antibiofilm efficacy of rauwolfia serpentina methanolic root extract against urinary klebsiella isolates from chronic kidney disease patients: a cross-sectional study

The rising prevalence of multidrug-resistant klebsiella species among chronic kidney disease patients with urinary tract infections poses a serious therapeutic challenge, especially due to their ability to form complex microbial communities called biofilms. in the present study, a total of 138 klebsiella isolates from kidney patients were identified, of which 61.59% were multidrug-resistant strains. high resistance was observed to ciprofloxacin and ceftazidime, while piperacillin-tazobactam, amikacin, and trimethoprim-sulfamethoxazole retained activity against many isolates. the antibiofilm capability of rauwolfia serpentina root extract was examined in the context of the necessity for other antibiofilm strategies crucial for the medical field. the presence of bioactive alkaloids and phenolic compounds was verified by methanolic extraction and hptlc examination. among 138 isolates, 81 (58.70%) were biofilm producers, with mdr strains showing a higher frequency of strong biofilm formation. at a sub-mic concentration of 112.5 mg/ml, the extract significantly reduced biofilm formation in strong biofilm-producing isolates. furthermore, rt-pcr analysis revealed downregulation of the biofilm-associated fimh1 gene in strains treated with the same concentration compared to untreated controls. these findings suggest that rauwolfia serpentina root extract exhibits promising antibiofilm activity and could serve as a complementary approach in managing persistent, biofilm-associated utis in ckd patients.