Antibacterial Activity of Psidium guajava Linn

The major phytochemical groups that have bactericidal activity are reported to be

phenolic acids, quinones, saponins, flavonoids, tannins, coumarins, terpenoids and alkaloids.

Major active compounds for antibacterial activity found in Psidium guajava L are flavonoids

(morin-3-O-lyxoside, morin-3-O-arabinoside, quercetin, and quercetin-3-O-arabinoside),

where guava leaves extracts have better bactericidal action against gram-positive bacterial

and fungal strains. It was reported that aqueous, methanol and ethanol extracts of the plant

effective against both Gram-positive pathogens such as Staphylococcus aureus, Bacillus

cereus and Gram-negative pathogens such as Salmonella typhi and Escherichia coli in

antibacterial activity (Rattanachaikunsopon & Phumkhachorn, 2010; Alo, Eze, & Anyim,

2012; Biswas et al., 2013; Ara Farhana et al., 2017).

2.2 URINARY TRACT INFECTION

According to Mayo Clinic, urinary tract infection is defined as infection in any part of

urinary system where it includes kidney, ureters, bladder and urethra but commonly affect

lower urinary tract which consists of bladder and urethra. There have been several studies in

the literature reporting that urinary tract infection not only involves the lower part of urinary

system, the infection can involve both lower and upper part of urinary tract. Term used to

define bladder infection that includes signs and symptoms is called cystitis where it shows

dysuria and urgency (Balakrishnan Indran, 2011). Meanwhile, infection that involved upper

tract infection is defined as acute pyelonephritis where it can cause flank pain and tenderness.

Urinary tract infection can be categorised into uncomplicated and complicated.

Previous research has shown that uncomplicated urinary tract infection is caused by normal

anatomical and physiological non-resident infectious resident (Balakrishnan, Indran, 2011).

Meanwhile, complicated urinary tract infection is infected by abnormal structural and

functional urinary tract in patient such as obstruction due to any cause or neurological

disorder (Kattan, 2013).

In 2015, Flores-Mireles, et al., stated there are around 150 million urinary tract

infection cases have been reported annually worldwide where it is more common in affecting

women (35%) (Sharms, Verma, 2009) compare in men due to anatomical predisposition and

a woman’s shorter urethra (Al-Badr & Al-Shaikh, 2013). It has been suggested that 50% of

women between ages 20 – 40 may have reoccurrence of UTIs if they had infected before

(Mustafa & Balingi, 2012).

 Urinary infection tract causing pathogen consists of Escherichia coli, Candida

albicans, Enterococcus faecalis, Pseudomonas aeruginosa, Klebsiella pneumonia and

Proteus mirabilis (Sharma, Chandraker, Patel, & Ramteke, 2009). Several studies have

revealed that Enterobacteriaceae family is causing UTIs both inpatients and outpatient

(Sharms, Verma, 2009). UTIs is mainly caused by a single bacteria species E.coli where it is

capable in causing infection in human (Kumar & Parameshwari, 2017). Staphylococcus sp.

from gram positive is another reason to cause an infection even though it is less common in

case (Engelkrik, Burton, 2004; Al-Jiffri et al., 2011). Nevertheless, bacteria such as Proteus

spp, Enterobacter spp, Enterococcus spp, Staphylococcus spp and Pseudomonas aeruginosa

are more common in recurrent cases (Balakrishnan Indran, 2011). UTIs bacteria may become

resistant to antibiotic overtime if a person has multiple antibiotic exposures for other illness.

There is a large volume of published studies describing that E.coli being the principal

pathogen in uncomplicated UTIs (90%) and complicated UTIs (78%) (Arslan, Azap, Ergönül,

& Timurkaynak, 2005). Antibiotic such as Trimethoprim/ sulfamethoxazole, ciprofloxacin,

semi-synthetic penicillin with or without inhibitors and nitrofurantoin are used in treating

UTIs (Arslan et al., 2005). However, due to high cost of antibiotics, antibiotics toxicity and

resistance phenomenon, the treatment for UTIs is complicated (Jean-De-Dieu Tamokou, et

al., 2017). For instance, Arslan (2005) found that trimethoprim/ sulfamethoxazole has the

prevalence of resistance lower than 10 – 20 % in treating of UTIs according to Infectious

Disease Society of America (IDSA) guidelines yet it is an ideal agent as they achieved good

urine concentration and tend not to disturb the anaerobic flora of gut and vagina. Thus, plants

contained antibacterial properties are being studied to replace the highly cost drug.
2.3 ESCHERICHIA COLI (E.coli)

2.3.1 Classification

Kingdom : Procaryotae

Domain : Bacteria

Phylum : Proteobacteria

Class : Gamma Proteobacteria

Order : Enterobacteriales

Family : Enterobacteriaceae

Genus : Escherichia

Species : Escherichia coli