EA + IMP
EA + TE
EA + POLB
EA + CAZ
EA + LVX





FIC ≤ 0.5
55%
30%
20%
10%
20%


0.5 <
45%
70%
80%
90%
75%


FIC ≤ 1







1 <




 5%


FIC ≤ 2







FIC > 2





















TABLE A43







Sensibilization effect of the Pithecellobium clypearia Benth 95%


ethanol extract to the IMP and MIC after combined use












EA
EA
IMP
IMP


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














A1
600
150
1
0.5


A2
600
150
32
8


A3
600
150
32
8


A4
600
150
8
0.5


A5
600
300
32
8


A6
600
150
32
16


A7
600
150
32
16


A8
600
150
32
16


A9
600
150
32
4


A10
600
150
16
8


A11
600
150
32
4


A12
600
150
32
8


A13
600
300
32
8


A14
600
300
32
8


A15
1200
600
32
8


A16
600
150
32
8


A17
600
150
16
2


A18
600
150
32
8


A19
600
150
32
8


A20
600
150
32
8
















TABLE A44







Sensibilization effect of the Pithecellobium clypearia Benth 95%


ethanol extract to the TE and MIC after combined use












EA
EA
TE
TE


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














A1
600
150
2
1


A2
600
150
256
64


A3
600
150
256
32


A4
600
300
8
1


A5
600
150
32
8


A6
600
300
256
128


A7
600
300
512
128


A8
600
300
256
32


A9
600
300
256
32


A10
600
300
128
32


A11
600
300
256
32


A12
600
300
512
128


A13
600
150
512
128


A14
600
150
256
32


A15
1200
300
1024
64


A16
600
300
512
128


A17
600
300
512
128


A18
600
300
512
128


A19
600
300
512
128


A20
600
300
256
32
















TABLE A45







Sensibilization effect of the Pithecellobium clypearia Benth 95%


ethanol extract to the POLB and MIC after combined use












EA
EA
POLB
POLB


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














A1
600
300
8
4


A2
600
300
2
0.5


A3
600
300
2
1


A4
600
300
2
1


A5
600
300
4
2


A6
600
150
8
2


A7
600
150
4
2


A8
600
300
8
1


A9
600
300
1
0.25


A10
600
150
32
8


A11
600
150
16
4


A12
600
300
2
1


A13
600
300
2
1


A14
600
300
0.5
0.25


A15
1200
300
2
0.0625


A16
600
300
4
0.0625


A17
600
300
64
4


A18
600
300
4
1


A19
600
300
4
1


A20
600
300
2
0.5
















TABLE A46







Sensibilization effect of the Pithecellobium clypearia Benth 95%


ethanol extract to the CAZ and MIC after combined use












EA
EA
CAZ
CAZ


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














A1
600
300
128
64


A2
600
300
512
128


A3
600
300
512
128


A4
600
300
256
64


A5
600
300
64
32


A6
600
300
1024
512


A7
600
150
1024
256


A8
600
300
512
256


A9
600
300
512
256


A10
600
300
512
256


A11
600
300
512
64


A12
600
300
512
128


A13
600
150
256
128


A14
600
300
512
256


A15
1200
300
256
128


A16
600
300
512
256


A17
600
300
256
128


A18
600
150
512
128


A19
600
150
256
128


A20
600
300
512
256
















TABLE A47







Sensibilization effect of the Pithecellobium clypearia Benth 95%


ethanol extract to the LVX and MIC after combined use













EA
LVX
LVX


Strain
EA single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














A1
600
300
0.5
0.25


A2
600
300
16
8


A3
600
300
16
2


A4
600
150
0.5
0.0625


A5
600
300
4
2


A6
600
300
8
4


A7
600
300
8
4


A8
600
300
4
2


A9
600
300
4
0.0625


A10
600
150
32
2


A11
600
300
4
4


A12
600
300
32
1


A13
600
300
32
2


A14
600
300
16
8


A15
1200
300
32
2


A16
600
150
8
4


A17
600
150
16
4


A18
600
300
8
4


A19
600
300
16
8


A20
600
150
16
8
















TABLE A48







MIC50 and MIC90 of the five antibiotics after combined use









Antibiotic (μg/ml)









Combined drug
MIC50 after combined use
MIC90 after combined use












EA + IMP
8
16


EA + TE
32
128


EA + POLB
1
4


EA + CAZ
128
256


EA + LVX
4
8









With the single use of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRABs, the MIC50 is 600 μg/ml, the MIC90 is 600 μg/ml, the MBC50 is 1200 μg/ml, and the MBC90 is 1200 μg/ml.


It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the IMP that the two drugs have the synergistic effect or partial synergistic effect, wherein 55% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the IMP is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 16 μg/ml and is reduced by 50%.


It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the TE to the 20 MDRABs that the two drugs have the synergistic effect or partial synergistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the TE is reduced from single-use 256 μg/ml to 32 μg/ml and is reduced by 87.5%; and the MIC90 is reduced from 512 μg/ml to 128 μg/ml and is reduced by 75%.


For the 20 MDRABs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the POLB that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the POLB is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC90 is reduced from 16 μg/ml to 4 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the CAZ to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 10% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the CAZ is reduced from single-use 512 μg/ml to 128 μg/ml and is reduced by 75%; and the MIC90 is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the LVX to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the LVX is reduced from single-use 8 μg/ml to 4 μg/ml and is reduced by 50%; and the MIC90 is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.


II. Inhibitory and Bactericidal Tests of the MDRPA Resistance of the EA and Test of the Sensibilization Effect by Respectively Using with the LVX, the IMP, the AMK, the CAZ and the CFP


Embodiment 2

1. Test method: the MDRPA (serial No.: P1-P20) strains are tested and are evaluated with reference to the method in the first embodiment.


2. Test results:


2.1. In-vitro inhibitory test results of the Pithecellobium clypearia Benth water extract and the five antibiotics (the LVX, the IMP, the AMK, the CAZ and the CFP) to the MDRPAs are shown in table P1.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth water extract to the MDRPAs are shown in table P2.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the EA and the five antibiotics to the MDRPAs is shown in table P3.


The statistic analysis on MBC50 and MBC90 of the EA to the MDRPAs is shown in table P4.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth water extract and the five antibiotics and distribution statistical results of the FIC values are shown in table P5 and table P6.


The sensibilization effects of the Pithecellobium clypearia Benth water extract to the five antibiotics and the MIC50 and MIC90 after combined use are shown in tables P7-P12.









TABLE P1







In-vitro inhibitory test results of the Pithecellobium clypearia Benth


water extract and the five antibiotics to the MDRPAs









MIC(μg/ml)













Strain No.
EA
LVX
IMP
AMK
CAZ
CFP
















 P1
800
32
32
1
32
128


 P2
800
4
64
1
64
256


 P3
800
8
64
4
4
16


 P4
800
8
32
1
256
8


 P5
800
1
64
2
64
512


 P6
1600
0.5
32
256
512
512


 P7
800
32
32
1
64
512


 P8
1600
1
64
1
256
16


 P9
800
4
32
1
8
64


P10
800
128
64
4
4
8


P11
800
2
8
1
2
8


P12
800
1
32
32
64
512


P13
800
2
8
2
16
256


P14
800
32
32
2
16
8


P15
800
2
32
2
256
64


P16
1600
32
16
256
32
>512


P17
800
4
16
1
32
16


P18
800
4
32
16
64
256


P19
800
16
64
1
4
64


P20
800
4
4
2
256
>512


ATCC27853
400
1
4
2
4
8
















TABLE P2







In-vitro bactericidal test results of the Pithecellobium


clypearia Benth water extract to the MDRPAs










Strain No.
MBC (μg/ml)







P1
1600



P2
1600



P3
1600



P4
1600



P5
1600



P6
1600



P7
1600



P8
1600



P9
1600



P10
1600



P11
1600



P12
1600



P13
1600



P14
3200



P15
1600



P16
1600



P17
1600



P18
1600



P19
3200



P20
1600

















TABLE P3







Statistical results on in-vitro inhibitory MIC50 and MIC90 of the


Pithecellobium clypearia Benth water


extract and the five antibiotics to the MDRPAs









MIC (μg/ml)










Drug
Range
MIC50
MIC90













EA
 800-1600
800
1600


CAZ
 2-512
32
256


CFP
 8-512
64
512


AMK
 1-256
1
32


IMP
 4-64
32
64


LVX
 0.5-128 
4
32
















TABLE P4







Bactericidal MBC50 and MBC90 of the Pithecellobiumclypearia


Benth water extract to the MDRPAs









MBC (μg/ml)










Drug
Range
MBC50
MBC90





EA
1600-3200
1600
1600
















TABLE P5







FIC values of the combined drug sensitive test of the Pithecellobium



clypearia Benth water extract and the five antibiotics










FIC












Strain No.
EA + CAZ
EA + CFP
EA + AMK
EA + IMP
EA + LVX















P1
0.5
0.375
0.5625
1
0.625


P2
0.5
1
0.1875
0.28125
0.507813


P3
0.75
0.375
0.375
0.28125
0.503906


P4
0.5
1
1.5
1.0625
0.75


P5
1
0.75
1.03125
0.5
0.53125


P6
0.625
0.75
0.75
0.5625
0.3125


P7
0.75
0.53125
0.5625
1.0625
1.000977


P8
0.375
0.15625
0.75
0.28125
0.28125


P9
1
1
0.5625
1
1


P10
1
0.5625
0.375
0.5
0.375


P11
1
0.75
1
0.75
1


P12
0.53125
0.250977
0.3125
0.5625
1


P13
0.5
0.375
0.28125
0.5
1


P14
1
0.5625
0.53125
0.625
1.03125


P15
1
0.5
0.53125
0.5
1.5


P16
0.5
0.375
0.250244
0.375
0.5625


P17
0.5
0.53125
0.5625
0.75
2


P18
0.5
0.75
0.5
0.625
2.03125


P19
1
0.507813
0.5625
0.5625
0.75


P20
0.5
0.500488
0.625
1
0.75
















TABLE P6







Distribution statistical results of the FIC values of the combined drug


sensitive test of the Pithecellobiumclypearia Benth water extract and


the five antibiotics

















EA +


FIC Range
EA + CAZ
EA + CFP
EA + AMK
EA + IMP
LVX





FIC ≤ 0.5
45%
35%
35%
40%
15%


0.5 < FIC ≤ 1
55%
65%
55%
50%
60%


1 < FIC ≤ 2


10%
10%
25%


FIC > 2





















TABLE P7







Sensibilization effect of the Pithecellobiumclypearia Benth water


extract to the CAZ and MIC after combined use















CAZ


Strain
EA single-use
EA combined-use
CAZ single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1
800
200
32
8


P2
800
200
64
16


P3
800
200
4
2


P4
800
200
256
64


P5
800
400
64
32


P6
1600
200
512
256


P7
800
200
64
32


P8
1600
200
256
64


P9
800
400
8
4


P10
800
400
4
2


P11
800
400
2
1


P12
800
400
64
2


P13
800
200
16
4


P14
800
400
16
8


P15
800
400
256
128


P16
1600
400
32
8


P17
800
200
32
8


P18
800
200
64
16


P19
800
400
4
2


P20
800
200
256
64
















TABLE P8







Sensibilization effect of the Pithecellobiumclypearia Benth water


extract to the CFP and MIC after combined use















CFP


Strain
EA single-use
EA combined-use
CFP single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1
800
100
128
32


P2
800
400
256
128


P3
800
200
16
2


P4
800
400
8
4


P5
800
200
512
256


P6
1600
400
512
256


P7
800
400
512
16


P8
1600
200
16
0.5


P9
800
400
64
32


P10
800
400
8
0.5


P11
800
200
8
4


P12
800
200
512
0.5


P13
800
200
256
32


P14
800
400
8
0.5


P15
800
200
64
16


P16
1600
200
1024
256


P17
800
400
16
0.5


P18
800
200
256
128


P19
800
400
64
0.5


P20
800
400
1024
0.5
















TABLE P9







Sensibilization effect of the Pithecellobiumclypearia Benth water


extract to the AMK and MIC after combined use















AMK


Strain
EA single-use
EA combined-use
AMK single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1
800
400
1
0.0625


P2
800
100
1
0.0625


P3
800
100
4
1


P4
800
800
1
0.5


P5
800
800
2
0.0625


P6
1600
800
256
64


P7
800
400
1
0.0625


P8
1600
400
1
0.5


P9
800
400
1
0.0625


P10
800
100
4
1


P11
800
400
1
0.5


P12
800
50
32
8


P13
800
200
2
0.0625


P14
800
400
2
0.0625


P15
800
400
2
0.0625


P16
1600
400
256
0.0625


P17
800
400
1
0.0625


P18
800
200
16
4


P19
800
400
1
0.0625


P20
800
100
2
1
















TABLE P10







Sensibilization effect of the Pithecellobiumclypearia Benth water


extract to the IMP and MIC after combined use















IMP


Strain
EA single-use
EA combined-use
IMP single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1
800
400
32
16


P2
800
200
64
2


P3
800
200
64
2


P4
800
800
32
2


P5
800
200
64
16


P6
1600
800
32
2


P7
800
800
32
2


P8
1600
400
64
2


P9
800
400
32
16


P10
800
200
64
16


P11
800
200
8
4


P12
800
400
32
2


P13
800
200
8
2


P14
800
400
32
4


P15
800
200
32
8


P16
1600
400
16
2


P17
800
400
16
4


P18
800
400
32
4


P19
800
400
64
4


P20
800
400
4
2
















TABLE P11







Sensibilization effect of the Pithecellobiumclypearia Benth water


extract to the LVX and MIC after combined use















LVX


Strain
EA single-use
EA combined-use
LVX single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1
800
400
32
4


P2
800
400
4
0.03125


P3
800
400
8
0.03125


P4
800
200
8
4


P5
800
400
1
0.03125


P6
1600
400
0.5
0.03125


P7
800
800
32
0.03125


P8
1600
400
1
0.03125


P9
800
400
4
2


P10
800
100
128
32


P11
800
400
2
1


P12
800
400
1
0.5


P13
800
400
2
1


P14
800
800
32
1


P15
800
800
2
1


P16
1600
800
32
2


P17
800
800
4
4


P18
800
25
4
8


P19
800
400
16
4


P20
800
400
4
1
















TABLE P12







MIC50 and MIC90 of the five antibiotics after combined use









Antibiotic (μg/ml)









Combined drug
MIC50 after combined use
MIC90 after combined use












EA + CAZ
8
64


EA + CFP
0.5
256


EA + AMK
0.0625
2


EA + IMP
2
16


EA + LVX
1
8









With the single use of the EA to the MDRPA, the MIC50 is 800 μg/ml, the MIC90 is 1600 μg/ml, the MBC50 is 1600 μg/ml, and the MBC90 is 1600 μg/ml.


For the 20 MDRPAs, it is indicated by FIC≤2 with the combined use of the EA and the CAZ that the two drugs have no antagonistic effect, wherein 45% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC50 of the CAZ is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC90 is reduced from 256 μg/ml to 64 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the EA and the CFP to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC50 of the CFP is reduced from single-use 64 μg/ml to 0.5 μg/ml and is reduced by 99.2%; and the MIC90 is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.


It is indicated by FIC≤2 with the combined use of the EA and the AMK that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC50 of the AMK is reduced from single-use 1 μg/ml to 0.0625 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 32 μg/ml to 2 μg/ml and is reduced by 93.75%.


It is indicated by FIC≤2 with the combined use of the EA and the IMP that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC50 of the IMP is reduced from single-use 32 μg/ml to 2 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the EA and the LVX to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRPA, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC50 of the LVX is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.


2.2. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics (the LVX, the IMP, the AMK, the CAZ and the CFP) to the MDRPAs are shown in table P13.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 10% ethanol extract to the MDRPAs are shown in table P14.


According to statistic analysis, the in-vitro inhibitory and bactericidal MBC50 and MBC90 of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics to the MDRPAs are shown in table P15.


According to statistic analysis, the bactericidal MBC50 and MBC90 of the EA to the MDRPAs are shown in table P16.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table P17 and table P18.


The sensibilization effects of the Pithecellobium clypearia Benth 10% ethanol extract to the five antibiotics and the MIC50 and MIC90 after combined use are shown in tables P19-P24.









TABLE P13







In-vitro inhibitory test results of the Pithecellobium clypearia Benth


10% ethanol extract and the five antibiotics to the MDRPAs









MIC(μg/ml)













Strain No.
EA
LVX
IMP
AMK
CAZ
CFP
















 P1
800
32
32
1
32
128


 P2
800
4
64
1
64
256


 P3
800
8
64
4
4
16


 P4
800
8
32
1
256
8


 P5
800
1
64
2
64
512


 P6
800
0.5
32
256
512
512


 P7
800
32
32
1
64
512


 P8
1600
1
64
1
256
16


 P9
800
4
32
1
8
64


P10
800
128
64
4
4
8


P11
800
2
8
1
2
8


P12
800
1
32
32
64
512


P13
800
2
8
2
16
256


P14
800
32
32
2
16
8


P15
800
2
32
2
256
64


P16
1600
32
16
256
32
>512


P17
800
4
16
1
32
16


P18
800
4
32
16
64
256


P19
800
16
64
1
4
64


P20
800
4
4
2
256
>512


ATCC27853
400
1
4
2
4
8
















TABLE P14







In-vitro bactericidal test results of the Pithecellobiumclypearia Benth


10% ethanol extract to the MDRPAs








Strain No.
MBC (μg/ml)





P1
1600


P2
1600


P3
1600


P4
1600


P5
1600


P6
1600


P7
1600


P8
1600


P9
1600


P10
1600


P11
1600


P12
1600


P13
1600


P14
1600


P15
1600


P16
1600


P17
1600


P18
1600


P19
3200


P20
1600
















TABLE P15







Statistical results on in-vitro inhibitory MIC50 and MIC90 of the



Pithecellobium
clypearia Benth 10% ethanol extract and the



antibiotics to the MDRPAs









MIC (μg/ml)










Drug
Range
MIC50
MIC90













EA
 800-1600
800
800


CAZ
 2-512
32
256


CFP
 8-512
64
512


AMK
 1-256
1
32


IMP
 4-64
32
64


LVX
 0.5-128
4
32
















TABLE P16







Bactericidal MBC50 and MBC90 of the Pithecellobiumclypearia


Benth 10% ethanol extract to the MDRPAs









MBC (μg/ml)










