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Microbiological safety of essential oils used in complementary therapies and

activity of these compounds against bacterial and fungal pathogens

Article  in  Supportive Care in Cancer · April 1999

DOI: 10.1007/s005200050235 · Source: PubMed

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Support Care Cancer (1999) 7:100–102
DOI 10.1007/s005209800532 SHORT COMMUNICATION
© Springer-Verlag 1999

Fiona Maudsley Microbiological safety of essential oils

Kevin G. Kerr
used in complementary therapies and
the activity of these compounds against
bacterial and fungal pathogens

Abstract To determine the safety of Key words Aromatherapy ·

Electronic publication: 14 December 1998
Presented (in part) at the Summer Meeting
of the Pathological Society of Great Britain
& Ireland, Leicester, July 1998
F. Maudsley, B.Sc.
Department of Microbiology,
University of Leeds, Leeds LS2 9JT, UK
K.G. Kerr, B.Sc., M.D., MRCPath (✉)
Department of Microbiology,
University of Leeds, Leeds LS2 9JT, UK
e-mail: mickgk@leeds.ac.uk
Tel.: +44 113 233 5617
Fax: +44 113 233 5649
plant essential oils we determined the Essential oils
sterility of eight of these products ob-
tained from retail outlets. In addition,
the ability of oils to support the
growth of fungal and bacterial patho-
gens was examined. The antimicro-
bial activity of these products against
seven bacterial species and Candida
albicans was also investigated. All
oils and their respective carriers were
sterile. Methicillin-resistant Staphylo-
coccus aureus and Pseudomonas
aeruginosa were unable to survive in
oils for longer than 6 h, whereas C.
albicans was able to survive, but not
multiply, in ylang ylang oil for at least
48 h.

Accordingly, we assessed the sterility of a range of prod-

Introduction
Infection remains a major cause of morbidity and mortali-
ty in cancer patients. Traditionally, patients undergoing
myeloablative therapy for haematological malignancies
have been regarded as being most predisposed to infec-
tion, but the growing use of more aggressive chemothera-
peutic regimens in the management of solid tumours,
which result in episodes of profound neutropenia, is likely
to render increasing numbers of these patients vulnerable
to infection. Increasingly, complementary and alternative
medicines are used as an adjunct to conventional regimens
in the management of patients with cancer [4, 5]. Al-
though it is recommended that massage of patients with
underlying malignancy is undertaken only by health care
professionals, it is, nevertheless, important to determine
whether materials used in these practices are a potential
source of either conventional or opportunistic pathogens.
ucts that are commercially available “off the shelf” and al-
so their ability to support the growth of several microbial
pathogens that might contaminate these oils under in-use
conditions. As there is increasing evidence to suggest that
some essential oils may have inherent antimicrobial prop-
erties, we examined the activity of eight commercially
available essential oil products against a range of bacterial
and fungal pathogens.
Materials and methods
The following essential oils were each purchased from one of three
reputable retail outlets; patchouli (Pogostemon cablin), myrrh
(Commiphora myrrha), bergamot (Citrus bergamia), geranium (Ge-
ranium maculatum), sandalwood (Santalum album), ylang ylang
(Cananga odorata), and tea tree (Melaleuca alternifolia). Lavender
(Lavendula officinalis) was purchased from two of these outlets. All
were produced by steam distillation, with the exception of bergamot,
 101

7 7

6 6

5 5
Log10 cfu / ml

Log10 cfu / ml
Bergamot Bergamot
4 4
Ylang Ylang Ylang Ylang
3 Control 3 Control

2 2

1 1

0 0
0 2 4 6 24 48 0 2 4 6 24 48
Time (h) Time (h)

Fig. 1 Survival of Pseudomonas aeruginosa in essential oils Fig. 3 Survival of Candida albicans in essential oils

6
Minimum inhibitory concentrations (MICs) were determined us-
5 ing a modification of a broth microdilution method [1] using Le-
theen broth supplemented with 0.5% triphenyl tetrazolium chloride.
Log10 cfu / ml

4 Each oil was tested over a dilution range of 0.0625–4.0% (v/v) with
Bergamot
an inoculum of 5×104 cfu/ml bacteria and 5×106 cfu/ml C. albicans.
3 Ylang Ylang Each oil/microbial combination was tested in triplicate.
Control
2

