Reduction Effect of Royal Jelly and Rape Honey Alone and in Combination Against Methicillin-Resistant Staphylococcus aureus (MRSA) Strains

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Journal of Bacteriology and Virology 2016. Vol. 46, No. 1 p.36 43 http://dx.doi.org/10.4167/jbv.2016.46.1.36 Original Article Reduction Effect of Royal Jelly and Rape Honey Alone and in Combination Against Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Dinko Dinkov 1*, Deyan Stratev 1, Ralitsa Balkanska 2, Daniel Sergelidis 3 and Ivan Vashin 1 1 Department of Food Hygiene and Control, Veterinary Legislation and Management, Trakia University, Faculty of Veterinary Medicine, 6000 Stara Zagora, Bulgaria; 2 Department of Special Branches - Bees, Institute of Animal Science, Kostinbrod, Bulgaria; 3 School of Veterinary Medicine, Aristotle University of Thessaloniki, Greece Multidrug resistant and methicilin-resistant Staphylococcus aureus (MRSA) is involved in severe difficult to treat skin and soft tissue infections in humans. In the present study the antibacterial reduction effect of royal jelly (RJ), rape honey (RH), as well as in combination (RJ:RH, 1:100 w/w) against multidrug resistant MRSA strains was evaluated by means of a microbiological method "in vitro". Royal jelly and rape honey mixture possessed a higher antibacterial activity than rape honey. The concentrations of royal jelly (20 and 30% v/v) had a total inhibitory effect against tested MRSA strains. Royal jelly alone and in rape honey mix (RJ:RH, 1:100 w/w) have a potential as alternative therapeutics against MRSA strains, resistant for antibiotics. Key Words: Bee honey, Royal jelly, Antibacterial activity, Methicilin-resistant Staphylococcus aureus INTRODUCTION The broad spectrum of antibacterial activity of honey is mainly against gram positive bacteria (1) gram-positive and gram-negative (2), and also fungi and yeasts (3) is highly complex due to the involvement of multiple compounds and due to the large variation in the concentrations of these compounds among honeys. The antimicrobial action of the hydrogen peroxide in honey that is produced by glucose oxidase (4, 5), the high osmolarity (honey consists of 80% w/v of sugars) (5), the presence of lysozyme and its high antimicrobial potential (6) are well characterized (7). Recently, methylglyoxal (MGO) in manuka honey and the antimicrobial peptide bee defensin-1 in revamil honey have been identified as important antibacterial compounds (8, 9). The high antibacterial effect of RJ has also been reported (10, 11). The antibacterial activity of royal jelly, rape honey, individually and in combination has been reported against resistant strain of Escherichia coli (12) and Aeromonas hydrophila (ATCC 7965) (13). Antibiotic-resistant bacteria represent a critical problem in modern medicine world-wide (14) and consequently; scientific efforts have been developed to control bacterial infections with alternative medicines beyond conventional antibiotic therapy. Among these alternative therapeutic agents are honey (15), propolis (16) and royal jelly (17). The difference between MRSA and other forms of S. aureus is that MRSA has become resistant to many kinds of antibiotics, making it more difficult to treat. Antimicrobial activities of Received: January 5, 2016/ Revised: February 1, 2016/ Accepted: February 5, 2016 * Corresponding author: Dinko Dinkov, PhD. Department of Food Hygiene and Control, Veterinary Legislation and Management, Trakia University, Faculty of Veterinary Medicine, 6000 Stara Zagora, Bulgaria. Phone: +35942699539, Fax: +3594257002, e-mail: dinkodinkov@abv.bg CC This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/license/by-nc/3.0/). 36

Effect of Honey on MRSA 37 Table 1. Physicochemical parameters of rape honey Parameters Mean SD Maximum Minimum Water content (%) 16.8 0.2108 17 16.6 Free acidity (meq.kg -1 ) 36.3 1.1595 38 35 рh 3.232 0.01032 3.25 3.22 Conductivity (ms.cm 1 ) 0.128 0.00105 0.13 0.127 Diastase activity (Ghote), (DN) 12.9 0.1051 13.1 12.8 Hydroxymethilfurfurol (HMF), (mg.kg -1 ) 14.89 0.3528 15.36 14.4 Invertase activity (IN) 10.643 0.0241 10.69 10.62 20 Specific optical rotation, [α] D (-) 12 0.8164 (-) 13 (-) 11 royal jelly (RJ), rape honey (RH), as well as in combination (RJ:RH, 1:100 w/w) against MRSA strains with multidrug resistance not has been reported previously. The aim of this study was to determine the antimicrobial effect of rape honey and royal jelly, individually or in combination (RJ:RH, 1:100 w/w) against MRSA strains with