Drug
Range
MBC50
MBC90





EA
1600-3200
1600
1600
















TABLE P17







FIC values of the combined drug sensitive test of the Pithecellobium



clypearia Benth 10% ethanol extract and the five antibiotics










FIC












Strain No.
EA + CAZ
EA + CFP
EA + AMK
EA + IMP
EA + LVX















P1
0.75
0.5
0.5625
0.75
0.625


P2
0.5
1
0.3125
0.28125
0.507813


P3
0.75
0.375
0.75
0.28125
0.503906


P4
0.5
1
1.5
1
1


P5
0.75
1
1.03125
0.5
0.53125


P6
0.75
0.625
0.75
0.5625
0.3125


P7
0.75
0.515625
0.5625
0.5625
1.000977


P8
0.375
0.15625
0.75
0.28125
0.28125


P9
1
1
0.5625
1
1


P10
0.75
0.75
0.5
0.5
0.75


P11
1
0.75
0.75
0.75
1


P12
0.53125
0.253906
0.5
0.5625
1


P13
0.5
0.375
0.28125
0.5
1


P14
1
0.53125
0.53125
0.625
0.5625


P15
1
0.375
0.53125
0.375
1


P16
0.5
0.375
0.257813
0.375
0.375


P17
0.5
0.53125
0.5625
0.625
1


P18
1
1
0.5
0.375
1.5


P19
1
0.507813
0.5625
0.375
0.75


P20
0.5
0.500977
50.5
1
0.75
















TABLE 18







Distribution statistical results of the FIC values of the combined drug


sensitive test of the Pithecellobiumclypearia Benth 10% ethanol


extract and the five antibiotics

















EA +


FIC Range
EA + CAZ
EA + CFP
EA + AMK
EA + IMP
LVX





FIC ≤ 0.5
35%
35%
30%
50%
15%


0.5 < FIC ≤ 1
65%
65%
55%
50%
75%


1 < FIC ≤ 2


15%

10%


FIC > 2





















TABLE P19







Sensibilization effect of the Pithecellobiumclypearia Benth 10%


ethanol extract to the CAZ and MIC after combined use















CAZ


Strain
EA single-use
EA combined-use
CAZ single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1
800
200
32
16


P2
800
200
64
16


P3
800
200
4
2


P4
800
200
256
64


P5
800
200
64
32


P6
800
200
512
256


P7
800
200
64
32


P8
1600
200
256
64


P9
800
400
8
4


P10
800
200
4
2


P11
800
400
2
1


P12
800
400
64
2


P13
800
200
16
4


P14
800
400
16
8


P15
800
400
256
128


P16
1600
400
32
8


P17
800
200
32
8


P18
800
400
64
32


P19
800
400
4
2


P20
800
200
256
64
















TABLE P20







Sensibilization effect of the Pithecellobium clypearia Benth 10%


ethanol extract to the CFP and MIC after combined use












EA
EA
CFP
CFP


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
800
200
128
32


P2 
800
400
256
128


P3 
800
200
16
2


P4 
800
400
8
4


P5 
800
400
512
256


P6 
1600
200
512
256


P7 
800
400
512
8


P8 
1600
200
16
0.5


P9 
800
400
64
32


P10
800
400
8
2


P11
800
200
8
4


P12
800
200
512
2


P13
800
200
256
32


P14
800
400
8
0.25


P15
800
200
64
8


P16
1600
200
1024
256


P17
800
400
16
0.5


P18
800
400
256
128


P19
800
400
64
0.5


P20
800
400
1024
1
















TABLE P21







Sensibilization effect of the Pithecellobium clypearia Benth 10%


ethanol extract to the AMK and MIC after combined use












EA
EA
AMK
AMK


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
800
400
1
0.0625


P2 
800
200
1
0.0625


P3 
800
200
4
2


P4 
800
800
1
0.5


P5 
800
800
2
0.0625


P6 
1600
800
256
64


P7 
800
400
1
0.0625


P8 
1600
400
1
0.5


P9 
800
400
1
0.0625


P10
800
200
4
1


P11
800
400
1
0.25


P12
800
200
32
8


P13
800
200
2
0.0625


P14
800
400
2
0.0625


P15
800
400
2
0.0625


P16
1600
400
256
2


P17
800
400
1
0.0625


P18
800
200
16
4


P19
800
400
1
0.0625


P20
800
40000
2
1
















TABLE P22







Sensibilization effect of the Pithecellobium clypearia Benth 10% ethanol


extract to the IMP and MIC after combined use












EA
EA
IMP
IMP


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
800
200
32
16


P2 
800
200
64
2


P3 
800
200
64
2


P4 
800
400
32
16


P5 
800
200
64
16


P6 
1600
800
32
2


P7 
800
400
32
2


P8 
1600
400
64
2


P9 
800
400
32
16


P10
800
200
64
16


P11
800
200
8
4


P12
800
400
32
2


P13
800
200
8
2


P14
800
400
32
4


P15
800
200
32
4


P16
1600
400
16
2


P17
800
400
16
2


P18
800
200
32
4


P19
800
200
64
8


P20
800
400
4
2
















TABLE P23







Sensibilization effect of the Pithecellobium clypearia Benth 10% ethanol


extract to the LVX and MIC after combined use












EA
EA
LVX
LVX


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
800
400
32
4


P2 
800
400
4
0.03125


P3 
800
400
8
0.03125


P4 
800
400
8
4


P5 
800
400
1
0.03125


P6 
1600
400
0.5
0.03125


P7 
800
800
32
0.03125


P8 
1600
400
1
0.03125


P9 
800
400
4
2


P10
800
400
128
32


P11
800
400
2
1


P12
800
400
1
0.5


P13
800
400
2
1


P14
800
400
32
2


P15
800
400
2
1


P16
1600
400
32
4


P17
800
400
4
2


P18
800
400
4
4


P19
800
400
16
4


P20
800
400
4
1
















TABLE P24







MIC50 and MIC90 of the five antibiotics after combined use









Antibiotic (μg/ml)









Combined drug
MIC50 after combined use
MIC90 after combined use












EA + CAZ
16
64


EA + CFP
4
256


EA + AMK
0.0625
4


EA + IMP
2
16


EA + LVX
1
4









With the single use of the Pithecellobium clypearia Benth 10% ethanol extract to the MDRPA, the MIC50 is 800 μg/ml, the MIC90 is 1600 μg/ml, the MBC50 is 1600 μg/ml, and the MBC90 is 1600 μg/ml.


For the 20 MDRPAs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the CAZ that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the CAZ is reduced from single-use 32 μg/ml to 16 μg/ml and is reduced by 50%; and the MIC90 is reduced from 256 μg/ml to 64 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the CFP to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the CFP is reduced from single-use 64 μg/ml to 4 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 30% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the AMK is reduced from single-use 1 μg/ml to 0.0625 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 32 μg/ml to 4 μg/ml and is reduced by 87.5%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the IMP that the two drugs have no antagonistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the IMP is reduced from single-use 32 μg/ml to 2 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the LVX to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRPA, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the LVX is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 4 μg/ml and is reduced by 87.5%.


2.3. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics (the LVX, the IMP, the AMK, the CAZ and the CFP) to the MDRPAs are shown in table P25.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 60% ethanol extract to the MDRPAs are shown in table P26.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics to the MDRPAs is shown in table P27.


The statistic analysis on bactericidal MBC50 and MBC90 of the EA to the MDRPAs is shown in table P28.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table P29 and table P30.


The sensibilization effects of the Pithecellobium clypearia Benth 60% ethanol extract to the five antibiotics and the MIC50 and MIC90 after combined use are shown in tables P31-P36.









TABLE P25







In-vitro inhibitory test results of the Pithecellobium clypearia Benth


60% ethanol extract and the five antibiotics to the MDRPAs









MIC(μg/ml)













Strain No.
EA
LVX
IMP
AMK
CAZ
CFP
















 P1
400
32
32
1
32
128


 P2
200
4
64
1
64
256


 P3
400
8
64
4
4
16


 P4
400
8
32
1
256
8


 P5
400
1
64
2
64
512


 P6
400
0.5
32
256
512
512


 P7
400
32
32
1
64
512


 P8
800
1
64
1
256
16


 P9
400
4
32
1
8
64


P10
400
128
64
4
4
8


P11
400
2
8
1
2
8


P12
400
1
32
32
64
512


P13
400
2
8
2
16
256


P14
800
32
32
2
16
8


P15
400
2
32
2
256
64


P16
800
32
16
256
32
>512


P17
400
4
16
1
32
16


P18
400
4
32
16
64
256


P19
800
16
64
1
4
64


P20
800
4
4
2
256
>512


ATCC27853
400
1
4
2
4
8
















TABLE P26







In-vitro bactericidal test results of the Pithecellobium clypearia Benth


60% ethanol extract to the MDRPAs










Strain No.
MBC (μg/ml)














P1 
400



P2 
400



P3 
800



P4 
800



P5 
800



P6 
800



P7 
800



P8 
800



P9 
1600



P10
1600



P11
1600



P12
1600



P13
1600



P14
1600



P15
1600



P16
1600



P17
1600



P18
1600



P19
1600



P20
1600

















TABLE P27







Statistical results on in-vitro inhibitory MIC50 and MIC90 of the


Pithecellobium clypearia Benth 60% ethanol extract and the five


antibiotics to the MDRPAs









MIC (μg/ml)










Drug
Range
MIC50
MIC90













EA
200-800
400
800


CAZ
 2-512
32
256


CFP
 8-512
64
512


AMK
 1-256
1
32


IMP
 4-64
32
64


LVX
 0.5-128
4
32
















TABLE P28







Bactericidal MBC50 and MBC90 of the Pithecellobium clypearia Benth


60% ethanol extract to the MDRPAs









MBC (μg/ml)










