Bartonella henselae is a Gram-negative, facultative intracellular bacterium which is the causative agent of cat scratch disease. In humans, infections with B. henselae can result in acute or chronic systemic infections with various clinical symptoms including local skin lesions, malaise, aches, chills, lymphadenopathy, endocarditis, or meningoencephalitis. The current treatment for Bartonella infections with antibiotics such as doxycycline and rifampin is not always effective presumably due to bacterial persistence. There have been various anecdotal reports of herbal extracts used for treating patients with persistent Bartonella infections but their activity on B. henselae is unknown. To test the potential antimicrobial activity of botanical or herbal medicines and develop better therapies for persistent Bartonella infections, in this study, we screened an herbal product collection against stationary phase B. henselae in vitro using SYBR Green I/ propidium iodide (PI) viability assay. These herbal medicines were selected by the fact that they are commonly used to treat Lyme and co-infections by patients and herbalists, and as a follow-up to our recent study where these herbs were tested against B. burgdorferi. We identified five herbal product extracts that had high activity against stationary phase B. henselae at 0.5% (v/v), including Cryptolepis sanguinolenta, Juglans nigra, Polygonum cuspidatum, Scutellaria baicalensis, and Scutellaria barbata. Among them, Cryptolepis sanguinolenta, Juglans nigra, and Polygonum cuspidatum could eradicate all stationary phase B. henselae cells within 7 days at 0.25% (v/v) in drug exposure time-kill assay, whereas Scutellaria baicalensis and Scutellaria barbata showed relatively poor activity. The minimum inhibitory concentration (MIC) determination of these top hits indicated they were not only active against stationary phase non-growing B. henselae but also had good activity against log phase growing B. henselae. Our findings may help to develop more effective treatments for persistent Bartonella infections. ### Competing Interest Statement Jacob Leone ND is owner of two naturopathic medical practices, FOCUS Health Group and Door One Concierge, which provides treatment to patients with tick-borne diseases. Dr. Leone does receive profits from medical services and botanical preparations he exclusively makes available to patients in these two practices and does not currently sell botanical products commercially.
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