multidrug resistance. MATERIALS AND METHODS Test substances Test substances were Bulgarian rape honey (RH), royal jelly (RJ) and mix of royal jelly and rape honey (RJ:RH), (1:100 w/w). The rape honey and royal jelly were obtained from beekeepers, immediately after the flowering of rape from the region of Stara Zagora, Bulgaria. During the honey collection period bees were not supplemented with carbohydrate syrups or treated with antimicrobial drugs. Until the analysis, samples were stored in sterilized jars in refrigerator at 0~4. Water content, ph, free acidity, electrical conductivity, diastase and invertase activity, specific optical activity and hydroxymethylfurfurol (HMF) content were assayed as per the harmonized methods of the European honey commission (18). The botanical origin of the samples was established by their melissopalynological, organoleptic, physical and chemical characteristics (19). All data referring to physical and chemical parameters of rape honey were statistically processed by the Student's t-test and presented as mean and standard deviation (SD) (Table 1). Royal jelly was pipetted directly from queens cells. The following parameters of samples were determined: sugars (fructose, glucose, sucrose by HPLC according to Sesta (20); proteins by Folin-Ciocalteu reagent; water content by refractometry; dry matter of the sample by subtracting the water content from 100; ph values by potentiometrically by ph meter Mi 150 (1% water solution of royal jelly); total acidity by titration with 0.1 N NaOH; electrical conductivity of 1% water solution of royal jelly by conductometer (18, 21) (Table 2). Royal jelly was stored prior to analyses in a dark bottle in freezing conditions (-20 ). Solutions containing 10, 20, 30 and 40% (v/v) of each test substances were prepared in sterile Tryptic Soy Broth (TSB) (Merck, Darmstadt, Germany). To prevent photodegradation of glucose oxidase, associated with antimicrobial activity in honey (21) all test substances were stored in the dark and dilutions were prepared immediately prior to testing (22). All data referring to physical and chemical parameters of used for s rape honey and royal jelly were statistically processed by the Student's t-test and presented as mean, standard deviation (SD), minimum and maximum values (Tables 1 and 2). Bacterial strains and preparation of inoculum Three MRSA isolates belonging to Dr. D. Sergelidis collection were used in our study. These isolates belonged to spa types t127 (isolated from goat carcass), t4038 (isolated

38 D Dinkov, et al. Table 2. Physicochemical characteristics of royal jelly Parameters Mean SD Maximum Minimum Water content (%) 62.7 1.43452 63.7 60.2 ph 3.97 0.07776 4.06 3.78 Total acidity (ml 0.1n NaOH/g) 4.08 0.38084 4.51 3.31 Electrical conductivity (μs/cm) 197 14.0791 224 180 Proteins (%) 16.94 1.37065 19.36 14.81 Fructose (%) 4.83 0.75832 6.19 3.59 Glucose (%) 3.85 0.99522 5.65 2.7 Sucrose (%) 1.70 0.86652 4.25 0.64 Table 3. Experimental data for dilutions of 0.5 McFarland standard and isolation rate of tested MRSA strains on Baird Parker agar with 0.01 and 0.0025% w/v potassium telluride Dilution of 0.5 McFarland standard % potassium telluride MRSA t127 CFU (0.1 ml) MRSA t548 CFU (0.1 ml) MRSA t4038 CFU (0.1 ml) 10-1 0.0025% > 10 7 > 10 7 > 10 7 0.01% > 10 7 > 10 7 > 10 7 10-2 0.0025% > 10 6 > 10 6 > 10 6 0.01% > 10 6 > 10 6 > 10 6 10-3 0.0025% > 10 5 > 10 5 > 10 5 0.01% 284 / 125 > 10 5 > 10 5 0.0025% 165 / 185 388 / 369 349 / 336 10-4 0.01% 98 / 82 176 / 173 3 / 3 0.0025% 45 / 36 59 / 31 45 / 33 10-5 0.01% 6 / 4 18 / 17 2 / 0 0.0025% 8 / 3 7 / 4 6 / 2 10-6 0.01% 0 / 0 1 / 0 0 / 0 0.0025% 1 / 0 1 / 0 0 / 0 10-7 0.01% 0 / 0 0 / 0 0 / 0 from unpasteurized goat's milk) and t548 (isolated from marinated anchovies). They were multidrug resistant exhibiting resistance to three or more antibiotic classes. Only strain belonged to spa type t127 was found to carry the specific meca gene (20). Strains were stored in cryo-tubes containing Tryptone Soy broth (Merck, Darmstadt, Germany) supplemented with 15% glycerol at -80. Prior to s the MRSA strains were incubated for 35 in TSB (Merck, Darmstadt, Germany) for 24 h and then a loopfull was streaked onto Blood agar and incubated for 24 h at 35. Three to four colonies were taken from the Blood agar and suspended in 5 ml sterile physiological solution for preparation of bacterial suspension adjusted to the 0.5 McFarland standard (1.5 10 8 CFU/ml). Decimal dilutions to 10-4 in 9 ml sterile TSB were prepared from the initial suspension.