Drug
Range
MBC50
MBC90





EA
400-1600
1600
1600
















TABLE P29







FIC values of the combined drug sensitive test of the Pithecellobium


clypearia Benth 60% ethanol extract and the five antibiotics








Strain
FIC












No.
EA + CAZ
EA + CFP
EA + AMK
EA + IMP
EA + LVX















P1 
0.375
0.375
1.0625
0.625
0.25


P2 
0.625
0.75
0.5625
0.53125
0.5078


P3 
1.125
1.03125
0.5
0.15625
1.0039


P4 
0.375
1.0625
1.5
1.0625
1


P5 
1.0078
0.625
1.03125
0.75
1.03125


P6 
0.75
1
1.125
1.0625
1.0625


P7 
1
0.625
1.0625
1.0625
1.0010


P8 
0.3125
0.53125
0.5625
0.53125
0.53125


P9 
1.0625
0.625
0.5625
0.75
1


P10
1.125
1.0625
0.375
0.75
0.5


P11
1.25
1.0625
0.75
1.25
2.0625


P12
0.5078
0.5010
0.375
0.5625
1.5


P13
0.75
0.375
0.53125
0.5
1.015625


P14
0.375
0.5625
0.53125
0.5
1.03125


P15
0.75
0.375
1.03125
0.75
2.5


P16
0.375
0.3125
0.5002
0.625
0.53125


P17
0.5
1.03125
1.0625
1.125
3


P18
0.5
0.625
0.375
1.0625
2.0625


P19
0.625
0.5078
0.5625
0.53125
0.625


P20
0.3125
0.5005
0.5625
0.625
0.625
















TABLE P30







Distribution statistical results of the FIC values of the combined drug


sensitive test of the Pithecellobium clypearia Benth 60% ethanol


extract and the five antibiotics













EA +
EA +
EA +
EA +
EA +


FIC Range
CAZ
CFP
AMK
IMP
LVX





FIC ≤ 0.5
40%
20%
20%
15%
10%


0.5 < FIC ≤ 1
35%
55%
45%
55%
35%


1 < FIC ≤ 2
25%
25%
35%
30%
35%


FIC > 2




20%
















TABLE P31







Sensibilization effect of the Pithecellobium clypearia Benth 60%


ethanol extract to the CAZ and MIC after combined use












EA
EA
CAZ
CAZ


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
400
50
32
8


P2 
200
100
64
8


P3 
400
50
4
4


P4 
400
50
256
64


P5 
400
400
64
0.5


P6 
400
100
512
256


P7 
400
200
64
32


P8 
800
50
256
64


P9 
400
400
8
0.5


P10
400
400
4
0.5


P11
400
400
2
0.5


P12
400
200
64
0.5


P13
400
100
16
8


P14
800
100
16
4


P15
400
100
256
128


P16
800
100
32
8


P17
400
100
32
8


P18
400
100
64
16


P19
800
400
4
0.5


P20
800
50
256
64
















TABLE P32







Sensibilization effect of the Pithecellobium clypearia Benth 60%


ethanol extract to the CFP and MIC after combined use












EA
EA
CFP
CFP


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
400
50
128
32


P2 
200
50
256
128


P3 
400
400
16
0.5


P4 
400
400
8
0.5


P5 
400
50
512
256


P6 
400
200
512
256


P7 
400
50
512
256


P8 
800
400
16
0.5


P9 
400
50
64
32


P10
400
400
8
0.5


P11
400
400
8
0.5


P12
400
200
512
0.5


P13
400
100
256
32


P14
800
400
8
0.5


P15
400
50
64
16


P16
800
50
1024
256


P17
400
400
16
0.5


P18
400
50
256
128


P19
800
400
64
0.5


P20
800
400
1024
0.5
















TABLE P33







Sensibilization effect of the Pithecellobium clypearia Benth 60%


ethanol extract to the AMK and MIC after combined use












EA
EA
AMK
AMK


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
400
400
1
0.0625


P2 
200
100
1
0.0625


P3 
400
100
4
1


P4 
400
400
1
0.5


P5 
400
400
2
0.0625


P6 
400
400
256
32


P7 
400
400
1
0.0625


P8 
800
50
1
0.5


P9 
400
200
1
0.0625


P10
400
50
4
1


P11
400
100
1
0.5


P12
400
50
32
8


P13
400
200
2
0.0625


P14
800
400
2
0.0625


P15
400
400
2
0.0625


P16
800
400
256
0.0625


P17
400
400
1
0.0625


P18
400
100
16
2


P19
800
400
1
0.0625


P20
800
50
2
1
















TABLE P34







Sensibilization effect of the Pithecellobium clypearia Benth 60%


ethanol extract to the IMP and MIC after combined use












EA
EA
IMP
IMP


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
400
50
32
16


P2 
200
100
64
2


P3 
400
50
64
2


P4 
400
400
32
2


P5 
400
200
64
16


P6 
400
400
32
2


P7 
400
400
32
2


P8 
800
400
64
2


P9 
400
100
32
16


P10
400
200
64
16


P11
400
400
8
2


P12
400
200
32
2


P13
400
100
8
2


P14
800
200
32
8


P15
400
200
32
8


P16
800
400
16
2


P17
400
400
16
2


P18
400
400
32
2


P19
800
400
64
2


P20
800
100
4
2
















TABLE P35







Sensibilization effect of the Pithecellobium clypearia Benth 60%


ethanol extract to the LVX and MIC after combined use












EA
EA
LVX
LVX


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)














P1 
400
50
32
4


P2 
200
100
4
0.03125


P3 
400
400
8
0.03125


P4 
400
200
8
4


P5 
400
400
1
0.03125


P6 
400
400
0.5
0.03125


P7 
400
400
32
0.03125


P8 
800
400
1
0.03125


P9 
400
200
4
2


P10
400
100
128
32


P11
400
25
2
4


P12
400
400
1
0.5


P13
400
400
2
0.03125


P14
800
800
32
1


P15
400
800
2
1


P16
800
25
32
16


P17
400
800
4
4


P18
400
25
4
8


P19
800
100
16
8


P20
800
100
4
2
















TABLE P36







MIC50 and MIC90 of the five antibiotics after combined use











Antibiotic (μg/ml)












MIC50 after
MIC90 after



Combined drug
combined use
combined use















EA + CAZ
8
64



EA + CFP
4
256



EA + AMK
0.0625
4



EA + IMP
2
16



EA + LVX
1
8










With the single use of the Pithecellobium clypearia Benth 60% ethanol extract to the MDRPA, the MIC50 is 800 μg/ml, the MIC90 is 1600 μg/ml, the MBC50 is 1600 μg/ml, and the MBC90 is 1600 μg/ml.


For the 20 MDRPAs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the CAZ that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the CAZ is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC90 is reduced from 256 μg/ml to 64 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the CFP to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the CFP is reduced from single-use 64 μg/ml to 4 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the AMK is reduced from single-use 1 μg/ml to 0.0625 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 32 μg/ml to 2 μg/ml and is reduced by 93.75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the IMP that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the IMP is reduced from single-use 32 μg/ml to 2 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.


With the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the LVX to the 20 MDRPAs, there are four strains with FIC greater than 2 and has the antagonistic effect, wherein 10% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRPA, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the LVX is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.


2.4. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics (the LVX, the IMP, the AMK, the CAZ and the CFP) to the MDRPAs are shown in table P37.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRPAs are shown in table P38.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics to the MDRPAs is shown in table P39.


The statistic analysis on bactericidal MBC50 and MBC90 of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRPAs is shown in table P40.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table P41 and table P42.


The sensibilization effects of the Pithecellobium clypearia Benth 95% ethanol extract to the five antibiotics and the MIC50 and MIC90 after combined use are shown in tables P43-P48.









TABLE P37







In-vitro inhibitory test results of the Pithecellobium clypearia Benth


95% ethanol extract and the five antibiotics to the MDRPAs









MIC(μg/ml)













Strain No.
EA
LVX
IMP
AMK
CAZ
CFP
















 P1
800
32
32
1
32
128


 P2
800
4
64
1
64
256


 P3
800
8
64
4
4
16


 P4
800
8
32
1
256
8


 P5
800
1
64
2
64
512


 P6
800
0.5
32
256
512
512


 P7
800
32
32
1
64
512


 P8
800
1
64
1
256
16


 P9
800
4
32
1
8
64


P10
800
128
64
4
4
8


P11
800
2
8
1
2
8


P12
800
1
32
32
64
512


P13
800
2
8
2
16
256


P14
800
32
32
2
16
8


P15
800
2
32
2
256
64


P16
800
32
16
256
32
>512


P17
800
4
16
1
32
16


P18
800
4
32
16
64
256


P19
800
16
64
1
4
64


P20
800
4
4
2
256
>512


ATCC27853
400
1
4
2
4
8
















TABLE P38







In-vitro bactericidal test results of the Pithecellobium


clypearia Benth 95% ethanol extract to the MDRPAs










Strain No.
MBC (μg/ml)







P1
1600



P2
1600



P3
1600



P4
1600



P5
1600



P6
1600



P7
1600



P8
1600



P9
1600



 P10
1600



 P11
1600



 P12
1600



 P13
1600



 P14
1600



 P15
1600



 P16
3200



 P17
1600



 P18
1600



 P19
1600



 P20
1600

















TABLE P39







Statistical results on in-vitro inhibitory MIC50 and


MIC90 of the Pithecellobium clypearia Benth 95%


ethanol extract and the five antibiotics to the MDRPAs











MIC (μg/ml)












Drug
Range
MIC50
MIC90
















EA
800
800
800



CAZ
2-512
32
256



CFP
8-512
64
512



AMK
1-256
1
32



IMP
4-64 
32
64



LVX
0.5-128  
4
32

















TABLE P40







Bactericidal MBC50 and MBC90 of the Pithecellobium


clypearia Benth 95% ethanol extract to the MDRPAs











MBC (μg/ml)












