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The increase in resistance by pathogenic bacteria to multiple antimicrobial agents has become a significant treat, as the effective antimicrobial agents available for the patients infected by such resistant bacteria are reduced, or even eliminated. Several natural plant extracts have exhibited antibacterial and synergistic activity against various resistant microorganisms. Houttuynia cordata is frequently used by many traditional medicine practicioners for its antimicrobial, antiviral, and anti-inflammatory properties. This study investigated the antibacterial effects of H. cordata extract against clinical multi-resistant bacteria, and compared the two methods used for the antimicrobial susceptibility testing. Thirty isolates of Methicillin-resistant Staphylococcus aureus (MRSA, 10), Vancomycin-resistant Enterococcus faecium (VRE, 10), Carbapenem-resistant Acinetobacter baumannii (CRAB, 10) were included in this study. The antibacterial effect of H. cordata was tested by disk diffusion and microbroth dilution methods as per CLSI guidelines. In disk diffusion, all isolates (30) showed no inhibition to 30,000 ug/mL of H. cordata. But in the microbroth dilution method, MIC90 of H. cordata was 4,096 ug/mL, 8,192 ug/mL and 4,096 ug/mL in MRSA, VRE and CRAB, respectively. These results demonstrate that H. cordata exhibits antibacterial activity against MRSA, VRE and CRAB. Moreover, the microbroth dilution method is a more effective method than disk diffusion to evaluate the antibacterial activity of natural products. The Disk diffusion method used to evaluate the antibacterial activity of natural products required new standard guidelines including inoculum concentration of bacteria.

Antimicrobial Activity of Houttuynia cordata Ethanol Extract against Major Clinical Resistant Microorganisms