{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T19:47:15Z","timestamp":1780343235944,"version":"3.54.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T00:00:00Z","timestamp":1464739200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:p>\n                    Emergence and spread of antibiotic-resistant\n                    <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                    have become a major public health concern. This study was designed to investigate the efficacy of\n                    <jats:italic toggle=\"yes\">Holarrhena antidysenterica<\/jats:italic>\n                    extract and its major steroidal alkaloid conessine as resistance-modifying agents (RMAs) on the susceptibility of\n                    <jats:italic toggle=\"yes\">A. baumannii<\/jats:italic>\n                    to novobiocin and rifampicin. A significant synergistic activity of both the extract and conessine in combination with either novobiocin or rifampicin with fractional inhibitory concentration index \u22640.5 was demonstrated. Fluorescent dyes and different efflux pump inhibitors were used to further investigate the synergism. Increase in the uptake of 1-\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    -phenylnaphthylamine in the bacterial cells treated with the extract and conessine was not observed indicating that both substances did not act as permeabilizers. With regard to efflux pump inhibition, no accumulation in ethidium bromide (EtBr) was noticed suggesting that the AdeABC pump was not involved. In contrast, accumulation in Pyronin Y was significantly increased (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05) demonstrating that the synergism was due to interference with the AdeIJK pump. Study on frequencies of the spontaneous mutational resistance to the extract in combination with antibiotics demonstrated attenuation in drug-resistant organisms. Thus,\n                    <jats:italic toggle=\"yes\">H. antidysenterica<\/jats:italic>\n                    extract and conessine as RMAs may offer a combinatory therapy to restore antibiotic susceptibility in the extensively drug-resistant\n                    <jats:italic toggle=\"yes\">A. baumannii<\/jats:italic>\n                    .\n                  <\/jats:p>","DOI":"10.1089\/mdr.2015.0194","type":"journal-article","created":{"date-parts":[[2016,1,8]],"date-time":"2016-01-08T23:36:02Z","timestamp":1452296162000},"page":"273-282","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":43,"title":["<i>Holarrhena antidysenterica<\/i>\n                    Extract and Its Steroidal Alkaloid, Conessine, as Resistance-Modifying Agents Against Extensively Drug-Resistant\n                    <i>Acinetobacter baumannii<\/i>"],"prefix":"10.1177","volume":"22","author":[{"given":"Thanyaluck","family":"Siriyong","sequence":"first","affiliation":[{"name":"Prince of Songkla University","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasitorn","family":"Chusri","sequence":"additional","affiliation":[{"name":"Prince of Songkla University","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Potjanee","family":"Srimanote","sequence":"additional","affiliation":[{"name":"Thammasat University","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varomyalin","family":"Tipmanee","sequence":"additional","affiliation":[{"name":"Prince of Songkla University","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supayang Piyawan","family":"Voravuthikunchai","sequence":"additional","affiliation":[{"name":"Prince of Songkla University","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1039\/c2np20035j"},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"3690","DOI":"10.1128\/JB.185.13.3690-3695.2003","article-title":"Mutants suppressing novobiocin hypersensitivity of a mukB null mutation","volume":"185","author":"Adachi S.","year":"2003","unstructured":"Adachi S., , and Hiraga S. 2003. Mutants suppressing novobiocin hypersensitivity of a mukB null mutation. J. Bacteriol., 185:3690\u20133695.","journal-title":"J. Bacteriol."},{"key":"e_1_3_3_4_2","first-page":"345","article-title":"Monograph of Holarrhena antidysenterica (linn.) Wall","volume":"2","author":"Ali shah S.M.","year":"2010","unstructured":"Ali shah S.M., , Usmanghani K., , Akhtar N., , Asif H.M., , Akram M., , Ahmed K., , Shaheen G., , Shamim T., , Rehman R., , Ahmad A., , and Sumreen L. 2010. Monograph of Holarrhena antidysenterica (linn.) Wall. Int. J. Phytomed., 2:345\u2013348.","journal-title":"Int. J. Phytomed."},{"key":"e_1_3_3_5_2","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1093\/jac\/dks084","article-title":"Colistin resistance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies","volume":"67","author":"Cai Y.","year":"2012","unstructured":"Cai Y., , Chai D., , Wang R., , Liang B., , and Bai N. 2012. Colistin resistance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies. J. Antimicrob. Chemother., 67:1607\u20131615.","journal-title":"J. Antimicrob. Chemother."},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S0378-8741(99)00119-1","article-title":"Antibacterial steroid alkaloids from the stem bark of Holarrhena pubescens","volume":"68","author":"Chakraborty A.","year":"1999","unstructured":"Chakraborty A., , and Brantner A.H. 1999. Antibacterial steroid alkaloids from the stem bark of Holarrhena pubescens. J. Ethnopharmacol., 68:339\u2013344.","journal-title":"J. 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