1
Results

0 None of the eight essential oils and three carrier oils yield-
0 2 4 6 24 48
Time (h)
Fig. 2 Survival of methicillin-resistant Staphylococcus aureus in
essential oils
which was derived from cold expression. Base oil as recommended
by each of the retailers was also purchased.
The bacterial strains employed were: Staphylococcus aureus
(NCTC 6571; NCTC 10442 [methicillin resistant]); Escherichia coli
(NCTC 10418); Pseudomonas aeruginosa (NCTC 10662); Entero-
coccus faecalis (NCTC 2421); coagulase-negative staphylococcus
(NCTC 7944); Stenotrophomonas maltophilia (CXC 1) and Candida
albicans (14850). The last two strains were clinical isolates from the
diagnostic laboratories of Leeds General Infirmary. All isolates were
maintained on horse blood agar at 4°C with weekly subcultures until
use.
Two hundred microlitres of each oil was added to 19.8 ml of Le-
theen broth (Difco) supplemented with 0.01% Triton X-100 and in-
cubated at 20°C, 30°C and 37°C for 48 h before subculture to tryp-
tone soya agar containing 0.07% lecithin and 0.5% Tween 80
(TSALT agar). Plates were incubated for 48 h at the temperatures de-
scribed previously.
Bergamot and ylang ylang oils were prepared according to the
manufacturers’ recommendation: 5 drops (approximately 150 ml) es-
sential oil in 10 ml carrier oil. Overnight broth cultures of each strain
were adjusted in sterile saline to 1×106 colony forming units (cfu)/ml
for P. aeruginosa and methicillin-resistant S. aureus and 4×106
cfu/ml for C. albicans. Oils were inoculated with 1 ml of each sus-
pension and incubated at 37°C. Aliquots were removed at 0, 2, 4, 6,
24, and 48 h, and a decimal dilution series from 10–1 to 104 in 0.1%
peptone water was prepared. Neat oils and their respective dilution
series were plated onto TSALT medium and the plates incubated at
37°C for 24 h, whereupon colonies were counted.
ed any bacterial or fungal growth on culture.
Neither the methicillin-resistant S. aureus nor the P.
aeruginosa isolates were able to survive in bergamot oil
for longer than 2 h. In ylang ylang, the survival times were
4 h and 6 h, respectively. In contrast, C. albicans was able
to survive, but not to multiply, in ylang ylang for ≤48 h,
but was not able to survive in bergamot oil (see Figs. 1–3).
The MICs of each oil against seven bacterial pathogens
and against Candida albicans are shown in Table 1.
Discussion
On the basis of this very limited survey, it would appear
that essential oils purchased from reputable retailers are
safe for use by cancer patients rendered immuno-
compromised by their underlying malignancy or antineo-
plastic therapy. It must be acknowledged, however, that
the number of samples tested was very small, and further
work is necessary before it can be unequivocally stated
that these products are safe. However, as we have shown
with C. albicans and ylang ylang oil, contamination under
in-use conditions may lead to survival of a potential patho-
gen in some of these products, which may then become a
source of subsequent infection.
The activity of essential oils against a selection of mi-
croorganisms associated with nosocomial infection was
determined as MICs. Although broth microdilutions are
technically more difficult to manipulate than aqueous so-
lutions of conventional antimicrobials, the reproducibility
102

Table 1 Minimum inhibitory concentrations (% v/v) of eight essential oils from three retail outlets: A, B, C (CNS coagulase-negative strep-
tococcus, MRSA methicillin-resistant Staphylococcus aureus)

Organism Lavender Lavender Geranium Sandalwood Tea tree Ylang Ylang Patchouli Myrrh Bergamot
A B A A B B C C C

CNS 0.5 0.125 0.125 1.0 0.5 1.0 0.5 0.125 1.0
S. aureus 0.0625 0.125 >4.0 2.0 0.5 1.0 0.5 0.125 0.5
MRSA 2.0 0.125 0.125 1.0 0.5 2.0 0.5 0.25 0.5
E. faecalis 2.0 2.0 1.0 4.0 1.0 1.0 1.0 0.5 4.0
E. coli 0.125 0.5 0.125 >4.0 0.0625 0.5 1.0 1.0 0.5
P. aeruginosa >4.0 >4.0 >4.0 >4.0 >4.0 >4.0 >4.0 >4.0 4.0
S. maltophilia 1.0 0.5 1.0 >4.0 0.5 0.5 0.5 1.0 0.5
C. albicans 1.0 1.0 0.25 >4.0 2.0 1.0 4.0 0.125 4.0

was good. On all occasions, MIC determinations were per-
formed in triplicate, and in those instances when results
were not in complete agreement there was never more
than one doubling dilution of difference. Bergamot oil was
the most active against P. aeruginosa. With the exception
of sandalwood, each oil appeared to be active against
Gram-positive and Gram-negative microorganisms and
against C. albicans. Interestingly, lavender oil from outlet
A yielded different results (>2 doubling dilutions) from
that obtained from outlet B against the coagulase-negative
staphylococcus E. faecalis and against E. coli. These find-
ings have implications not only for the intralaboratory re-
producibility of MIC determinations, but also for compari-
son of results obtained in studies undertaken by different
centres. Further analysis of other examples of the same
product from different outlets (and by implication different
manufacturers) and of different lots of a given oil from the
same outlet is, therefore, warranted.
Conclusions
We conclude that essential oils can safely be used as com-
plementary therapies by immunosuppressed cancer pa-
tients, although care must be taken not to contaminate
these products under in-use conditions. We and others [2,
3] have shown that essential oils have inherent antimicro-
bial activity and that these agents may ultimately be used
therapeutically in this respect, although further studies ex-
amining much larger numbers of strains are necessary.

References
1. Carrson CF, Cookson BD, Farrelly HD,
Riley TV (1995) Susceptibility of
methicillin-resistant Staphylococcus
aureus to the essential oil of Melaleuca
alternifolia. J Antimicrob Chemother
35:421–424
2. Lis-Balchin M, Deans SG (1997)
Bioactivity of selected plant essential
oils against Listeria monocytogenes.
J Appl Microbiol 82:759–762
3. Nelson RRS (1997) In vitro activities of
five plant essential oils against methicil-
lin resistant Staphylococcus aureus and
vancomycin resistant Enterococcus
faecium. J Antimicrob Chemother
40:305–306
4. Wilkinson S, Leslie K (1995)
Aromatherapy massage – does it
improve cancer patients’ quality of life?
Eur J Cancer 31:1342
5. Wilson B (1995) Practical steps in
establishing a therapeutic massage
service. Eur J Cancer 31:1342

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