Drug
Rance
MBC50
MBC90







EA
1600-3200
1600
1600

















TABLE P41







FIC values of the combined drug sensitive


test of the Pithecellobium clypearia Benth


95% ethanol extract and the five antibiotics









FIC












Strain
EA +
EA +
EA +
EA +
EA +


No.
CAZ
CFP
AMK
IMP
LVX















P1
1
0.5
0.5625
1
0.625


P2
0.75
1
0.3125
0.3125
0.507813


P3
0.75
0.5
1
0.3125
0.503906


P4
1
1
1.5
0.75
1


P5
1
1
1.03125
0.375
1.03125


P6
1
0.75
1.125
0.5625
1.0625


P7
0.75
0.515625
0.37
0.5625
1.000977


P8
0.5
0.28125
0.75
0.5
0.53125


P9
1
1
0.3125
1
1


 P10
1
0.375
0.5
0.5
0.75


 P11
1
1
1
0.75
1


 P12
0.53125
0.503906
0.5
0.5625
1


 P13
0.5
0.375
0.28125
0.75
1


 P14
1
0.53125
0.53125
0.625
0.3125


 P15
1
0.375
0.28125
0.375
1


 P16
0.375
0.5
0.507813
0.625
0.625


 P17
0.375
0.53125
0.5625
0.625
1


 P18
1
0.75
0.5
0.375
1.5


 P19
0.75
0.28125
0.5625
0.375
0.5


 P20
0.5
0.500977
1
1
0.75
















TABLE P42







Distribution statistical results of the FIC values of the


combined drug sensitive test of the Pithecellobium


clypearia Benth 95% ethanol extract and the five antibiotics












FIC
EA +
EA +
EA +
EA +
EA +


Strain No.
CAZ
CFP
AMK
IMP
LVX





FIC ≤ 0.5
25%
40%
40%
40%
10%


0.5 < FIC ≤ 1
75%
60%
45%
60%
70%


1 < FIC ≤ 2


15%

20%


FIC > 2





















TABLE P43







Sensibilization effect of the Pithecellobium clypearia Benth 95%


ethanol extract to the CAZ and MIC after combined use












EA
EA
CAZ
CAZ



single-use
combined-
single-use
combined-


Strain
MIC
use MIC
MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














P1
800
400
32
16


P2
800
400
64
16


P3
800
400
4
1


P4
800
400
256
128


P5
800
400
64
32


P6
800
400
512
256


P7
800
200
64
32


P8
800
200
256
64


P9
800
400
8
4


 P10
800
400
4
2


 P11
800
400
2
1


 P12
800
400
64
2


 P13
800
200
16
4


 P14
800
400
16
8


 P15
800
400
256
128


 P16
800
200
32
4


 P17
800
200
32
4


 P18
800
400
64
32


 P19
800
400
4
1


 P20
800
200
256
64
















TABLE P44







Sensibilization effect of the Pithecellobium clypearia Benth


95% ethanol extract to the CFP and MIC after combined use












EA
EA
CFP
CFP



single-use
combined-
single-use
combined-use


Strain
MIC
use MIC
MIC
MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














P1
800
200
128
32


P2
800
400
256
128


P3
800
200
16
4


P4
800
400
8
4


P5
800
400
512
256


P6
800
400
512
128


P7
800
400
512
8


P8
800
200
16
0.5


P9
800
400
64
32


 P10
800
200
8
1


 P11
800
400
8
4


 P12
800
400
512
2


 P13
800
200
256
32


 P14
800
400
8
0.25


 P15
800
200
64
8


 P16
800
200
1024
256


 P17
800
400
16
0.5


 P18
800
200
256
128


 P19
800
200
64
2


 P20
800
400
1024
1
















TABLE P45







Sensibilization effect of the Pithecellobium clypearia Benth


95% ethanol extract to the AMK and MIC after combined use












EA
EA
AMK
AMK



single-use
combined-use
single-use
combined-use


Strain
MIC
MIC
MIC
MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














P1
800
400
1
0.0625


P2
800
200
1
0.0625


P3
800
400
4
2


P4
800
800
1
0.5


P5
800
800
2
0.0625


P6
800
800
256
32


P7
800
200
1
0.12


P8
800
200
1
0.5


P9
800
200
1
0.0625


 P10
800
200
4
1


 P11
800
400
1
0.5


 P12
800
200
32
8


 P13
800
200
2
0.0625


 P14
800
400
2
0.0625


 P15
800
200
2
0.0625


 P16
800
400
256
2


 P17
800
400
1
0.0625


 P18
800
200
16
4


 P19
800
400
1
0.0625


 P20
800
400
2
1
















TABLE P46







Sensibilization effect of the Pithecellobium clypearia Benth


95% ethanol extract to the IMP and MIC after combined use












EA
EA
IMP
IMP



single-use
combined-use
single-use
combined-use


Strain
MIC
MIC
MIC
MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














P1
800
400
32
16


P2
800
200
64
4


P3
800
200
64
4


P4
800
400
32
8


P5
800
200
64
8


P6
800
400
32
2


P7
800
400
32
2


P8
800
200
64
16


P9
800
400
32
16


 P10
800
200
64
16


 P11
800
200
8
4


 P12
800
400
32
2


 P13
800
400
8
2


 P14
800
400
32
4


 P15
800
200
32
4


 P16
800
400
16
2


 P17
800
400
16
2


 P18
800
200
32
4


 P19
800
200
64
8


 P20
800
400
4
2
















TABLE P47







Sensibilization effect of the Pithecellobium clypearia Benth


95% ethanol extract to the LVX and MIC after combined use












EA
EA
LVX
LVX



single-use
combined-use
single-use
combined-use


Strain
MIC
MIC
MIC
MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)














P1
800
400
32
4


P2
800
400
4
0.03125


P3
800
400
8
0.03125


P4
800
400
8
4


P5
800
800
1
0.03125


P6
800
800
0.5
0.03125


P7
800
800
32
0.03125


P8
800
400
1
0.03125


P9
800
400
4
2


 P10
800
400
128
32


 P11
800
400
2
1


 P12
800
400
1
0.5


 P13
800
400
2
1


 P14
800
200
32
2


 P15
800
400
2
1


 P16
800
400
32
4


 P17
800
400
4
2


 P18
800
400
4
4


 P19
800
200
16
4


 P20
800
400
4
1
















TABLE P48







MIC50 and MIC90 of the five antibiotics after combined use











Antibiotic (μg/ml)











Combined
MIC50 after
MIC90 after



drug
combined use
combined use















EA + CAZ
16
128



EA + CFP
4
128



EA + AMK
0.12
4



EA + IMP
4
16



EA + LVX
1
4










With the single use of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRPA, the MIC50 is 800 μg/ml, the MIC90 is 800 μg/ml, the MBC50 is 1600 μg/ml, and the MBC90 is 1600 μg/ml.


For the 20 MDRPAs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the CAZ that the two drugs have no antagonistic effect, wherein 25% with FIC≤0.5 have the synergistic effect.


For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the CAZ is reduced from single-use 32 μg/ml to 16 μg/ml and is reduced by 50%; and the MIC90 is reduced from 256 μg/ml to 128 μg/ml and is reduced by 50%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the CFP to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the CFP is reduced from single-use 64 μg/ml to 4 μg/ml and is reduced by 93.75%; and the MIC90 is reduced from 512 μg/ml to 128 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the AMK is reduced from single-use 1 μg/ml to 0.12 μg/ml and is reduced by 87.5%; and the MIC90 is reduced from 32 μg/ml to 4 μg/ml and is reduced by 87.5%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the IMP that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the IMP is reduced from single-use 32 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC90 is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the LVX to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 10% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRPA, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 of the LVX is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC90 is reduced from 32 μg/ml to 4 μg/ml and is reduced by 87.5%.


III. Inhibitory and Bactericidal Tests of the ESBL-Producing Escherichia coli (Hereinafter Referred to as an ESBL-Producing ECO) Resistance of the EA and Test of the Sensibilization Effect by Respectively Using with the AMK or the SXT


Embodiment 3

1. Test method: the MDRPA (serial No.: E1-E20) strains are tested and are evaluated with reference to the method in the first embodiment.


2. Test results


2.1. In-vitro inhibitory test results of the Pithecellobium clypearia Benth water extract and the two antibiotics (the AMK and the SXT) to the ESBL-producing ECOs are shown in table E1.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth water extract to the ESBL-producing ECOs are shown in table E2.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth water extract and the two antibiotics to the ESBL-producing ECOs is shown in table E3.


The statistic analysis on bactericidal MBC50 and MBC90 of the EA to the ESBL-producing ECOs is shown in table E4.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth water extract and the two antibiotics and distribution statistical results of the FIC values are shown in table E5 and table E6.


The sensibilization effects of the Pithecellobium clypearia Benth water extract to the two antibiotics and the MIC50 and MIC90 after combined use are shown in tables E7-E9.












TABLE E1










MIC (μg/ml)












Strain No.
EA
AMK
SXT







E1
1600
4
2432/128



E2
1600
16
2432/128



E3
1600
512
2432/128



E4
1600
4
76/4



E5
1600
16
2432/128



E6
1600
4
2432/128



E7
1600
32
2432/128



E8
1600
32
2432/128



E9
1600
64
2432/128



 E10
1600
8
2432/128



 E11
1600
32
76/4



 E12
1600
32
2432/128



 E13
1600
4
2432/128



 E14
1600
8
2432/128



 E15
1600
8
2432/128



 E16
1600
16
2432/128



 E17
1600
8
2432/128



 E18
1600
128
2432/128



 E19
1600
64
152/8 



 E20
1600
16
76/4



ATCC25922
 800
4
 9.5/0.5




















TABLE E2







Strain No.
MBC (μg/ml)









E1
3200



E2
3200



E3
3200



E4
3200



E5
3200



E6
3200



E7
3200



E8
3200



E9
3200



 E10
3200



 E11
3200



 E12
3200



 E13
3200



 E14
3200



 E15
3200



 E16
3200



 E17
3200



 E18
3200



 E19
3200



 E20
3200




















TABLE E3










MIC (μg/ml)












Drug
Range
MIC50
MIC90
















EA
1600
1600
1600



AMK
4-512
16
64



SXT
76/4-2432/128
2432/128
2432/128


















TABLE E4








MBC (μg/ml)










