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Open wounds are easily susceptible to infection by multi-drug resistant (MDR) pathogens. The emergence of MDR super bacteria such as Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus spp, fungi such as Aspergillus niger and Candida spp, has been identified to significantly increase the incidence rate. Therefore, it is necessary to develop a suitable barrier to prevent infection and enhance wound healing. On the other hand, medicinal plants could represent a significant source of new antimicrobial drugs for combating MDR pathogens. Out of 60 clinical skin burn cases, 51 patients (85%) had polymicrobial infections, while the remaining had monomicrobial infections. Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumonia were identified as the most common bacterial isolates based on morphological and biochemical tests. However, Candida albicans, Candida parasitosis, Candida glabrata, Candida famata, Aspergillus niger, and Exophilia spinifera were the most common fungal isolates found in skin burn cases. MDR classification was reported in 21 of the 39 bacterial isolates and 8 of the 27 fungal isolates. The antimicrobial activity of tested acetonic plant extracts rosemary, henna, and licorice against MDR isolates was compared to the commercial antibiotic agents. Acetonic rosemary extract outperformed henna and licorice extracts in antibacterial activity, while licorice extract outperformed henna and rosemary extracts on antifungal activity. As a result, rosemary and licorice extracts were chosen to prepare a topical cream for further in vivo wound healing and histopathology. Based on the antimicrobial potential of acetonic plant extracts against MDR isolates, BI-41 and FI-17 were chosen for in vivo wound healing. BI-41 stands for the molecularly identified species Pseudomonas aeruginosa SSM-15, while FI-17 stands for molecularly identified species Aspergillus niger SSM-27. In vivo testing showed that both cream formulas had excellent healing properties when administered topically. In vivo histopathological examination revealed that acetonic rosemary and licorice extract could be promising for wound healing, combating MDR pathogens of burn wound infections.

Exploring the therapeutic potential of acetonic plant extracts in the healing of skin wounds infected with multidrug resistant pathogens