Effect of Honey on MRSA 39 Experimental design Because of possibility that potassium tellurite in Baird Parker agar could have inhibitory effect for Staphylococcus aureus and it should be reduced to maximize the isolation rate it was made initial with MRSA strains. It was found that dilutions of bacterial suspension adjusted to the 0.5 McFarland standard (1.5 10 8 CFU/ml) from all MRSA strains possessed different isolation rate in Baird- Parker agar with 0.01 and 0.0025% w/v after 24 h incubation at 35. The high isolation rate in Baird Parker agar with 0.0025% w/v potassium telluride explain using of this percent for next s with RH, RJ:RH and RJ (Table 3). Dilutions of test substances In sterile glass were weigh 20 g of rape honey (RH) and add 20 ml sterile TSB to prepare 50% (w/v). For preparing of mix from rape honey and royal jelly (RJ:RH, 1:100 w/w) in sterile glass were weigh 0.2 g of royal jelly and add 20 g of rape honey. To prepare 50% (w/v) solution from RJ:RH (1:100 w/w mix) then add 20.2 ml of sterile TSB. To prepare 50% (w/v) RJ solution with sterile stick were weigh equal parts royal jelly and sterile TSB. All initial solutions were shake well with glass sticks. From initial 50% (w/v) solutions were made 5.7 ml 10, 20, 30 (RJ) and 40% (v/v) (RH and RJ:RH) solutions. The tubes were inoculated with the bacterial cultures from each MRSA isolate according to the method described by Patton et al. (23). After contamination all solutions were incubated at 35 for 24 h for first and respectively for 48 h for second. In order to the determination of survived staphylococci after 24 and 48 h, serial 10-fold Dilution Table 4. Calculation and convertion to logarithmic CFU /ml for positive controls Mean values from 2 Petri dishes 1st 2nd Mean from two s MRSA spa type t127 Positive control (contamination) CFU/ml log CFU/ml 10-4 216 229 222.5 2.2 10 3 3.34 Positive control (10-4 ) after incubation for 24 h 10-5 146 169 157.5 1.6 10 8 8.2 10-6 Uncountable - - - - MRSA spa type t548 Positive control (contamination) 10-4 148 152 150 1.5 10 3 3.17 Positive control (10-4 ) after incubation for 24 h 10-5 62 78 70 0.7 10 8 7.85 10-6 Uncountable - - - - MRSA spa type t4038 Positive control (contamination) 10-4 155 170 162.5 1.6 10 3 3.2 Positive control (10-4 ) after incubation for 24 h 10-5 91 96 93.5 9.35 10 7 7.97 10-6 Uncountable - - - -

40 D Dinkov, et al. dilutions in 0.1% peptone water supplemented with 2.5% NaCl were prepared. Thereafter, 0.1 ml from each tube was streaked onto Baird Parker agar (Merck, Darmstadt, Germany) containing 0.0025% w/v potassium telluride and rabbit plasma fibrinogen. Typical S. aureus colonies were counted after incubation at 35 for 24 h. For the detection of survivors at populations lower than 10 CFU/g, the first dilution was incubated for enrichment at 35 for 24 h and then 10 μl were spread plated on Baird Parker agar. The s were performed twice and the results Table 5. Antibacterial activity of Rape Honey (RP), Royal Jelly (RJ) and mix RJ:RH (1:100) at several concentrations in Tryptone Soy broth (TSB) against MRSA t127 Substance Initial inoculum Positive control Count after 24 h RH 3.34 log CFU/ml 8.2 log CFU/ml RJ 3.34 log CFU/ml 8.2 log CFU/ml RJ:RH (1:100) 3.34 log CFU/ml 8.2 log CFU/ml Concentration Counts after first (24 h) Counts after second (48 h) 10% >8 log CFU/ml >8 log CFU/ml 20% >8 log CFU/ml >8 log CFU/ml 30% 3.53 CFU/ml 1.39 CFU/ml 40% 0 0 10% >8 log CFU/ml >8 log CFU/ml 20% 0 0 10% >8 log CFU/ml >8 log CFU/ml 20% 3.58 log CFU/ml 2.11 log CFU/ml 40% 0 0 Table 6. Antibacterial activity of Rape Honey (RP), Royal Jelly (RJ) and mix RJ:RH (1:100) at several concentrations