Drug
Range
MBC50
MBC90





EA
3200
3200
3200

















TABLE E5








FIC









Strain No.
EA + AMK
EA + SXT












E1 
0.75
0.507813


E2 
0.375
1.003906


E3 
0.28125
0.507813


E4 
0.75
0.75


E5 
0.625
0.507813


E6 
1
0.515625


E7 
0.375
0.507813


E8 
0.5
0.507813


E9 
0.375
0.500061


E10
0.75
0.507813


E11
0.5
0.375


E12
0.75
0.125485


E13
1.25
0.507813


E14
0.75
0.507813


E15
0.75
0.500058


E16
0.5
0.125485


E17
0.5
0.507813


E18
0.625
0.250977


E19
0.375
0.375


E20
0.5
0.75


















TABLE E6





FIC Range
EA + AMK
EA + SXT







FIC ≤ 0.5
50%
25%


0.5 < FIC ≤ 1
45%
70%


1 < FIC ≤ 2
 5%
 5%


FIC > 2






















TABLE E7






EA single-
EA combined-
AMK single-
AMK combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)



















E1 
1600
400
4
2


E2 
1600
200
16
4


E3 
1600
400
512
16


E4 
1600
400
4
2


E5 
1600
200
16
8


E6 
1600
800
4
2


E7 
1600
200
32
8


E8 
1600
400
32
8


E9 
1600
400
64
8


E10
1600
400
8
4


E11
1600
400
32
8


E12
1600
400
32
16


E13
1600
800
4
2


E14
1600
400
8
4


E15
1600
400
8
4


E16
1600
400
16
4


E17
1600
400
8
2


E18
1600
800
128
16


E19
1600
200
64
16


E20
1600
400
16
4




















TABLE E8






EA
EA
SXT
SXT



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)



















E1 
1600
800
2432/128
19/1 


E2 
1600
1600
2432/128
9.5/0.5


E3 
1600
800
2432/128
19/1 


E4 
1600
800
76/4
19/1 


E5 
1600
800
2432/128
19/1 


E6 
1600
800
2432/128
38/2 


E7 
1600
800
2432/128
19/1 


E8 
1600
800
2432/128
19/1 


E9 
1600
800
2432/128
0.148438/0.078125


E10
1600
800
2432/128
19/1 


E11
1600
200
76/4
19/1 


E12
1600
200
2432/128
1.1875/0.0625


E13
1600
800
2432/128
19/1 


E14
1600
800
2432/128
19/1 


E15
1600
800
2432/128
0.148438/0.078125


E16
1600
200
2432/128
1.1875/0.0625


E17
1600
800
2432/128
19/1 


E18
1600
400
2432/128
2.375/0.125


E19
1600
400
152/8 
19/1 


E20
1600
800
76/4
19/1 

















TABLE E9








Antibiotic (μg/ml)










MIC50 after
MIC90 after


Combined drug
combined use
combined use





EA + AMK
4
16


EA + SXT
19/1
19/1









The test results shows that, with the single use of the Pithecellobium clypearia Benth water extract to the ESBL-producing ECOs, the MIC50 is 1600 μg/ml, the MIC90 is 1600 μg/ml, the MBC50 is 3200 μg/ml, and the MBC90 is 3200 μg/ml.


For the 20 ESBL-producing ECOs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the AMK that the two drugs have no antagonistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth water extract is smaller than or equal to ½ MIC, the MIC50 of the AMK is reduced from single-use 16 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC90 is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the SXT to the 20 ESBL-producing ECOs that the two drugs have no antagonistic effect, wherein 25% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC50 and the MIC90 of the SXT are respectively reduced from single-use 2432/128 μg/ml to 19/1 μg/ml, and are reduced by 99.3%.


2.2. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 10% ethanol extract and the two antibiotics (the AMK and the SXT) to the ESBL-producing ECOs are shown in table E10.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing ECOs are shown in table E11.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth 10% ethanol extract and the two antibiotics to the ESBL-producing ECOs is shown in table E12.


The statistic analysis on bactericidal MBC50 and MBC90 of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing ECOs is shown in table E13


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 10% ethanol extract and the two antibiotics and distribution statistical results of the FIC values are shown in table E14 and table E15.


The sensibilization effects of the Pithecellobium clypearia Benth 10% ethanol extract to the two antibiotics and the MIC50 and MIC90 after combined use are shown in tables E16-E18.










TABLE E10








MIC (μg/ml)










Strain No.
EA
AMK
SXT













E1 
1600
4
2432/128


E2 
1600
16
2432/128


E3 
1600
512
2432/128


E4 
1600
4
76/4


E5 
1600
16
2432/128


E6 
1600
4
2432/128


E7 
1600
32
2432/128


E8 
1600
32
2432/128


E9 
1600
64
2432/128


E10
1600
8
2432/128


E11
1600
32
76/4


E12
1600
32
2432/128


E13
1600
4
2432/128


E14
1600
8
2432/128


E15
1600
8
2432/128


E16
1600
16
2432/128


E17
1600
8
2432/128


E18
1600
128
2432/128


E19
1600
64
152/8 


E20
1600
16
76/4


ATCC25922
800
4
 9.5/0.5

















TABLE E11





Strain No.
MBC (μg/ml)







E1 
3200


E2 
3200


E3 
3200


E4 
3200


E5 
3200


E6 
3200


E7 
3200


E8 
3200


E9 
3200


E10
3200


E11
3200


E12
3200


E13
3200


E14
3200


E15
3200


E16
3200


E17
3200


E18
3200


E19
3200


E20
3200

















TABLE E12








MIC (μg/ml)










Drug
Range
MIC50
MIC90





EA
1600
1600
1600


AMK
4-512
 16
 64


SXT
76/4-2432/128
2432/128
2432/128

















TABLE E13








MBC (μg/ml)










Drug
Range
MBC50
MBC90





EA
3200
3200
3200

















TABLE E14








FIC









Strain No.
EA + AMK
EA + SXT












E1 
1
0.507813


E2 
0.75
0.507813


E3 
0.265625
0.507813


E4 
0.5
0.75


E5 
0.5
0.507813


E6 
1
0.507813


E7 
0.5
0.507813


E8 
0.75
0.507813


E9 
0.5
0.500061


E10
0.75
0.507813


E11
0.5
0.5


E12
0.75
0.250975


E13
1
0.507813


E14
1
0.507813


E15
0.75
0.500058


E16
0.5
0.125485


E17
0.75
0.507813


E18
0.5
1.000977


E19
0.375
0.375


E20
0.5
0.75


















TABLE E15





FIC Range
EA + AMK
EA + SXT







FIC ≤ 0.5
50%
20%


0.5 < FIC ≤ 1
50%
75%


1 < FIC ≤ 2

 5%


FIC > 2






















TABLE E16






EA single-
EA combined-
AMK single-
AMK combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)



















E1 
1600
800
4
2


E2 
1600
800
16
4


E3 
1600
400
512
8


E4 
1600
400
4
1


E5 
1600
400
16
4


E6 
1600
800
4
2


E7 
1600
400
32
8


E8 
1600
800
32
8


E9 
1600
400
64
16


E10
1600
400
8
4


E11
1600
400
32
8


E12
1600
400
32
16


E13
1600
800
4
2


E14
1600
800
8
4


E15
1600
400
8
4


E16
1600
400
16
4


E17
1600
800
8
2


E18
1600
400
128
32


E19
1600
400
64
8


E20
1600
400
16
4




















TABLE E17






EA
EA
SXT
SXT



single-
combined-
single-
combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)



















E1 
1600
800
2432/128
19/1 


E2 
1600
800
2432/128
19/1 


E3 
1600
800
2432/128
19/1 


E4 
1600
800
76/4
19/1 


E5 
1600
800
2432/128
19/1 


E6 
1600
800
2432/128
19/1 


E7 
1600
800
2432/128
19/1 


E8 
1600
800
2432/128
19/1 


E9 
1600
800
2432/128
0.148438/0.078125


E10
1600
800
2432/128
19/1 


E11
1600
400
76/4
19/1 


E12
1600
400
2432/128
2.375/0.125


E13
1600
800
2432/128
19/1 


E14
1600
800
2432/128
19/1 


E15
1600
800
2432/128
0.148438/0.078125


E16
1600
200
2432/128
1.1875/0.0625


E17
1600
800
2432/128
19/1 


E18
1600
1600
2432/128
2.375/0.125


E19
1600
400
152/8 
19/1 


E20
1600
800
76/4
19/1 

















TABLE E18








Antibiotic (μg/ml)










MIC50 after
MIC90 after


Combined drug
combined use
combined use





EA + AMK
4
16


EA + SXT
19/1
19/1









The test results shows that, with the single use of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing ECOs, the MIC50 is 1600 μg/ml, the MIC90 is 1600 μg/ml, the MBC50 is 3200 μg/ml, and the MBC90 is 3200 μg/ml.


For the 20 ESBL-producing ECOs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to ½ MIC, the MIC50 of the AMK is reduced from single-use 16 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC90 is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the SXT to the 20 ESBL-producing ECOs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 and the MIC90 of the SXT are respectively reduced from single-use 2432/128 μg/ml to 19/1 μg/ml, and are reduced by 99.3%.


2.3. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 60% ethanol extract and the two antibiotics (the AMK and the SXT) to the ESBL-producing ECOs are shown in table E19.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing ECOs are shown in table E20.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth 60% ethanol extract and the two antibiotics to the ESBL-producing ECOs is shown in table E21.


The statistic analysis on bactericidal MBC50 and MBC90 of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing ECOs is shown in table E22.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 60% ethanol extract and the two antibiotics and distribution statistical results of the FIC values are shown in table E23 and table E24.


The sensibilization effects of the Pithecellobium clypearia Benth 60% ethanol extract to the two antibiotics and the MIC50 and MIC90 after combined use are shown in tables E25-E27.












