Growing risks of antimicrobial resistance (AMR) in herbal therapies: a comparison of commercial and homemade treatments for stomach ulcers, typhoid fever, and malaria
Authors: T. Abd-Elhalim Basma , Ambo Dennis Samuel , Gideon Mathew , Anton Kuzmin 
Published: October 2024

Abstract Due to their accessibility and low cost, herbal medicinal products (HMPs) are in considerable demand in developing and undeveloped countries for the treatment of illnesses and infections. The objective of this study is to measure the level of microbial contamination present in herbal products marketed in Kaduna markets and in orthodox herbal cocktail regimens used to treat malaria, typhoid, and stomach ulcers. Additionally, the study will assess the extent to which these regimens contribute to the rise in antimicrobial resistance (AMR) in high- and medium-density settlements in Kaduna State, Nigeria. Two natural remedies for malaria and typhoid were purchased from a trader at Kaduna Central Market, Nigeria. Also two herbal items recommended for treating ulcers from Kawo Market in Kaduna were obtained. While mango, guava, moringa, lemongrass, banana, and orange leaves were collected from farmlands within Sabon Tasha GRA, Kaduna South, unripe plantains were bought at Sabon Tasha Market. The herbal cocktail routine involves heating, collecting, and this process is repeated seven days a day for analysis. The trial stage aimed to isolate and identify specific bacteria strains using a methodical process. Equipment was autoclaved to ensure sterility. Eosin Methylene Blue (EMB) agar plates were prepared, and a serial dilution of samples was done using syringes and sterile distilled water. The plates were incubated for 24 hours at 37°C, and colony counts were used to determine the microbial load for each sample. The process involved using Salmonella Shigella (SS) agar plates for separating and identifying Shigella sp. and Salmonella sp., and MSA plates for S. aureus. Gram staining was used to determine morphological properties, and catalase tests were performed to distinguish between Staphylococcus sp. and Streptococcus species. The study isolated and characterized Shigella sp., E. coli, Salmonella sp., and S. aureus bacteria, tested for antibiotic susceptibility using discs, and subcultured using Kirby-Bauer disk diffusion test with Mueller Hinton Agar. The investigation found that all samples had concerningly high levels of bacterial contamination. The total count of Shigella spp. exceeded the World Health Organization (WHO) guideline of 10^2 CFU/ml by a factor of 3.37 x 10^5 CFU/ml. Fermented plantain had the greatest bacterial count, especially for S. aureus (1.07 x 10^6 CFU/ml), whereas registered herbal items had the highest count of S. aureus (1.82 x 10^5 CFU/ml). Multi-drug-resistant (MDR) strain S. aureus shown strong resistance to several antibiotics, such as Pefloxacin, Ciprofloxacin, Streptomycin, and Rocephin. Though not yet MDR, Salmonella spp. exhibited early indications of resistance to Pefloxacin and Gentamycin. Classified as MDR, Shigella spp. shown strong resistance to Ciprofloxacin, Amoxicillin, Pefloxacin, Gentamycin, and Sparfloxacin. Due to its widespread multidrug resistance (MDR) to Amoxicillin, Pefloxacin, Septrin, Streptomycin, Ciprofloxacin, Ampiclox, Gentamycin, Sparfloxacin, and Tarivid, Escherichia coli (E. coli) has brought attention to the need for novel antibiotic therapies. These results highlight the critical necessity for strict quality control procedures to guarantee the security of herbal medicines and to reduce any possible health hazards and AMR contributions related to their use. We can highlight the key points of the current investigation as: