In Vitro Antibacterial Activity of Hot and Cold Aqueous Banana Peel Extracts Against Pseudomonas aeruginosa Isolated from Pediatric Otitis Media: A Preliminary Study

In Vitro Antibacterial Activity of Hot and Cold Aqueous Banana Peel Extracts Against Pseudomonas aeruginosa Isolated from Pediatric Otitis Media: A Preliminary Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article In Vitro Antibacterial Activity of Hot and Cold Aqueous Banana Peel Extracts Against Pseudomonas aeruginosa Isolated from Pediatric Otitis Media: A Preliminary Study Dhafer Rahman Abed Al-janabi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8660214/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background This in vitro study evaluated the antibacterial activity of hot and cold aqueous banana peel extracts against Pseudomonas aeruginosa isolated from children with otitis media. Aim To make hot and cold aqueous extracts, banana peels were cleaned, dried, and processed. Tests were conducted at three different concentrations (50, 100, and 200 mg/mL). Inhibition zones were determined and the antibacterial activity was evaluated using the agar well diffusion method. The extracts' effects were contrasted with those of common antibiotics, such as imipenem and amikacin. The data were statistically analyzed and presented as mean ± standard deviation. Methods At every studied concentration, the hot aqueous extract exhibited noticeably greater antibacterial activity than the cold extract. The heated extract at 200 mg/mL showed the maximum activity (21.73 ± 4.47 mm). The heated extract did not significantly differ from amikacin (p = 0.913), but it did significantly differ from imipenem (p < 0.001). At every concentration, the cold aqueous extract showed reduced antibacterial activity. Conclusions Pseudomonas aeruginosa isolated from pediatric otitis media showed significant in vitro antibacterial activity against hot aqueous banana peel extract, indicating its potential as a supplemental or natural alternative antibacterial agent. Applied & Industrial Microbiology Bacteriology Drug Discovery, Design, & Development Botany Tropical Medicine Banana peel extract Pseudomonas aeruginosa Otitis media Antibacterial activity Pediatric infections Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction The search for substitute antimicrobial drugs derived from natural sources has been prompted by the rise of antibiotic-resistant bacteria in recent years, which has become a significant public health concern (1)(2) Due to their high concentration of bioactive substances including polyphenols, flavonoids, and other secondary metabolites with potential antibacterial qualities, plant-derived extracts—particularly those obtained from agricultural byproducts like fruit peels—have garnered significant scientific attention(3) (4)(5). The peel of bananas (Musa paradisiaca), a common fruit waste product, has been shown to have strong antibacterial action against a range of harmful microbes. Banana peel extracts have been shown in studies to suppress the growth of both gram-positive and gram-negative bacteria, indicating its potential as a low-cost and environmentally friendly medicinal agent (6)(7)(8). The search for complementary and alternative therapeutic approaches derived from medicinal plants has become more intense due to the growing global problem of antibiotic resistance. Because of its bioactive components, relative safety, and accessibility, herbal medicines continue to be a mainstay of traditional healthcare systems around the world. Plant by-products, especially fruit peels, have received more attention recently as sustainable sources of antibacterial chemicals. The peel of bananas (Musa paradisiaca), a plentiful agricultural waste, has long been utilized in traditional medicine and has shown a variety of biological activities, such as antibacterial, anti-inflammatory, and antioxidant properties (9)(10) Banana peel includes phenolic acids, flavonoids, tannins, and other polar chemicals that may contribute to its antibacterial qualities, according to phytochemical research. Crucially, traditional herbal preparation procedures are reflected in aqueous extraction methods, which also increase the study' clinical relevance. Pseudomonas aeruginosa , a pathogen recognized for its innate resistance mechanisms and capacity to produce biofilms, is often linked to otitis media, one of the most common bacterial infections in children (11)(2) Particularly in environments with limited resources, P. aeruginosa's growing resistance to widely used antibiotics presents serious therapeutic hurdles. There is still little information comparing the effectiveness of hot and cold aqueous preparations against clinically isolated P. aeruginosa from pediatric illnesses, despite earlier observations on the antibacterial activity of banana peel extracts. In order to highlight their potential as a sustainable and natural herbal remedy for antibiotic-resistant illnesses, this work examines the in vitro antibacterial activity of hot and cold aqueous banana peel extracts against P. aeruginosa isolated from children otitis media. The goal of the current study was to assess the in vitro antibacterial activity of hot and cold aqueous extracts of banana peel (Musa paradisiaca), a frequently used plant-derived by-product, against Pseudomonas aeruginosa that was isolated from pediatric otitis media and to compare their efficacy with a few conventional antibiotics. The project also aims to investigate banana peel's potential as a sustainable, safe, and easily accessible herbal resource for treating bacterial illnesses resistant to antibiotics. Methods Study Design This in vitro experimental study was conducted to evaluate the antibacterial activity of hot and cold aqueous banana peel extracts against Pseudomonas aeruginosa isolated from children diagnosed with otitis media. Patient Samples and Study Setting This study comprised 34 pediatric patients with otitis media, 20 of whom were male and 14 of whom were female, ages 3 to 14. Between March and October of 2025, middle ear swabs were taken from Al-Najaf Teaching Hospital and Al-Sadr Teaching Hospital in Al-Najaf Province, Iraq. Every swab was brought in sterile containers to the microbiology lab, where it was processed in two hours. Pseudomonas aeruginosa was isolated and identified using conventional microbiological and biochemical techniques. Isolates of Bacteria Middle ear swabs from children with otitis media were used to obtain clinical isolates of Pseudomonas aeruginosa. Standard microbiological and biochemical techniques were used to identify the isolates, which were then stored at 4°C on nutrient agar slants until needed. Preparation of Banana Peel Extracts Fresh banana peels (Musa paradisiaca) were ground into a fine powder after being carefully cleaned with distilled water and allowed to air dry at room temperature. A known weight of banana peel powder was combined with distilled water and heated to 60–70°C for 30 minutes to create the hot aqueous extract. After cooling, the mixture was filtered using sterile Whatman No. 1 filter paper. The banana peel powder was soaked in distilled water at room temperature for 24 hours with sporadic shaking to create the cold aqueous extract, which was then filtered through sterile filter paper. Before being used again, the concentrated filtrates were kept at 4°C. Preparation of Extract Concentrations Three concentrations of each extract (50, 100, and 200 mg/mL) were prepared by dissolving the appropriate amount of dried extract in sterile distilled water under aseptic conditions. Antibacterial Activity Assay The agar well diffusion method was used to assess the extracts' antibacterial activity. Standardized bacterial suspensions equal to 0.5 McFarland standard were used to inoculate Mueller-Hinton agar plates. After punching 6 mm-diameter wells into the agar, 100 µL of each extract concentration was applied. For a whole day, the plates were incubated at 37°C. A calibrated ruler was used to measure the inhibition zones' sizes in millimeters following incubation. Every experiment was carried out three times. Determination of Minimum Inhibitory Concentration (MIC) The broth dilution method was used to calculate the minimum inhibitory concentration (MIC) of the hot and cold aqueous banana peel extracts against Pseudomonas aeruginosa. To achieve a range of concentrations, serial two-fold dilutions of each extract were made in sterile Mueller-Hinton broth. Each tube holding the extract dilutions was infected with a standardized bacterial suspension equal to 0.5 McFarland standard. There were negative control tubes with broth alone and positive control tubes with bacterial suspension without extract. For a whole day, each tube was incubated at 37°C. The lowest concentration of the extract that, when compared to the control tubes, did not exhibit any discernible bacterial growth after incubation was known as the minimum inhibitory concentration (MIC). To guarantee reproducibility, every experiment was conducted in triplicate. Antibiotic Susceptibility Testing The Kirby-Bauer disc diffusion method on Mueller-Hinton agar was used for antibiotic susceptibility testing in accordance with conventional protocols. Piperacillin (PIP), piperacillin–tazobactam (TPZ), aztreonam (ATM), imipenem (IPM), tobramycin (TOB), netilmicin (NET), amikacin (AK), and ciprofloxacin (CIP) were among the eight antibiotics that were evaluated. Amikacin and imipenem were chosen for comparison with the banana peel extracts because they showed the strongest antibacterial activity against Pseudomonas aeruginosa isolates based on the inhibition zone widths. Statistical Analysis Data were expressed as mean ± standard deviation (SD). Statistical analysis was performed using appropriate statistical software. Comparisons between groups were conducted using suitable statistical t-test, and a p-value of less than 0.05 was considered statistically significant. Ethical Considerations Ethical approval for the collection of clinical isolates was obtained from the relevant institutional ethics committee. All procedures were conducted in accordance with ethical guidelines. Results Bacterial Isolates Between March and October 2025, 34 middle ear swab samples were taken from pediatric patients (20 men and 14 females, ages 3–14) at Al-Najaf Teaching Hospital and Al-Sadr Teaching Hospital in Iraq. Of them, 11 isolates (32.4%)—seven from male patients and four from female patients—tested positive for Pseudomonas aeruginosa . Subsequent antimicrobial testing was conducted using these isolates. Susceptibility to Antibiotics Eight antibiotics—piperacillin (PIP), piperacillin–tazobactam (TPZ), aztreonam (ATM), imipenem (IPM), tobramycin (TOB), netilmicin (NET), amikacin (AK), and ciprofloxacin (CIP)—were evaluated against each of the eleven P. aeruginosa isolates. Amikacin (AK) and imipenem (IPM), which had the strongest antibacterial activity based on inhibition zone widths, were chosen for comparison with banana peel extracts. . Table 1 Antibiotic susceptibility of P. aeruginosa isolates Antibiotic No. Sensitive /11 % Sensitive PIP 2 18% TPZ 2 18% ATM 0 0% IPM 10 91% TOB 7 64% NET 8 73% AK 9 82% CIP 7 64% Antibacterial Activity of Banana Peel Extracts The in vitro antibacterial activity of hot and cold banana peel extracts was assessed at concentrations of 50, 100, and 200 mg/mL. The hot aqueous extract demonstrated higher activity than the cold extract at all tested concentrations. Table 2 Inhibition zones (mm) of hot and cold banana peel extracts against P. aeruginosa Extract 50 mg/mL 100 mg/Ml 200 mg/mL Hot 16.45 ± 5.18 19.09 ± 5.80 21.73 ± 4.47 Cold 10.27 ± 1.10 11.36 ± 1.50 14.55 ± 4.34 Minimum Inhibitory Concentration -MIC The broth dilution method was used to calculate the MIC values of banana peel extracts. The higher antibacterial potency of the hot extract was confirmed by the MIC of 6.25 mg/mL for the hot aqueous extract and 12.5 mg/mL for the cold aqueous extract. Comparing Standard Antibiotics Imipenem demonstrated somewhat greater action (p < 0.001), while the heated extract at 200 mg/mL shown similar activity to amikacin (p = 0.913). At every concentration, statistical analysis revealed significant differences between the hot and cold extracts (p < 0.05). Table 3 Comparison of inhibition zones (mm) between banana peel extracts and standard antibiotics Isolate Hot 200 mg/mL Cold 200 mg/mL AK IPM p-value (Hot vs AK) p-value (Hot vs IPM) P. aeruginosa 21.73 ± 4.47 14.55 ± 4.34 21.55 ± 3.11 24.09 ± 3.41 0.913 < 0.001 Discussion Pseudomonas aeruginosa was found in 32.4% of pediatric middle ear samples in this investigation, which is in line with its known involvement in chronic suppurative otitis media (CSOM). According to Alatoom et al. (2024) and Taha. (2025),(12)(13) P. aeruginosa is renowned for its environmental resistance and capacity to build biofilms, which lead to persistent infections and decreased treatment efficacy. Although more research is needed, the increased occurrence in men (7/11) might be due to anatomical or behavioral variations in pediatric groups. Imipenem (91%) and amikacin (82%) were the most effective antibiotics, according to the antibiotic susceptibility pattern, while aztreonam exhibited no activity. The sensitivity of other antibiotics was in the middle. These results are consistent with reports from Iraq and surrounding areas showing a rising trend of P. aeruginosa multidrug resistance (MDR) (14). The production of β-lactamases, such as carbapenemases and extended-spectrum ones, is one of P. aeruginosa's resistance strategies. Biofilm production, which creates a barrier to antimicrobials; Efflux pumps, which remove antibiotics from the cell (15)(16).Although caution is required due to the possibility of resistance developing, the observed high sensitivity to imipenem and amikacin indicates that these antibiotics are still therapeutically efficacious for the majority of isolates. In vitro antibacterial activity against P. aeruginosa was shown by both hot and cold aqueous extracts of banana peel, however the hot extract was consistently more effective at all tested doses .Similar antibacterial effects of plant extracts against P. aeruginosa have been reported previously(17)(18)(19). The hot extract's higher potency was confirmed by its minimum inhibitory concentration (MIC), which was 6.25 mg/mL as opposed to 12.5 mg/mL for the cold extract. Banana peels include bioactive substances such flavonoids, phenolics, and tannins (2)(20) which have been shown to damage bacterial cell membranes and impede metabolic activities (21)(22)(23). The greater activity of the hot extract can be explained by the fact that heat seems to improve the extraction of these polar bioactive chemicals (21)(24). Imipenem continued to be more effective (p < 0.001), although the heated banana peel extract demonstrated antibacterial activity similar to amikacin at a concentration of 200 mg/mL (p = 0.913). Mechanistically, banana peel chemicals probably cause bacterial suppression by interfering with metabolic enzymes and rupturing the cell membrane. Amikacin binds to the bacterial 30S ribosomal subunit, impeding protein synthesis; Imipenem inhibits penicillin-binding proteins, inhibiting cell wall synthesis. The heated extract's similar activity to amikacin points to its potential as a natural antibacterial agent, especially in environments with limited resources or as a supplement to traditional treatment. These findings suggest that extracts from banana peels could be a useful source of natural antibacterial agents, especially against MDR pathogens like P. aeruginosa . But: 1. Direct therapeutic application may be limited by the relatively high effective concentrations in vitro. 2. To isolate and characterize active chemicals using methods like LC-MS/MS, more study is needed. 3. To assess safety, pharmacokinetics, and efficacy in vivo, preclinical and clinical research are required. 4. Research on how these extracts affect the development of biofilms may shed light on their potential as supplemental therapies. Conclusion The study shows that P. aeruginosa , which exhibits multidrug resistance in line with worldwide trends, is still a prominent infection in pediatric otitis media. Extracts from banana peels, especially hot aqueous extracts, have strong antibacterial activity that is on par with amikacin, indicating their potential as complementing or substitute antibacterial agents. These results demonstrate the need of investigating plant-based bioactives as instruments against illnesses resistant to antibiotics. Declarations Acknowledgements Islamic University, College of Medical Technologies, Ministry of Health Najaf Health Directorate, College of Science, University of Kufa. References Enas DRAA janabiand, Semysim A al RA. Synergistic effect of aqueous and alcoholic extracts of L. nobilis, R. officinalis and Q. rubra plants against bacteria isolated from burn patients. 2025; Poole K. Pseudomonas aeruginosa: resistance to the max. Front Microbiol. 2011;2:65. Sofy AR, Aboseidah AA, El-Morsi ES, Azmy HA, Hmed AA. Evaluation of Antibacterial and Antibiofilm Activity of New Antimicrobials as an Urgent Need to Counteract Stubborn Multidrug-resistant Bacteria. J Pure Appl Microbiol. 2020;14(1). Al-janabi DRA, Semysim EA al RA. INTERNATIONAL JOURNAL OF RESEARCH IN PHARMACEUTICAL SCIENCES. 2020; Chaudhry F, Ahmad ML, Hayat Z, Ranjha MMAN, Chaudhry K, Elboughdiri N, et al. Extraction and evaluation of the antimicrobial activity of polyphenols from banana peels employing different extraction techniques. Separations. 2022;9(7):165. Hikal WM, Said-Al Ahl HAH, Bratovcic A, Tkachenko KG, Sharifi-Rad J, Kačániová M, et al. Banana peels: A waste treasure for human being. Evidence‐Based Complement Altern Med. 2022;2022(1):7616452. Hikal WM, Said-Al Ahl HA, Kacaniova M. Banana peels as possible antioxidant and antimicrobial agents. Asian J Res Rev Agric. 2021;3(3):35–45. Al-Janabi DRA, Raheem MH. Phytochemical and Antimicrobial Activities of Musa paradisiaca Peel Extracts against Multidrug-Resistant Bacteria from Post-Acne Skin Infections. Egypt J Med Microbiol. 2026; Widoyanti AAE, Chaikong K, Rangsinth P, Saengratwatchara P, Leung GPH, Prasansuklab A. Valorization of nam wah banana (Musa paradisiaca L.) byproducts as a source of bioactive compounds with antioxidant and anti-inflammatory properties: in vitro and in silico studies. Foods. 2023;12(21):3955. Truong QT, Nguyen DK. Optimization of Extraction Parameters of Phenolic Compounds from Cau Banana (Musa paradisiaca) Peel and Evaluation for Antioxidant and Antibacterial Potential. Eur J Biol. 2024;83(2):131–43. Al-Dahmoshi H, Al-Obaidi RD, Al-Khafaji N. Pseudomonas aeruginosa: diseases, biofilm and antibiotic resistance. In: Pseudomonas Aeruginosa-Biofilm Formation, Infections and Treatments. IntechOpen; 2020. Taha AB. Bacteriological profile, antibiotic susceptibility, and biofilm formation in children with chronic suppurative otitis media. Int J Pediatr Otorhinolaryngol. 2025;188:112208. Alatoom A, Alattas M, Alraddadi B, Moubareck CA, Hassanien A, Jamal W, et al. Antimicrobial Resistance Profiles of Pseudomonas aeruginosa in the Arabian Gulf Region Over a 12-Year Period (2010–2021). J Epidemiol Glob Health. 2024;14(3):529–48. Saadoon WK, Al-Hadithi HSAR. Detection of Extended-Spectrum β-Lactamase Producing Escherichia coli and Klebsiella pneumoniae in Urinary Tract Infection in Selected Baghdad Hospitals. J Univ Babylon Pure Appl Sci. 2025;273–84. Oliver A, Arca-Suárez J, Gomis-Font MA, González-Pinto L, López-Causapé C. Emerging resistance mechanisms to newer β-lactams in Pseudomonas aeruginosa. Clin Microbiol Infect. 2025; Elfadadny A, Ragab RF, AlHarbi M, Badshah F, Ibáñez-Arancibia E, Farag A, et al. Antimicrobial resistance of. Pseudomonas aeruginosa. 2024; Alshaybawee MR, Asgari S, Ghadersoltani P, Mehrabian A, Saniee P. Exploring the antibacterial and anti-biofilm activity of two Iranian medical-grade kinds of honey on multidrug-resistant Pseudomonas aeruginosa. BMC Complement Med Ther. 2025;25(1):39. Amankwah FKD, Gbedema SY, Boakye YD, Bayor MT, Boamah VE. Antimicrobial potential of extract from a Pseudomonas aeruginosa isolate. Scientifica (Cairo). 2022;2022(1):4230397. Murugesan V, Palanivel P, Ramesh G, Ganesh D, Michael HSR, Bandhumy Lingam S, et al. Exploring the antibacterial potential of Clidemia hirta leaf extract against the pathogenicity of Pseudomonas aeruginosa: in vitro and in silico approaches. Front Pharmacol. 2025;16:1555542. Zeineldin M, Esmael A, Al-Hindi RR, Alharbi MG, Ashenafi Bekele D, Teklemariam AD. Beyond the risk of biofilms: An up-and-coming battleground of bacterial life and potential antibiofilm agents. Life. 2023;13(2):503. Deepa B, Sivakumar T. Phytochemical Analysis and Antibacterial Efficacy of Ethanolic Extract of Musa paradisiaca. Res Biot Int J. 2020;2(3):126–30. Jubair N, Rajagopal M, Chinnappan S, Abdullah NB, Fatima A. Review on the antibacterial mechanism of plant‐derived compounds against multidrug‐resistant bacteria (MDR). Evidence‐Based Complement Altern Med. 2021;2021(1):3663315. Eedee KF, Martha E, Giami L, Patience Nkiru D, Konne OE, Roseanne Adah O, et al. Antimicrobial activities of ethanol extract of banana (Musa sapientum L.) peels against organisms associated with urinary tract infection. Asian J Res Infect Dis. 2022;9(1):1–7. Ajijolakewu KA, Ayoola AS, Agbabiaka TO, Zakariyah FR, Ahmed NR, Oyedele OJ, et al. A review of the ethnomedicinal, antimicrobial, and phytochemical properties of Musa paradisiaca (plantain). Bull Natl Res Cent. 2021;45(1):86. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8660214","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":578147570,"identity":"cb59c518-b1f7-4eb3-9027-9ddde4b78f5b","order_by":0,"name":"Dhafer Rahman Abed Al-janabi","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0001-7576-0555","institution":"The Islamic University of Najaf, College of Medical Technology","correspondingAuthor":true,"prefix":"","firstName":"Dhafer","middleName":"Rahman Abed","lastName":"Al-janabi","suffix":""}],"badges":[],"createdAt":"2026-01-21 13:18:14","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8660214/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8660214/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101751093,"identity":"bbb67271-ed64-4d66-842c-f505601e68b3","added_by":"auto","created_at":"2026-02-03 10:13:12","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":813392,"visible":true,"origin":"","legend":"","description":"","filename":"InVitroAntibacterialActivityof.docx","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/d435177da9b9b1ef6240ce43.docx"},{"id":100949536,"identity":"a9a517c1-0cd5-4756-9730-b34463a93169","added_by":"auto","created_at":"2026-01-23 07:04:05","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":342,"visible":true,"origin":"","legend":"","description":"","filename":"rs8660214.json","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/fc2b771137e5bce2ec3414bf.json"},{"id":100877124,"identity":"eed63d93-6824-4928-b511-e089247240c5","added_by":"auto","created_at":"2026-01-22 10:27:59","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":46028,"visible":true,"origin":"","legend":"","description":"","filename":"rs86602140enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/3d5e693e955ca1925c7ad197.xml"},{"id":100877123,"identity":"22212c51-77a2-4e6d-8f08-8e5f3f900b27","added_by":"auto","created_at":"2026-01-22 10:27:59","extension":"jpeg","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":155121,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/f00dcfca968dd6b69387bf70.jpeg"},{"id":100877120,"identity":"b341a214-32bc-4a4b-bbbf-123eaeed305d","added_by":"auto","created_at":"2026-01-22 10:27:59","extension":"jpeg","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":159930,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/92ac476f63addd5a9426e3c0.jpeg"},{"id":100950555,"identity":"98e85072-b22d-41a0-9258-fc0b9b119c49","added_by":"auto","created_at":"2026-01-23 07:08:35","extension":"emf","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":31944,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.emf","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/ce29a3583ef417759a2b8445.emf"},{"id":100950392,"identity":"4dfee866-8141-4fa0-b10e-a020cda48859","added_by":"auto","created_at":"2026-01-23 07:07:55","extension":"jpeg","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1185870,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage4.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/3175ae1e5449ec00b09c49e1.jpeg"},{"id":100950704,"identity":"8d7d2e4a-e513-425d-b903-fb88b0fc5bbd","added_by":"auto","created_at":"2026-01-23 07:08:57","extension":"jpeg","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1036195,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/85d5c487ff3add89ebe37822.jpeg"},{"id":100877128,"identity":"c3acab3e-41e8-41b0-a96d-84f61ce941d5","added_by":"auto","created_at":"2026-01-22 10:27:59","extension":"jpeg","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1074,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage6.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/4a5b8ba7ea4737d4ed1d854a.jpeg"},{"id":100950611,"identity":"74136b89-3c58-493c-9ea9-61c7aec3b053","added_by":"auto","created_at":"2026-01-23 07:08:46","extension":"png","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":28401,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/7695f0fae4ea504876967979.png"},{"id":100950463,"identity":"6bde60fe-39db-4676-842b-903dc3c4e7b8","added_by":"auto","created_at":"2026-01-23 07:08:15","extension":"png","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":29119,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/df9a614d6e1331db1021048d.png"},{"id":100877137,"identity":"22640e45-b05d-4db5-b3e5-bed3aa1bb197","added_by":"auto","created_at":"2026-01-22 10:28:00","extension":"png","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7367,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/08540b4cf11742353411e2b7.png"},{"id":100877133,"identity":"d0c43cce-b9e9-4e4b-a9b3-4bd892f7c499","added_by":"auto","created_at":"2026-01-22 10:27:59","extension":"png","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":490609,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/4192ac16d853730f9ddd8a29.png"},{"id":100950464,"identity":"1cc8aec5-0fcd-4048-925a-89da42d8096b","added_by":"auto","created_at":"2026-01-23 07:08:16","extension":"png","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":414570,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/e2b2d511afc84e390cc69003.png"},{"id":100950395,"identity":"a229609f-d80d-49c1-a5f4-eb2671889f6a","added_by":"auto","created_at":"2026-01-23 07:07:56","extension":"png","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":935,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/52abc212dce8f7a28c185b88.png"},{"id":100877136,"identity":"9cf904e5-9021-4d67-a7f3-c0c1eb3f3fb3","added_by":"auto","created_at":"2026-01-22 10:27:59","extension":"xml","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":43318,"visible":true,"origin":"","legend":"","description":"","filename":"rs86602140structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/d3d3595ba6fa085ce566c497.xml"},{"id":100877134,"identity":"ada3b07c-1921-42d4-874d-2e4656278d10","added_by":"auto","created_at":"2026-01-22 10:27:59","extension":"html","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":51921,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/8e3176b719ed4d43ce60caf5.html"},{"id":100950316,"identity":"dfb85089-35fb-4e4b-94bb-71da3cb42644","added_by":"auto","created_at":"2026-01-23 07:07:37","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":40892,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eEffect of Hot Banana Peel Extracts at Different Concentrations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInhibition zones (mm) of hot and cold aqueous banana peel extracts at concentrations of 50, 100, and 200 mg/mL against \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolates (n = 11). Values are presented as mean ± SD.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/5c26623d552bba02fcd89459.jpg"},{"id":100950025,"identity":"3c32f58d-842d-4d8a-a6cd-93bb000a2220","added_by":"auto","created_at":"2026-01-23 07:06:42","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":39192,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eEffect of Cold Banana Peel Extracts at Different Concentrations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInhibition zones (mm) of cold aqueous banana peel extracts at concentrations of 50, 100, and 200 mg/mL against \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolates (n = 11). Values are presented as mean ± SD.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/4c04dda9192ee17976eea624.jpg"},{"id":100950787,"identity":"67442997-31a5-4658-9387-9b2912fc2fed","added_by":"auto","created_at":"2026-01-23 07:09:12","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":40565,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of Hot and Cold Extracts at 200 mg/mL with Standard Antibiotics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eComparison of inhibition zones (mm) for hot and cold banana peel extracts at 200 mg/mL with standard antibiotics amikacin (AK) and imipenem (IPM) against \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolates (n = 11).\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/d4c4cec63a432ef9845155f4.jpg"},{"id":100950119,"identity":"f464728e-bad7-4659-8375-58e16653598f","added_by":"auto","created_at":"2026-01-23 07:06:55","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":160411,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAntibacterial Activity of Standard Antibiotics\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/2bc3eebd653433b80a4acfe0.jpg"},{"id":101202628,"identity":"18160302-ce86-4f0a-bee3-e592257392b8","added_by":"auto","created_at":"2026-01-27 09:36:50","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":126974,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAqueous Banana Peel Extracts Against \u003c/strong\u003e\u003cem\u003e\u003cstrong\u003eP. aeruginosa\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e Isolated from Paediatric Otitis Media. (1) 50mg/ml (2) 100mg/ml (3) 200mg/ml (4) Control (A) Cold water (B) Hot water\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/247f9cc2985ec8137098d845.jpg"},{"id":101754848,"identity":"10bf08ed-74f6-434c-b389-016a6032b842","added_by":"auto","created_at":"2026-02-03 10:47:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1209568,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8660214/v1/9611a30d-8d80-4a86-8463-8964d6f8cab8.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eIn Vitro Antibacterial Activity of Hot and Cold Aqueous Banana Peel Extracts Against \u003c/strong\u003e\u003cem\u003e\u003cstrong\u003ePseudomonas aeruginosa\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e Isolated from Pediatric Otitis Media: A Preliminary Study\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe search for substitute antimicrobial drugs derived from natural sources has been prompted by the rise of antibiotic-resistant bacteria in recent years, which has become a significant public health concern (1)(2) Due to their high concentration of bioactive substances including polyphenols, flavonoids, and other secondary metabolites with potential antibacterial qualities, plant-derived extracts\u0026mdash;particularly those obtained from agricultural byproducts like fruit peels\u0026mdash;have garnered significant scientific attention(3) (4)(5).\u003c/p\u003e \u003cp\u003eThe peel of bananas (Musa paradisiaca), a common fruit waste product, has been shown to have strong antibacterial action against a range of harmful microbes. Banana peel extracts have been shown in studies to suppress the growth of both gram-positive and gram-negative bacteria, indicating its potential as a low-cost and environmentally friendly medicinal agent (6)(7)(8).\u003c/p\u003e \u003cp\u003eThe search for complementary and alternative therapeutic approaches derived from medicinal plants has become more intense due to the growing global problem of antibiotic resistance. Because of its bioactive components, relative safety, and accessibility, herbal medicines continue to be a mainstay of traditional healthcare systems around the world. Plant by-products, especially fruit peels, have received more attention recently as sustainable sources of antibacterial chemicals. The peel of bananas (Musa paradisiaca), a plentiful agricultural waste, has long been utilized in traditional medicine and has shown a variety of biological activities, such as antibacterial, anti-inflammatory, and antioxidant properties (9)(10) Banana peel includes phenolic acids, flavonoids, tannins, and other polar chemicals that may contribute to its antibacterial qualities, according to phytochemical research. Crucially, traditional herbal preparation procedures are reflected in aqueous extraction methods, which also increase the study' clinical relevance.\u003c/p\u003e \u003cp\u003e \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e, a pathogen recognized for its innate resistance mechanisms and capacity to produce biofilms, is often linked to otitis media, one of the most common bacterial infections in children (11)(2) Particularly in environments with limited resources, \u003cem\u003eP. aeruginosa's\u003c/em\u003e growing resistance to widely used antibiotics presents serious therapeutic hurdles. There is still little information comparing the effectiveness of hot and cold aqueous preparations against clinically isolated \u003cem\u003eP. aeruginosa\u003c/em\u003e from pediatric illnesses, despite earlier observations on the antibacterial activity of banana peel extracts. In order to highlight their potential as a sustainable and natural herbal remedy for antibiotic-resistant illnesses, this work examines the in vitro antibacterial activity of hot and cold aqueous banana peel extracts against \u003cem\u003eP. aeruginosa\u003c/em\u003e isolated from children otitis media. The goal of the current study was to assess the in vitro antibacterial activity of hot and cold aqueous extracts of banana peel (Musa paradisiaca), a frequently used plant-derived by-product, against Pseudomonas aeruginosa that was isolated from pediatric otitis media and to compare their efficacy with a few conventional antibiotics. The project also aims to investigate banana peel's potential as a sustainable, safe, and easily accessible herbal resource for treating bacterial illnesses resistant to antibiotics.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis in vitro experimental study was conducted to evaluate the antibacterial activity of hot and cold aqueous banana peel extracts against \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolated from children diagnosed with otitis media.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePatient Samples and Study Setting\u003c/h3\u003e\n\u003cp\u003eThis study comprised 34 pediatric patients with otitis media, 20 of whom were male and 14 of whom were female, ages 3 to 14. Between March and October of 2025, middle ear swabs were taken from Al-Najaf Teaching Hospital and Al-Sadr Teaching Hospital in Al-Najaf Province, Iraq. Every swab was brought in sterile containers to the microbiology lab, where it was processed in two hours. \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e was isolated and identified using conventional microbiological and biochemical techniques.\u003c/p\u003e\n\u003ch3\u003eIsolates of Bacteria\u003c/h3\u003e\n\u003cp\u003eMiddle ear swabs from children with otitis media were used to obtain clinical isolates of \u003cem\u003ePseudomonas aeruginosa.\u003c/em\u003e Standard microbiological and biochemical techniques were used to identify the isolates, which were then stored at 4\u0026deg;C on nutrient agar slants until needed.\u003c/p\u003e\n\u003ch3\u003ePreparation of Banana Peel Extracts\u003c/h3\u003e\n\u003cp\u003eFresh banana peels (Musa paradisiaca) were ground into a fine powder after being carefully cleaned with distilled water and allowed to air dry at room temperature. A known weight of banana peel powder was combined with distilled water and heated to 60\u0026ndash;70\u0026deg;C for 30 minutes to create the hot aqueous extract. After cooling, the mixture was filtered using sterile Whatman No. 1 filter paper. The banana peel powder was soaked in distilled water at room temperature for 24 hours with sporadic shaking to create the cold aqueous extract, which was then filtered through sterile filter paper. Before being used again, the concentrated filtrates were kept at 4\u0026deg;C.\u003c/p\u003e\n\u003ch3\u003ePreparation of Extract Concentrations\u003c/h3\u003e\n\u003cp\u003eThree concentrations of each extract (50, 100, and 200 mg/mL) were prepared by dissolving the appropriate amount of dried extract in sterile distilled water under aseptic conditions.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eAntibacterial Activity Assay\u003c/h2\u003e \u003cp\u003eThe agar well diffusion method was used to assess the extracts' antibacterial activity. Standardized bacterial suspensions equal to 0.5 McFarland standard were used to inoculate Mueller-Hinton agar plates. After punching 6 mm-diameter wells into the agar, 100 \u0026micro;L of each extract concentration was applied. For a whole day, the plates were incubated at 37\u0026deg;C. A calibrated ruler was used to measure the inhibition zones' sizes in millimeters following incubation. Every experiment was carried out three times.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eDetermination of Minimum Inhibitory Concentration (MIC)\u003c/h3\u003e\n\u003cp\u003eThe broth dilution method was used to calculate the minimum inhibitory concentration (MIC) of the hot and cold aqueous banana peel extracts against Pseudomonas aeruginosa. To achieve a range of concentrations, serial two-fold dilutions of each extract were made in sterile Mueller-Hinton broth. Each tube holding the extract dilutions was infected with a standardized bacterial suspension equal to 0.5 McFarland standard. There were negative control tubes with broth alone and positive control tubes with bacterial suspension without extract. For a whole day, each tube was incubated at 37\u0026deg;C. The lowest concentration of the extract that, when compared to the control tubes, did not exhibit any discernible bacterial growth after incubation was known as the minimum inhibitory concentration (MIC). To guarantee reproducibility, every experiment was conducted in triplicate.\u003c/p\u003e\n\u003ch3\u003eAntibiotic Susceptibility Testing\u003c/h3\u003e\n\u003cp\u003eThe Kirby-Bauer disc diffusion method on Mueller-Hinton agar was used for antibiotic susceptibility testing in accordance with conventional protocols. Piperacillin (PIP), piperacillin\u0026ndash;tazobactam (TPZ), aztreonam (ATM), imipenem (IPM), tobramycin (TOB), netilmicin (NET), amikacin (AK), and ciprofloxacin (CIP) were among the eight antibiotics that were evaluated. Amikacin and imipenem were chosen for comparison with the banana peel extracts because they showed the strongest antibacterial activity against Pseudomonas aeruginosa isolates based on the inhibition zone widths.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eData were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD). Statistical analysis was performed using appropriate statistical software. Comparisons between groups were conducted using suitable statistical t-test, and a p-value of less than 0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003efor the collection of clinical isolates was obtained from the relevant institutional ethics committee. All procedures were conducted in accordance with ethical guidelines.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eBacterial Isolates\u003c/h2\u003e \u003cp\u003eBetween March and October 2025, 34 middle ear swab samples were taken from pediatric patients (20 men and 14 females, ages 3\u0026ndash;14) at Al-Najaf Teaching Hospital and Al-Sadr Teaching Hospital in Iraq. Of them, 11 isolates (32.4%)\u0026mdash;seven from male patients and four from female patients\u0026mdash;tested positive for \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e. Subsequent antimicrobial testing was conducted using these isolates.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eSusceptibility to Antibiotics\u003c/h2\u003e \u003cp\u003eEight antibiotics\u0026mdash;piperacillin (PIP), piperacillin\u0026ndash;tazobactam (TPZ), aztreonam (ATM), imipenem (IPM), tobramycin (TOB), netilmicin (NET), amikacin (AK), and ciprofloxacin (CIP)\u0026mdash;were evaluated against each of the eleven P. aeruginosa isolates. Amikacin (AK) and imipenem (IPM), which had the strongest antibacterial activity based on inhibition zone widths, were chosen for comparison with banana peel extracts.\u003c/p\u003e \u003cp\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAntibiotic susceptibility of \u003cem\u003eP. aeruginosa\u003c/em\u003e isolates\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAntibiotic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo. Sensitive /11\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% Sensitive\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePIP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTPZ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eATM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIPM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTOB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNET\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCIP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eAntibacterial Activity of Banana Peel Extracts\u003c/h2\u003e \u003cp\u003eThe in vitro antibacterial activity of hot and cold banana peel extracts was assessed at concentrations of 50, 100, and 200 mg/mL. The hot aqueous extract demonstrated higher activity than the cold extract at all tested concentrations.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInhibition zones (mm) of hot and cold banana peel extracts against \u003cem\u003eP. aeruginosa\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExtract\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 mg/mL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100 mg/Ml\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e200 mg/mL\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHot\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e16.45\u0026thinsp;\u0026plusmn;\u0026thinsp;5.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e19.09\u0026thinsp;\u0026plusmn;\u0026thinsp;5.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e21.73\u0026thinsp;\u0026plusmn;\u0026thinsp;4.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCold\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e10.27\u0026thinsp;\u0026plusmn;\u0026thinsp;1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e11.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e14.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eMinimum Inhibitory Concentration -MIC\u003c/h2\u003e \u003cp\u003eThe broth dilution method was used to calculate the MIC values of banana peel extracts. The higher antibacterial potency of the hot extract was confirmed by the MIC of 6.25 mg/mL for the hot aqueous extract and 12.5 mg/mL for the cold aqueous extract.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eComparing Standard Antibiotics\u003c/h2\u003e \u003cp\u003eImipenem demonstrated somewhat greater action (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while the heated extract at 200 mg/mL shown similar activity to amikacin (p\u0026thinsp;=\u0026thinsp;0.913). At every concentration, statistical analysis revealed significant differences between the hot and cold extracts (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of inhibition zones (mm) between banana peel extracts and standard antibiotics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIsolate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHot 200 mg/mL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCold 200 mg/mL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAK\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIPM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value (Hot vs AK)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep-value (Hot vs IPM)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eP. aeruginosa\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.73\u0026thinsp;\u0026plusmn;\u0026thinsp;4.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.55\u0026thinsp;\u0026plusmn;\u0026thinsp;3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.09\u0026thinsp;\u0026plusmn;\u0026thinsp;3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.913\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Discussion","content":"\u003cp\u003e\u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e was found in 32.4% of pediatric middle ear samples in this investigation, which is in line with its known involvement in chronic suppurative otitis media (CSOM). According to Alatoom et al. (2024) and Taha. (2025),(12)(13) \u003cem\u003eP. aeruginosa\u003c/em\u003e is renowned for its environmental resistance and capacity to build biofilms, which lead to persistent infections and decreased treatment efficacy. Although more research is needed, the increased occurrence in men (7/11) might be due to anatomical or behavioral variations in pediatric groups. \u0026nbsp; Imipenem (91%) and amikacin (82%) were the most effective antibiotics, according to the antibiotic susceptibility pattern, while aztreonam exhibited no activity. The sensitivity of other antibiotics was in the middle. These results are consistent with reports from Iraq and surrounding areas showing a rising trend of \u003cem\u003eP. aeruginosa\u003c/em\u003e multidrug resistance (MDR) (14). \u0026nbsp; The production of \u0026beta;-lactamases, such as carbapenemases and extended-spectrum ones, is one of \u003cem\u003eP. aeruginosa\u0026apos;s\u0026nbsp;\u003c/em\u003eresistance strategies. Biofilm production, which creates a barrier to antimicrobials; Efflux pumps, which remove antibiotics from the cell (15)(16).Although caution is required due to the possibility of resistance developing, the observed high sensitivity to imipenem and amikacin indicates that these antibiotics are still therapeutically efficacious for the majority of isolates. In vitro antibacterial activity against P. aeruginosa was shown by both hot and cold aqueous extracts of banana peel, however the hot extract was consistently more effective at all tested doses .Similar antibacterial effects of plant extracts against \u003cem\u003eP. aeruginosa\u003c/em\u003e have been reported previously(17)(18)(19).\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eThe hot extract\u0026apos;s higher potency was confirmed by its minimum inhibitory concentration (MIC), which was 6.25 mg/mL as opposed to 12.5 mg/mL for the cold extract. Banana peels include bioactive substances such flavonoids, phenolics, and tannins\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e(2)(20) which have been shown to damage bacterial cell membranes and impede metabolic activities (21)(22)(23). The greater activity of the hot extract can be explained by the fact that heat seems to improve the extraction of these polar bioactive chemicals (21)(24). Imipenem continued to be more effective (p \u0026lt; 0.001), although the heated banana peel extract demonstrated antibacterial activity similar to amikacin at a concentration of 200 mg/mL (p = 0.913). Mechanistically, banana peel chemicals probably cause bacterial suppression by interfering with metabolic enzymes and rupturing the cell membrane. \u0026nbsp;Amikacin binds to the bacterial 30S ribosomal subunit, impeding protein synthesis; Imipenem inhibits penicillin-binding proteins, inhibiting cell wall synthesis. The heated extract\u0026apos;s similar activity to amikacin points to its potential as a natural antibacterial agent, especially in environments with limited resources or as a supplement to traditional treatment. These findings suggest that extracts from banana peels could be a useful source of natural antibacterial agents, especially against MDR pathogens like \u003cem\u003eP. aeruginosa\u003c/em\u003e. But:\u003c/p\u003e\n\u003cp\u003e1. Direct therapeutic application may be limited by the relatively high effective concentrations in vitro.\u003c/p\u003e\n\u003cp\u003e2. To isolate and characterize active chemicals using methods like LC-MS/MS, more study is needed.\u003c/p\u003e\n\u003cp\u003e3. To assess safety, pharmacokinetics, and efficacy in vivo, preclinical and clinical research are required.\u003c/p\u003e\n\u003cp\u003e4. Research on how these extracts affect the development of biofilms may shed light on their potential as supplemental therapies.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study shows that \u003cem\u003eP. aeruginosa\u003c/em\u003e, which exhibits multidrug resistance in line with worldwide trends, is still a prominent infection in pediatric otitis media. Extracts from banana peels, especially hot aqueous extracts, have strong antibacterial activity that is on par with amikacin, indicating their potential as complementing or substitute antibacterial agents. These results demonstrate the need of investigating plant-based bioactives as instruments against illnesses resistant to antibiotics.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eIslamic University, College of Medical Technologies, Ministry of Health Najaf Health Directorate, College of Science, University of Kufa.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eEnas DRAA janabiand, Semysim A al RA. Synergistic effect of aqueous and alcoholic extracts of L. nobilis, R. officinalis and Q. rubra plants against bacteria isolated from burn patients. 2025; \u003c/li\u003e\n\u003cli\u003ePoole K. Pseudomonas aeruginosa: resistance to the max. Front Microbiol. 2011;2:65. \u003c/li\u003e\n\u003cli\u003eSofy AR, Aboseidah AA, El-Morsi ES, Azmy HA, Hmed AA. Evaluation of Antibacterial and Antibiofilm Activity of New Antimicrobials as an Urgent Need to Counteract Stubborn Multidrug-resistant Bacteria. J Pure Appl Microbiol. 2020;14(1). \u003c/li\u003e\n\u003cli\u003eAl-janabi DRA, Semysim EA al RA. INTERNATIONAL JOURNAL OF RESEARCH IN PHARMACEUTICAL SCIENCES. 2020; \u003c/li\u003e\n\u003cli\u003eChaudhry F, Ahmad ML, Hayat Z, Ranjha MMAN, Chaudhry K, Elboughdiri N, et al. Extraction and evaluation of the antimicrobial activity of polyphenols from banana peels employing different extraction techniques. Separations. 2022;9(7):165. \u003c/li\u003e\n\u003cli\u003eHikal WM, Said-Al Ahl HAH, Bratovcic A, Tkachenko KG, Sharifi-Rad J, Kač\u0026aacute;niov\u0026aacute; M, et al. Banana peels: A waste treasure for human being. Evidence‐Based Complement Altern Med. 2022;2022(1):7616452. \u003c/li\u003e\n\u003cli\u003eHikal WM, Said-Al Ahl HA, Kacaniova M. Banana peels as possible antioxidant and antimicrobial agents. Asian J Res Rev Agric. 2021;3(3):35\u0026ndash;45. \u003c/li\u003e\n\u003cli\u003eAl-Janabi DRA, Raheem MH. Phytochemical and Antimicrobial Activities of Musa paradisiaca Peel Extracts against Multidrug-Resistant Bacteria from Post-Acne Skin Infections. Egypt J Med Microbiol. 2026; \u003c/li\u003e\n\u003cli\u003eWidoyanti AAE, Chaikong K, Rangsinth P, Saengratwatchara P, Leung GPH, Prasansuklab A. Valorization of nam wah banana (Musa paradisiaca L.) byproducts as a source of bioactive compounds with antioxidant and anti-inflammatory properties: in vitro and in silico studies. Foods. 2023;12(21):3955. \u003c/li\u003e\n\u003cli\u003eTruong QT, Nguyen DK. Optimization of Extraction Parameters of Phenolic Compounds from Cau Banana (Musa paradisiaca) Peel and Evaluation for Antioxidant and Antibacterial Potential. Eur J Biol. 2024;83(2):131\u0026ndash;43. \u003c/li\u003e\n\u003cli\u003eAl-Dahmoshi H, Al-Obaidi RD, Al-Khafaji N. Pseudomonas aeruginosa: diseases, biofilm and antibiotic resistance. In: Pseudomonas Aeruginosa-Biofilm Formation, Infections and Treatments. IntechOpen; 2020. \u003c/li\u003e\n\u003cli\u003eTaha AB. Bacteriological profile, antibiotic susceptibility, and biofilm formation in children with chronic suppurative otitis media. Int J Pediatr Otorhinolaryngol. 2025;188:112208. \u003c/li\u003e\n\u003cli\u003eAlatoom A, Alattas M, Alraddadi B, Moubareck CA, Hassanien A, Jamal W, et al. Antimicrobial Resistance Profiles of Pseudomonas aeruginosa in the Arabian Gulf Region Over a 12-Year Period (2010\u0026ndash;2021). J Epidemiol Glob Health. 2024;14(3):529\u0026ndash;48. \u003c/li\u003e\n\u003cli\u003eSaadoon WK, Al-Hadithi HSAR. Detection of Extended-Spectrum \u0026beta;-Lactamase Producing Escherichia coli and Klebsiella pneumoniae in Urinary Tract Infection in Selected Baghdad Hospitals. J Univ Babylon Pure Appl Sci. 2025;273\u0026ndash;84. \u003c/li\u003e\n\u003cli\u003eOliver A, Arca-Su\u0026aacute;rez J, Gomis-Font MA, Gonz\u0026aacute;lez-Pinto L, L\u0026oacute;pez-Causap\u0026eacute; C. Emerging resistance mechanisms to newer \u0026beta;-lactams in Pseudomonas aeruginosa. Clin Microbiol Infect. 2025; \u003c/li\u003e\n\u003cli\u003eElfadadny A, Ragab RF, AlHarbi M, Badshah F, Ib\u0026aacute;\u0026ntilde;ez-Arancibia E, Farag A, et al. Antimicrobial resistance of. Pseudomonas aeruginosa. 2024; \u003c/li\u003e\n\u003cli\u003eAlshaybawee MR, Asgari S, Ghadersoltani P, Mehrabian A, Saniee P. Exploring the antibacterial and anti-biofilm activity of two Iranian medical-grade kinds of honey on multidrug-resistant Pseudomonas aeruginosa. BMC Complement Med Ther. 2025;25(1):39. \u003c/li\u003e\n\u003cli\u003eAmankwah FKD, Gbedema SY, Boakye YD, Bayor MT, Boamah VE. Antimicrobial potential of extract from a Pseudomonas aeruginosa isolate. Scientifica (Cairo). 2022;2022(1):4230397. \u003c/li\u003e\n\u003cli\u003eMurugesan V, Palanivel P, Ramesh G, Ganesh D, Michael HSR, Bandhumy Lingam S, et al. Exploring the antibacterial potential of Clidemia hirta leaf extract against the pathogenicity of Pseudomonas aeruginosa: in vitro and in silico approaches. Front Pharmacol. 2025;16:1555542. \u003c/li\u003e\n\u003cli\u003eZeineldin M, Esmael A, Al-Hindi RR, Alharbi MG, Ashenafi Bekele D, Teklemariam AD. Beyond the risk of biofilms: An up-and-coming battleground of bacterial life and potential antibiofilm agents. Life. 2023;13(2):503. \u003c/li\u003e\n\u003cli\u003eDeepa B, Sivakumar T. Phytochemical Analysis and Antibacterial Efficacy of Ethanolic Extract of Musa paradisiaca. Res Biot Int J. 2020;2(3):126\u0026ndash;30. \u003c/li\u003e\n\u003cli\u003eJubair N, Rajagopal M, Chinnappan S, Abdullah NB, Fatima A. Review on the antibacterial mechanism of plant‐derived compounds against multidrug‐resistant bacteria (MDR). Evidence‐Based Complement Altern Med. 2021;2021(1):3663315. \u003c/li\u003e\n\u003cli\u003eEedee KF, Martha E, Giami L, Patience Nkiru D, Konne OE, Roseanne Adah O, et al. Antimicrobial activities of ethanol extract of banana (Musa sapientum L.) peels against organisms associated with urinary tract infection. Asian J Res Infect Dis. 2022;9(1):1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eAjijolakewu KA, Ayoola AS, Agbabiaka TO, Zakariyah FR, Ahmed NR, Oyedele OJ, et al. A review of the ethnomedicinal, antimicrobial, and phytochemical properties of Musa paradisiaca (plantain). Bull Natl Res Cent. 2021;45(1):86. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"The Islamic University of Najaf, College of Medical Technology, Department of Medical Laboratory Technology, ","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Banana peel extract, Pseudomonas aeruginosa, Otitis media, Antibacterial activity, Pediatric infections","lastPublishedDoi":"10.21203/rs.3.rs-8660214/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8660214/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis in vitro study evaluated the antibacterial activity of hot and cold aqueous banana peel extracts against Pseudomonas aeruginosa isolated from children with otitis media.\u003c/p\u003e\u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eTo make hot and cold aqueous extracts, banana peels were cleaned, dried, and processed. Tests were conducted at three different concentrations (50, 100, and 200 mg/mL). Inhibition zones were determined and the antibacterial activity was evaluated using the agar well diffusion method. The extracts' effects were contrasted with those of common antibiotics, such as imipenem and amikacin. The data were statistically analyzed and presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAt every studied concentration, the hot aqueous extract exhibited noticeably greater antibacterial activity than the cold extract. The heated extract at 200 mg/mL showed the maximum activity (21.73\u0026thinsp;\u0026plusmn;\u0026thinsp;4.47 mm). The heated extract did not significantly differ from amikacin (p\u0026thinsp;=\u0026thinsp;0.913), but it did significantly differ from imipenem (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). At every concentration, the cold aqueous extract showed reduced antibacterial activity.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003e \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolated from pediatric otitis media showed significant in vitro antibacterial activity against hot aqueous banana peel extract, indicating its potential as a supplemental or natural alternative antibacterial agent.\u003c/p\u003e","manuscriptTitle":"In Vitro Antibacterial Activity of Hot and Cold Aqueous Banana Peel Extracts Against Pseudomonas aeruginosa Isolated from Pediatric Otitis Media: A Preliminary Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-22 10:27:50","doi":"10.21203/rs.3.rs-8660214/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"924a8b6b-d1cc-4ae0-a50e-a38b9efd2486","owner":[],"postedDate":"January 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":61515136,"name":"Applied \u0026 Industrial Microbiology"},{"id":61515137,"name":"Bacteriology"},{"id":61515138,"name":"Drug Discovery, Design, \u0026 Development"},{"id":61515139,"name":"Botany"},{"id":61515140,"name":"Tropical Medicine"}],"tags":[],"updatedAt":"2026-01-22T10:27:51+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-22 10:27:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8660214","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8660214","identity":"rs-8660214","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}