TABLE E19










MIC (μg/ml)












Strain No.
EA
AMK
SXT
















E1
800
4
2432/128



E2
800
16
2432/128



E3
800
512
2432/128



E4
800
4
76/4



E5
800
16
2432/128



E6
1600 
4
2432/128



E7
800
32
2432/128



E8
800
32
2432/128



E9
800
64
2432/128



E10
800
8
2432/128



E11
800
32
76/4



E12
800
32
2432/128



E13
400
4
2432/128



E14
800
8
2432/128



E15
800
8
2432/128



E16
800
16
2432/128



E17
800
8
2432/128



E18
800
128
2432/128



E19
800
64
152/8 



E20
800
16
76/4



ATCC25922
800
4
 9.5/0.5




















TABLE E20





Strain No.
MBC(μg/ml)
Strain No.
MBC(μg/ml)







E1
1600
E11
1600


E2
1600
E12
1600


E3
1600
E13
>1600 


E4
1600
E14
1600


E5
1600
E15
1600


E6
>1600 
E16
1600


E7
1600
E17
1600


E8
1600
E18
1600


E9
1600
E19
1600


E10
1600
E20
1600



















TABLE E21










MIC (μg/ml)












Drug
Range
MIC50
MIC90







EA
400-1600
800
800



AMK
 4-512
 16
 64



SXT
  76/4-2432/128
2432/128
2432/128




















TABLE E22










MBC (μg/ml)












Drug
Range
MBC50
MBC90







EA
≥1600
1600
1600




















TABLE E23










FIC











Strain No.
EA + AMK
EA + SXT















E1
0.5625
1.0078



E2
0.25
1.0039



E3
0.2656
1.0001



E4
0.5625
0.75



E5
0.5625
0.5078



E6
0.375
0.2656



E7
0.125
0.5078



E8
0.1875
0.5078



E9
0.3125
1.0001



E10
0.5625
0.5078



E11
0.1875
0.0703



E12
0.1875
0.0630



E13
1.125
1.0039



E14
0.5625
0.5156



E15
0.3125
1.0001



E16
0.1875
0.0630



E17
0.3125
0.5078



E18
0.375
0.0635



E19
0.25
0.625



E20
0.3125
0.375





















TABLE E24







FIC Range
EA + AMK
EA + SXT









FIC ≤ 0.5
70%
30%



0.5 < FIC ≤ 1
25%
40%



  1 < FIC ≤ 2
 5%
30%



FIC > 2























TABLE E25






EA
EA
AMK
AMK


Strain
single-use
combined-use
single-use
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)
MIC (μg/ml)



















E1
800
50
4
2


E2
800
100 
16
2


E3
800
200 
512
8


E4
800
50
4
2


E5
800
50
16
8


E6
1600 
400 
4
  0.5


E7
800
50
32
2


E8
800
50
32
4


E9
800
200 
64
4


E10
800
50
8
4


E11
800
50
32
4


E12
800
50
32
4


E13
400
50
4
4


E14
800
50
8
4


E15
800
50
8
2


E16
800
50
16
2


E17
800
50
8
2


E18
800
100 
128
32 


E19
800
100 
64
8


E20
800
50
16
4




















TABLE E26






EA
EA
SXT
SXT


Strain
single-use
combined-use
single-use MIC
combined-use


No.
MIC (μg/ml)
MIC (μg/ml)
(μg/ml)
MIC (μg/ml)



















E1
800
800
2432/128
19/1


E2
800
800
2432/128
 9.5/0.5


E3
800
800
2432/128
0.148438/0.07812






5


E4
800
400
76/4
19/1


E5
800
400
2432/128
19/1


E6
1600 
400
2432/128
38/2


E7
800
400
2432/128
19/1


E8
800
400
2432/128
19/1


E9
800
800
2432/128
0.148438/0.07812






5


E10
800
400
2432/128
19/1


E11
800
 50
76/4
19/1


E12
800
 50
2432/128
 1.1875/0.0625


E13
400
400
2432/128
 9.5/0.5


E14
800
400
2432/128
38/2


E15
800
800
2432/128
0.148438/0.07812






5


E16
800
 50
2432/128
 1.1875/0.0625


E17
800
400
2432/128
19/1


E18
800
 50
2432/128
 2.375/0.125


E19
800
400
152/8 
19/1


E20
800
100
76/4
19/1

















TABLE E27








Antibiotic (μg/ml)









Combined drug
MIC50 after combined use
MIC90 after combined use





EA + AMK
4
8


EA + SXT
19/1
19/1









The test results shows that, with the single use of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing ECOs, the MIC50 is 800 μg/ml, the MIC90 is 800 μg/ml, the MBC50 is 1600 μg/ml, and the MBC90 is 1600 μg/ml.


For the 20 ESBL-producing ECOs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 70% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to ¼ MIC, the MIC50 of the AMK is reduced from single-use 16 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC90 is reduced from 64 μg/ml to 8 μg/ml.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the SXT to the 20 ESBL-producing ECOs that the two drugs have no antagonistic effect, wherein 30% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 and the MIC90 of the SXT are respectively reduced from single-use 2432/128 μg/ml to 19/1 μg/ml, and are reduced by 99.3%.


2.4. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 95% ethanol extract and the two antibiotics (the AMK and the SXT) to the ESBL-producing ECOs are shown in table E28.


In-vitro bactericidal test results of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing ECOs are shown in table E29.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50 and MIC90 of the Pithecellobium clypearia Benth 95% ethanol extract and the two antibiotics to the ESBL-producing ECOs is shown in table E30.


The statistic analysis on bactericidal MBC50 and MBC90 of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing ECOs is shown in table E31.


FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 95% ethanol extract and the two antibiotics and distribution statistical results of the FIC values are shown in table E32 and table E33.


The sensibilization effects of the Pithecellobium clypearia Benth 95% ethanol extract to the two antibiotics and the MIC50 and MIC90 after combined use are shown in tables E34-E36.












TABLE E28










MIC (μg/ml)












Strain No.
EA
AMK
SXT
















E1
1600
4
2432/128



E2
1600
16
2432/128



E3
1600
512
2432/128



E4
1600
4
76/4



E5
1600
16
2432/128



E6
1600
4
2432/128



E7
1600
32
2432/128



E8
1600
32
2432/128



E9
1600
64
2432/128



E10
1600
8
2432/128



E11
1600
32
76/4



E12
1600
32
2432/128



E13
1600
4
2432/128



E14
1600
8
2432/128



E15
1600
8
2432/128



E16
1600
16
2432/128



E17
1600
8
2432/128



E18
1600
128
2432/128



E19
1600
64
 152/8 



E20
1600
16
76/4



ATCC25922
 800
4
9.5/0.5




















TABLE E29





Strain No.
MBC(μg/ml)
Strain No.
MBC(μg/ml)







E1
3200
E11
3200


E2
3200
E12
3200


E3
3200
E13
3200


E4
3200
E14
3200


E5
3200
E15
3200


E6
3200
E16
3200


E7
3200
E17
3200


E8
3200
E18
3200


E9
3200
E19
3200


E10
3200
E20
3200



















TABLE E30










MIC (μg/ml)












Drug
Range
MIC50
MIC90







EA
1600
1600
1600



AMK
4-512 
 16
 64



SXT
76/4-2432/128
2432/128
2432/128




















TABLE E31










MBC (μg/ml)












Drug
Range
MBC50
MBC90







EA
3200
3200
3200




















TABLE E32










FIC











Strain No.
EA + AMK
EA + SXT







E1
1
0.507813



E2
0.5
0.507813



E3
0.53125
0.507813



E4
0.5
0.75



E5
0.5
0.507813



E6
0.75
0.507813



E7
0.75
0.503906



E8
0.75
0.507813



E9
0.75
0.503906



E10
0.75
0.507813



E11
0.75
0.75



E12
0.5
1.000975



E13
0.75
0.507813



E14
0.75
0.507813



E15
0.75
0.500058



E16
0.5
0.132813



E17
0.75
0.507813



E18
0.5
1.000977



E19
0.375
0.625



E20
0.5
0.75





















TABLE E33







FIC Range
EA + AMK
EA + SXT









FIC ≤ 0.5
40%
 5%



0.5 < FIC ≤ 1
60%
85%



  1 < FIC ≤ 2

10%



FIC > 2























TABLE E34






EA single-
EA combined-
AMK single-
AMK combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)



















E1
1600
800
4
2


E2
1600
400
16
4


E3
1600
800
512
16


E4
1600
400
4
1


E5
1600
400
16
4


E6
1600
800
4
1


E7
1600
800
32
8


E8
1600
800
32
8


E9
1600
800
64
16


E10
1600
400
8
4


E11
1600
800
32
8


E12
1600
400
32
8


E13
1600
400
4
2


E14
1600
800
8
2


E15
1600
400
8
4


E16
1600
400
16
4


E17
1600
800
8
2


E18
1600
400
128
32


E19
1600
400
64
8


E20
1600
400
16
4




















TABLE E35






EA single-
EA combined-
SXT single-
SXT combined-


Strain
use MIC
use MIC
use MIC
use MIC


No.
(μg/ml)
(μg/ml)
(μg/ml)
(μg/ml)







E1
1600
 800
2432/128
    19/1


E2
1600
 800
2432/128
    19/1


E3
1600
 800
2432/128
    19/1


E4
1600
 800
 76/4
    19/1


E5
1600
 800
2432/128
    19/1


E6
1600
 800
2432/128
    19/1


E7
1600
 800
2432/128
   9.5/0.5


E8
1600
 800
2432/128
    19/1


E9
1600
 800
2432/128
   9.5/0.5


E10
1600
 800
2432/128
    19/1


E11
1600
 800
 76/4
    19/1


E12
1600
1600
2432/128
  2.375/0.125


E13
1600
 800
2432/128
    19/1


E14
1600
 800
2432/128
    19/1


E15
1600
 800
2432/128
0.148438/0.078125


E16
1600
 200
2432/128
    19/1


E17
1600
 800
2432/128
    19/1


E18
1600
1600
2432/128
  2.375/0.125


E19
1600
 800
 152/8
    19/1


E20
1600
 800
 76/4
    19/1



















TABLE E36










Antibiotic (μg/ml)












MIC50 after
MIC90 after



Combined drug
combined use
combined use







EA + AMK
 4
16



EA + SXT
19/1
19/1










The test results shows that, with the single use of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing ECOs, the MIC50 is 1600 μg/ml, the MIC90 is 1600 μg/ml, the MBC50 is 3200 μg/ml, and the MBC90 is 3200 μg/ml.


For the 20 ESBL-producing ECOs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to ½ MIC, the MIC50 of the AMK is reduced from single-use 16 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC90 is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.


It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the SXT to the 20 ESBL-producing ECOs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC50 and the MIC90 of the SXT are respectively reduced from single-use 2432/128 μg/ml to 19/1 μg/ml, and are reduced by 99.3%.


IV. Inhibitory and Bactericidal Tests of ESBL-Producing Klebsiella pneumoniae (Hereinafter Referred to as an ESBL-Producing KPN) Resistance of the EA


Embodiment 4

1. Test method: the ESBL-producing KPN (serial No.: K1-K20) strains are tested and are evaluated with reference to the inhibitory and bactericidal test method in the first embodiment.


2. Test results


In-vitro inhibitory and bactericidal test results of the Pithecellobium clypearia Benth water extract to the ESBL-producing KPNs are shown in table K1.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50, MIC90, MBC50 and MBC90 of the Pithecellobium clypearia Benth water extract to the ESBL-producing KPNs is shown in table K2 and table K3.


In-vitro inhibitory and bactericidal test results of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing KPNs are shown in table K4.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50, MIC90, MBC50 and MBC90 of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing KPNs is shown in table K5 and table K6.


In-vitro inhibitory and bactericidal test results of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing KPNs are shown in table K7.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50, MIC90, MBC50 and MBC90 of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing KPNs is shown in table K8 and table K9.


In-vitro inhibitory and bactericidal test results of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing KPNs are shown in table K10.


The statistic analysis on in-vitro inhibitory and bactericidal MIC50, MIC90, MBC50 and MBC90 of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing KPNs is shown in table K11 and table K12.









TABLE K1







In-vitro inhibitory and bactericidal test results


of the Pithecellobium clypearia Benth


water extract to the ESBL-producing KPNs











Strain No.
MIC (μg/ml)
MBC (μg/ml)







K1
1600
>1600



K2
1600
>1600



K3
1600
>1600



K4
1600
>1600



K5
1600
>1600



K6
1600
>1600



K7
1600
>1600



K8
1600
>1600



K9
1600
>1600



K10
1600
>1600



K11
1600
>1600



K12
1600
>1600



K13
1600
>1600



K14
1600
>1600



K15
1600
>1600



K16
1600
>1600



K17
1600
>1600



K18
1600
>1600



K19
1600
>1600



K20
1600
>1600

















TABLE K2







In-vitro inhibitory MIC50 and MIC90 of the


Pithecellobium clypearia Benth


water extract to the ESBL-producing KPNs











MIC Range
MIC50
MIC90







1600
1600
1600

















TABLE K3







In-vitro inhibitory MBC50 and MBC90 of


the Pithecellobium clypearia Benth


water extract to the ESBL-producing KPNs











MBC Range
MBC50
MBC90







>1600
>1600
>1600

















TABLE K4







In-vitro inhibitory and bactericidal test results


of the Pithecellobium clypearia Benth


10% ethanol extract to the ESBL-producing KPNs











Strain No.
MIC (μg/ml)
MBC (μg/ml)







K1
1600
>1600



K2
 800
>1600



K3
1600
>1600



K4
 800
>1600



K5
1600
>1600



K6
1600
>1600



K7
1600
>1600



K8
1600
>1600



K9
1600
>1600



K10
1600
>1600



K11
1600
>1600



K12
1600
>1600



K13
1600
>1600



K14
1600
>1600



K15
 800
>1600



K16
 800
>1600



K17
1600
>1600



K18
1600
>1600



K19
1600
>1600



K20
1600
>1600

















TABLE K5







In-vitro inhibitory MIC50 and MIC90


of the Pithecellobium clypearia Benth


10% ethanol extract to the ESBL-producing KPNs











MIC Range
MIC50
MIC90







800-1600
1600
1600

















TABLE K6







In-vitro inhibitory MBC50 and MBC90


of the Pithecellobium clypearia Benth


10% ethanol extract to the ESBL-producing KPNs











MBC Range
MBC50
MBC90







>1600
>1600
>1600

















TABLE K7







In-vitro inhibitory and bactericidal


test results of the Pithecellobium clypearia Benth


60% ethanol extract to the ESBL-producing KPNs











Strain No.
MIC (μg/ml)
MBC (μg/ml)







K1
1600
>1600



K2
 800
>1600



K3
 800
>1600



K4
 800
>1600



K5
1600
>1600



K6
1600
>1600



K7
 400
>1600



K8
 800
>1600



K9
1600
>1600



K10
1600
>1600



K11
1600
>1600



K12
1600
>1600



K13
 800
>1600



K14
 800
>1600



K15
 400
>1600



K16
 800
>1600



K17
1600
>1600



K18
1600
>1600



K19
 800
>1600



K20
 800
>1600

















TABLE K8







In-vitro inhibitory MIC50 and MIC90


of the Pithecellobium clypearia Benth


60% ethanol extract to the ESBL-producing KPNs











MIC Range
MIC50
MIC90







400-1600
800
1600

















TABLE K9







In-vitro inhibitory MBC50 and MBC90 of


the Pithecellobium clypearia Benth


60% ethanol extract to the ESBL-producing KPNs











MBC Range
MBC50
MBC90







>1600
>1600
>1600

















TABLE K10







In-vitro inhibitory and bactericidal test results


of the Pithecellobium clypearia Benth


95% ethanol extract to the ESBL-producing KPNs











Strain No.
MIC (μg/ml)
MBC (μg/ml)







K1
1600
>1600



K2
1600
>1600



K3
1600
>1600



K4
1600
>1600



K5
1600
>1600



K6
1600
>1600



K7
1600
>1600



K8
1600
>1600



K9
1600
>1600



K10
1600
>1600



K11
1600
>1600



K12
1600
>1600



K13
 800
>1600



K14
 800
>1600



K15
1600
>1600



K16
1600
>1600



K17
1600
>1600



K18
1600
>1600



K19
1600
>1600



K20
1600
>1600

















TABLE K11







In-vitro inhibitory MIC50 and MIC90


of the Pithecellobium clypearia Benth


95% ethanol extract to the ESBL-producing KPNs











MIC Range
MIC50
MIC90







800-1600
1600
1600

















TABLE K12







In-vitro inhibitory MBC50 and MBC90


of the Pithecellobium clypearia Benth


95% ethanol extract to the ESBL-producing KPNs











MBC Range
MBC50
MBC90







>1600
>1600
>1600










With the single use of the Pithecellobium clypearia Benth water extract to the ESBL-producing KPNs, the MIC50 is 1600 μg/ml, the MIC90 is 1600 μg/ml, and both the MBC50 and the MBC90 are greater than 1600 μg/ml.


With the single use of the Pithecellobium clypearia Benth 10% ethanol extract to the KPNs, the MIC50 is 1600 μg/ml, the MIC90 is 1600 μg/ml, and both the MBC50 and the MBC90 are greater than 1600 μg/ml.


With the single use of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing KPNs, the MIC50 is 1600 μg/ml, the MIC90 is 1600 μg/ml, and both the MBC50 and the MBC90 are greater than 1600 μg/ml.


With the single use of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing KPNs, the MIC50 is 1600 μg/ml, the MIC90 is 1600 μg/ml, and both the MBC50 and the MBC90 are greater than 1600 μg/ml.

Claims
  • 1. A method of treating a disease caused by an Extended-Spectrum Beta-Lactamase producing Escherichia coli infection, comprising administering a Pithecellobium clypearia Benth Extract (EA) in combination with at least one antibiotic selected from the group consisting of Amikacin and Sulfamethoxazole, wherein the EA is a water extract or ethanol extract.
  • 2. The method of claim 1, wherein the Pithecellobium clypearia Benth water extract or the Pithecellobium clypearia Benth ethanol extract is prepared with a following method: extracting Pithecellobium clypearia Benth coarse powder with water or an ethanol aqueous solution having a concentration of 10%-95% by a volume ratio, and then extracting an obtained extracting solution with ethyl acetate, in which the obtained extract is a final product.
  • 3. The method of claim 2, wherein the ethanol aqueous solution is an ethanol aqueous solution having the concentration of 60% by the volume ratio.
Priority Claims (4)
Number Date Country Kind
201610308207.4 May 2016 CN national
201610308716.7 May 2016 CN national
201610308717.1 May 2016 CN national
201610308718.6 May 2016 CN national
CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is continuation application of U.S. patent application Ser. No. 17/129,885 filed on Dec. 21, 2020, which is a divisional application of U.S. patent application Ser. No. 15/920,480 filed on Mar. 14, 2018, which is a continuation application of PCT application No. PCT/CN2017/071671 filed on Jan. 19, 2017, which claims the benefit of Chinese patent application Nos. 201610308716.7, 201610308717.1, 201610308207.4 and 201610308718.6, each filed on May 10, 2016. The contents of all of the above are hereby incorporated by reference.

Divisions (1)
Number Date Country
Parent 15920480 Mar 2018 US
Child 17129885 US
Continuations (2)
Number Date Country
Parent 17129885 Dec 2020 US
Child 17494850 US
Parent PCT/CN2017/071671 Jan 2017 US
Child 15920480 US