Critical Appraisal of North African Medicinal Plant Activity Against Carbapenem-Resistant Klebsiella pneumoniae and Acinetobacter baumannii

Sultana Mohamed Al-Aswad; Abdelgani  Mohammed Abobaker

doi:10.51984/qydhp576

Authors

Sultana Mohamed Al-Aswad Central Blood Bank, Sebha, Libya https://orcid.org/0009-0008-6063-8926
Abdelgani Mohammed Abobaker Sebha University, Faculty of Science, Department of Botany, Sebha, Libya https://orcid.org/0009-0002-6060-8926

DOI:

https://doi.org/10.51984/qydhp576

Keywords:

Drug resistance, bacterial Plant extracts Oils, Drug synergism, Microbial sensitivity tests, Africa, Northern

Abstract

Carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii cause hospital outbreaks across North Africa, where access to newer antibiotics is limited and plant-derived agents are widely proposed as alternatives. This critical narrative review appraises what the published evidence from Algeria, Egypt, Libya, Morocco and Tunisia can support. A scholarly index was searched on 9 October 2026, and complemented by a structured PubMed search; thirteen primary studies that tested plant-derived material against isolates documented as carbapenem-resistant or carbapenemase-positive were appraised, three of them in full text, across five domains: identity of the material, characterisation of the isolates, assay design, interpretation of potency and synergy, and translational depth. A minority of studies reported carbapenemase genes for the tested isolates, none of those read reported cytotoxicity, and stand-alone minimum inhibitory concentrations of oils and extracts generally exceeded conventional potency criteria. The strongest signal came from carvacrol- and thymol-rich oils of the mint family: in one Tunisian study carvacrol at 2–4 µg/mL lowered imipenem minimum inhibitory concentrations to the susceptible range in seven of twelve isolates, while five did not reach it. On a four-level evidence scale no candidate reached confirmatory readiness, one group reached the level of credible lead, and most other claims could not be falsified because the material or the isolates were undefined. The review proposes a minimum reporting standard and sets priorities: a shared set of genotyped isolates, authenticated and chemically defined material, reference-method testing adapted for volatile agents, selectivity and larval-model data, and tests against oxacillinase (OXA)-type carbapenemases.

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Author Biographies

Sultana Mohamed Al-Aswad, Central Blood Bank, Sebha, Libya

Central Blood Bank, Sebha, Libya
Abdelgani Mohammed Abobaker, Sebha University, Faculty of Science, Department of Botany, Sebha, Libya

Sebha University, Faculty of Science, Department of Botany, Sebha, Libya

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