Title : Effect of aloe vera extracts on multi-drug resistant bacterial isolates from semen of infertile men in northern iran
Abstract:
Background and Objectives: One of the important causes of infertility in men is genitourinary tract infections. Some microorganisms disrupt parameters such as number, motility, viability, morphology and function of sperm, as well as inflammation of the epididymis, and prostate through adhesion or agglutination. On the other hand, with increasing antibiotic resistance, control and treatment of infections have become a bit difficult. Therefore, failure to identify and control genital infections in men can increase the prevalence of infertility. This study aimed to determine the frequency of bacterial isolates and investigate the antimicrobial activity of Aloe vera extracts against the isolates in semen of infertile individuals with unknown cause. Materials and Methods: In this descriptive cross-sectional study, semen of infertile men (n=96) referred to laboratories in Gorgan, northern Iran, was examined during 2022-2023. At first, semen analysis was determined in terms of semen volume, liquefaction time, pH, concentration, morphology, motility and white blood cell count according to the guidelines of the World Health Organization. Microbiological methods and chemical tests were used to isolate possible bacterial agents in semen. The antibiotic susceptibility test on isolates was performed by Kirby-Bauer method according to CLSI-2021 guidelines. The minimum inhibitory concentration (MIC) of the Aloe vera extracts was determined by microdilution method.
Results: Examination of Spermograma of 35 positive microbial cultures (36.5%) of the total semen samples of infertile people showed that the indicators of number, movement and morphology were 41%, 54%, 76%, respectively, and in all samples the number White blood cells were higher than normal (1- 0). Also, the pH of 42% of people was higher than normal (7.1-8). Of the thirty-five positive samples, (97.1%, 34) samples were infected with bacteria, and the highest frequency with a rate of 45% belonged to Staphylococcus aureus. Escherichia coli, Staphylococcus epidermidis and Klebsiella pneumoniae were isolated from other bacterial agents. The highest resistance and susceptibility were observed in S. aureus isolates to azithromycin (57%) and vancomycin (100%), respectively. This frequency was observed in E. coli isolates to gentamicin (33%) and ceftriaxone (86%), In S. epidermidis isolates to cefazolin (75%) and vancomycin (100%), and in K. pneumoniae isolates to cefixime (25%) and ceftriaxone (80%), respectively. The inhibitory activity of the Aloe vera honey extract was significantly higher than the Aloe vera leaf extract (P<0.01). 25.7% of S. aureus isolates, 35.7% of E. coli Isolates, 41.0% of S. epidermidis and 38.7% of K. pneumoniae multi-drug resistant isolates respectively, did not grow in concentrations with MIC?1024 μl/ml.
Conclusion: Urinary tract infection can lead to disorders in the male reproductive system. Therefore, timely examination and treatment of such infections can prevent semen infection and infertility to some extent. According to the results of the present study, the aloe vera honey extract showed proper inhibitory effects on semen bacterial isolates at high concentrations.