in Tryptone Soy broth (TSB) against MRSA t548 Substance RH Initial inoculum 3.17 log CFU/ml Positive control Count after 24 h 7.85 log CFU/ml RJ 3.17 log CFU/ml 7.85 log CFU/ml RJ:RH (1:100) 3.17 log CFU/ml 7.85 log CFU/ml Concentration Counts after first (24 h) Counts after second (48 h) 10% >7 log CFU/ml >7 log CFU/ml 20% >7 log CFU/ml >7 log CFU/ml 30% >7 log CFU/ml >7 log CFU/ml 40% 3.54 log CFU/ml >7 log CFU/ml 10% 0 0 20% 0 0 10% >7 log CFU/ml >7 log CFU/ml 20% >7 log CFU/ml >7 log CFU/ml 30% >7 log CFU/ml >7 log CFU/ml 40% 0 3.47 log CFU/ml

Effect of Honey on MRSA 41 Table 7. Antibacterial activity of Rape Honey (RP), Royal Jelly (RJ) and mix RJ:RH (1:100) at several concentrations in Tryptone Soy broth (TSB) against MRSA t4038 Substance Initial inoculum Positive control Count after 24 h RH 3.2 log CFU/ml 7.97 log CFU/ml RJ 3.2 log CFU/ml 7.97 log CFU/ml RJ:RH (1:100) 3.2 log CFU/ml 7.97 log CFU/ml Concentration Counts after first (24 h) Counts after second (48 h) 10% >7 log CFU/ml 3.47 log CFU/ml 20% >7 log CFU/ml 3.26 log CFU/ml 30% 3.29 log CFU/ml 0 40% 0 0 10% 0 0 20% 0 0 10% >7 log CFU/ml >7 log CFU/ml 20% 0 0 40% 0 0 are presented as mean values. To calculate the reduction rate the counts of MRSA cells in the positive controls after 24 h incubation in TSB (Table 4) was compared with results from two s (Tables 5, 6, and 7). All analyses were done in Department of "Food Hygiene and Control, Veterinary Legislation and Management", Trakia University, Faculty of Veterinary Medicine, Stara Zagora, Bulgaria. RESULTS There were not survived cells of MRSA t127 (3.34 log10 reduction) after 24 h of incubation in TSB with 40% RH, with 20 and 30% RJ and with 30 and 40% mix of RJ:RH (1:100). A reduction of 1.95 log10 and 1.23 log10 was observed in TSB with 30% RH and 20% RJ:RH (1:100) after 48 h of incubation (Table 5). The counts in the other concentrations of all substances were more than 8 log10 after 48 h. A reduction of 3.17 log10 of MRSA t548 was observed after 24 h of incubation in TSA with 10, 20 and 30% RJ and with 40% RJ:RH (1:100) (Table 6). Although a reduction almost 3.17 log10 was observed after 24 h in TSA with 40% RJ:RH (1:100), count of MRSA t548 reached 3.54 log10 at 48 h. The counts in the other concentrations of all substances were more than 7 log10 after 48 h. The staphylococcal cell count of MRSA t4038 was reduced by 3.2 log10 after 24 h in TSB with 40% RH, 10, 20 and 30% RJ, 20~40% RJ:RH (1:100), and after 48 hours in TSB with 30% RH and again with 20, 30 and 40% RJ:RH (1:100) (Table 7). The population reached 7 log10 after 24 h incubation in TSB with 10 and 20% RH and then after 48 h of incubation it declined to 3.47 and 3.26 log10, respectively. In all other cases the population was grown by at least 7 log10. DISCUSSION There are not many references in the literature on the antimicrobial activity of royal jelly and honey, and particularly for the MRSA. RJ has shown antimicrobial effects against a wide range of bacteria, viruses, yeast, and fungi (24). It has been reported that RJ has antibacterial activity against both Gram-positive and Gram-negative bacteria due mainly to fatty acids present in RJ, such as trans-10- hydroxydec-2-enoic acid, 3-hydroxydodecanoic acid, 11-

