Antibacterial, Antibiofilm, and Anti-Inflammatory Activities of <i>Ginger</i> Extract against <i>Helicobacter pylori</i>

The increased emergence of multidrug-resistant <i>Helicobacter pylori</i> is related to many health issues. <i>Zingiber officinale</i> (<i>Z. officinale</i>) is a plant usually used in folk medicine to treat a variety of diseases. This study was conducted to evaluate the ability of <i>Z. officinale</i> extract to combat resistant <i>H. pylori</i>. The disc diffusion, microdilution, and microplate assays were performed to evaluate the susceptibility to antibiotics and the antibacterial and antibiofilm activities of the <i>Z. officinale</i> extracts. Using the checkerboard method, the combined effects of gentamicin and <i>Z. officinale</i> extract were investigated. In addition, anti-inflammatory activity and GC-MS analysis were performed according to a modified protocol. According to the findings, <i>H. pylori</i> isolates exhibited resistance rates of 56.33, 50.0, and 45.85 against metronidazole, gentamicin, and tetracycline, respectively. The methanolic extract of <i>Z. officinale</i> showed the strongest effectiveness against resistant <i>H. pylori</i> isolates with MICs of 20.0 to 50.0 µg/mL, including both <i>H. pylori</i> isolates and the standard strain NCTC 11637. <i>Z. officinale</i> extract suppresses the biofilm formed by <i>H. pylori</i> isolates with a percentage of 92.96% at 50.0 µg/mL, compared with 97.19% for gentamicin at the same concentration. According to FICI values, the combination of methanolic <i>Z. officinale</i> extract with gentamicin increases bacterial sensitivity to such drugs. Moreover, the <i>Z. officinale</i> extract exhibits strong anti-inflammatory activity, with inhibition of red blood cell membrane stabilization increasing from 49.83% to 61.47% at a concentration of 4 to 32 µg/mL. The GC-MS analysis of <i>Z. officinale</i> extract exhibits 17 different chemical compounds. Besides showing antibacterial properties, the extract also contains the anti-inflammatory compound gingerol as the main constituent, which inhibits the growth of <i>H. pylori</i> and its biofilm and is a promising natural therapeutic alternative or enhances antibiotic activity.