## 3 Results and Discussion
\begin{table}
\begin{tabular}{c c c c c} \hline \hline  & **Normal Control** & **Model Group** & **9-Methodyellipticine-Treated** & **Gentamycin** \\  & **Group** & & **Group** & **(GEN)-Treated Group** \\ \hline Necrobiotic changes in tubular epithelium & \(-\) & +++ & \(+\) & \(+\) \\ Interstitial inflammatory cell infiltration & \(-\) & \(+\) & \(-\) & \(+\) \\ Interstitial hemorrhage & \(-\) & \(+\) & \(-\) & \(-\) \\ Subcapsular hemorrhage & \(-\) & \(++\) & \(-\) & \(-\) \\ Renal cast & \(-\) & \(-\) & \(+\) & \(-\) \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Scoring of kidney lesions. Figure 5: H&E of kidneys of mice infected with MDR _E. coli_. (**a**) Model group (\(\times\)400), (**b**) gentamycin (GEN)-treated group (\(\times\)200), and (**c**) 9-methoxyellipticine-treated group (\(\times\)400). \begin{table}
\begin{tabular}{c c c c} \hline \hline  & **Normal Control Group** & **Model Group** & **9-Methodyellipticine-Treated** & **Gentamycin** \\  & & & **Group** & **(GEN)-Treated Group** \\ \hline Thickened interalveolar septa & \(-\) & +++ & \(+\) & \(+\) \\   Perivascular edema & \(-\) & +++ & \(+\) & \(-\) \\   Hemorrhage & \(-\) & +++ & \(-\) & \(-\) \\ RBCs in alveolar lamina & \(-\) & +++ & \(+\) & \(-\) \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Scoring lung lesions. In the STEC-infected animal renal lesions, (Figure 5a-c and Table 4), (untreated group), the manifestation of multi-sized vacuoles in the cytoplasm of tubular epithelium implied necrotic alterations. Additionally, representative of histopathological alteration, coagulation necrosis with karyopyknotic nuclei was also detected. However, the kidney of the animal infected with STEC and treated with 9-methoxyelliptice displayed interstitial inflammatory cell infiltration. In addition, renal lesions of the animal infected with STEC and treated with GEN showed focal inflammatory cell infiltration in the renal interstitial tissue and deteriorating alterations of the renal tubular epithelium. The histopathological scores (Tables 3 and 4) demonstrated that mice treated with 9-methoxyelliptice had no renal cast, subcapsular and interstitial hemorrhage, necrotic alterations of tubular epithelium, and interstitial inflammatory cell infiltration. The fecal counts of _E. coli_ in animal feces decreased to \(5\times 10^{1}\) after ten days of administration of 9-methoxyellipticine, but those for the GEN-treated animal decreased from \(1\times 10^{8}\) to \(2\times 10^{3}\). Conversely, 9-methoxyellipticine and GEN can decrease the bacterial loads of _K. pneumoniae_ from \(23\times 10^{6}\) to \(3\times 10^{2}\) and from \(2\times 10^{6}\) to \(>\)220 \(\times 10^{2}\), respectively (Tables 5 and 6). In addition to this, the calculation of colonizing _K. pneumoniae_ in pulmonary and renal tissues reflected a substantial decline in the bacterial count to \(5\times 10^{1}\) in lungs and to total eradication in kidneys. As is known, MDR STEC infection outbreaks in humans or animals cause a vast risk to public health and safety. Over 700,000 deaths per year globally are due to infection with MDR bacteria [46]. Therefore, finding alternative antibacterial agents with limited side effects has become a must. [PERSON] et al. [20] who tested ellipticine HCl against multidrug-resistant extraintestinal pathogenic _E. coli_ reported a MIC nearly half that obtained with 9-methoxy ellipticine (1000 \(\upmu\)g /mL for ellipticine HCl and 500 \(\upmu\)g /mL for 9- methoxy ellipticine). In addition, the in vivo antibacterial assessment revealed an effective bactericidal activity that was proven by lowering bacterial count to \(2\times 10^{1}\) and \(5\times 10^{1}\) in the lungs and feces, respectively. Therefore, it can be seen that the isolated compound has powerful bactericidal activity. Furthermore, the scoring of histopathological renal and pulmonary lesions revealed a remarkable enhancement in the severity of tissue damage and this indeed proves the ability of 9-methoxy ellipticine to attenuate bacterial pathogenicity.