42 D Dinkov, et al. oxododecanoic acid, and 11-S-hydroxydodecanoic acid (11, 24). Furthermore, a series of short peptides (jelleines, royalisin) present in RJ have also been shown to possess strong antibacterial properties against Gram-positive and Gram-negative bacteria and yeasts (17, 24~26). In study from Algeria, the minimum inhibitory concentration (MIC) of RJ was 1.7% (v/v) against S. aureus and 2% against E. coli (27). When starch was added in RJ, a MIC decrease of 61% and 30% against S. aureus and E. coli, respectively. The MIC of four varieties of honey from Algeria for S. aureus ranged between 20% and 21% (v/v), while the MIC of RJ was 2% (v/v). When honey and RJ were used jointly, all honey varieties had a more than 50% decrease in MIC with 1% (v/v) RJ (28). Manuka honey showed a MIC of 6% and 7% against methicillin-resistant and methicillin-sensitive S. aureus (29). In general from our results, by means of a microbiological method independent use of rape honey (10~30%) not have total antibacterial effect on MRSA strains. Royal jelly and rape honey mixes possessed a higher antibacterial activity than rape honey. Royal jelly alone and in rape honey mix (1:100 w/w) have a potential for alternative therapy against MRSA strains, resistant for antibiotics. Acknowledgments The authors thank the Dr. D. Sergelidis for MRSA strains. REFERENCES 1) Marcucci MC, Ferreres F, Garcia-Viguera C, Bankova VS, De Castro SL, Dantas AP, et al. Phenolic compounds from Brazilian propolis with pharmacological activities. J Ethnopharmacol 2001;74:105-12. 2) Cooper RA, Halas E, Molan PC. The efficacy of honey in inhibiting strains of Pseudomonas aeruginosa from infected burns. J Burn Care Rehabil 2002;23:366-70. 3) Moussa A, Saad A, Djebli ND, Meslem A, Benhalima AEK. Antifungal Activity of Four Honeys of Different Types from Algeria Against Pathogenic Yeast: Candida albicans and Rhodotorula sp. Int J Microbiol Res 2011; 2:276-9. 4) Taormina PJ, Niemira BA, Beuchat LR. Inhibitory activity of honey against foodborne pathogens as influenced by the presence of hydrogen peroxide and level of antioxidant power. Int J Food Microbiol 2001;69:217-25. 5) Dustmann JH. Antibacterial effect of honey. Apiacta 1979;1:1-3. 6) Bogdanov S. Nature and Origin of the Antibacterial Substances in Honey. LWT - Food Science and Technology 1997;30:748-53. 7) Willix DJ, Molan PC, Harfoot CG. A comparison of the sensitivity of wound-infecting species of bacteria to the antibacterial activity of manuka honey and other honey. J Appl Bacteriol 1992;73:388-94. 8) Adams CJ, Boult CH, Deadman BJ, Farr JM, Grainger MN, Manley-Harris M, et al. Isolation by HPLC and characterisation of the bioactive fraction of New Zealand manuka (Leptospermum scoparium) honey. Carbohydr Res 2008;343:651-9. 9) Mavric E, Wittmann S, Barth G, Henle T. Identification and quantification of methylglyoxal as the dominant antibacterial constituent of Manuka (Leptospermum scoparium) honeys from New Zealand. Mol Nutr Food Res 2008;52:483-9. 10) Blum MS, Novak AF, Taber S, 3rd. 10-hydroxy-delta 2-decenoic acid, an antibiotic found in royal jelly. Science 1959;130:452-3. 11) Melliou E, Chinou I. Chemistry and bioactivity of royal jelly from Greece. J Agric Food Chem 2005;53:8987-92. 12) Dinkov D, Stratev D, Balkanska R. In vitro atibacterial activity of Royal Gelly against pathogen Escherichia coli. Vet J Rep Srpska (Banja Luka) 2014;14:14-25. 13) Stratev D, Vashin I, Balkanska R, Dinkov D. Antibacterial activity of Royal jelly and rape honey against Aeromonas hydrophila (ATCC 7965). J Food Healh Sci 2015;1:64-74. 14) Antimicrobial resistance: Global Report on Surveillance. W. H. Organization, 2014. http://apps.who.int/iris/ bitstream/10665/112642/1/9789241564748_eng.pdf 15) Molan PC. Honey as an Antimicrobial Agent. Springer, 1997. 16) Kujumgiev A, Tsvetkova I, Serkedjieva Y, Bankova V, Christov R, Popov S. Antibacterial, antifungal and antiviral activity of propolis of different geographic origin. J Ethnopharmacol 1999;64:235-40.

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