Enhanced Efficacy of Some Antibiotics in the Presence of Silver Nanoparticles Against Clinical Isolate of Pseudomonas aeruginosa Recovered from Cystic Fibrosis Patients

Abstract

Hafez Al-Momani,1 Hadeel Albalawi,2 Dua’a Al Balawi,2 Khaled M Khleifat,3 Iman Aolymat,4 Saja Hamed,5 Borhan Aldeen Albiss,6 Ashraf I Khasawneh,1 Ola Ebbeni,7 Ayman Alsheikh,8 AbdelRahman M Zueter,9 Jeffrey Peter Pearson,10 Christopher Ward11 1Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan; 2Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan; 3Biology Department, College of Science, Mutah University, Mutah, Karak, 61710, Jordan; 4Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan; 5Department of Pharmaceutics & Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, 13133, Jordan; 6Nanotechnology Institute, Jordan University of Science & Technology, Irbid, 22110, Jordan; 7Department of Pharmacology and Public Health, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan; 8Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Zarqa University, Zarqa, 13110, Jordan; 9Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan; 10Biosciences Institute, Newcastle University Medical School, Newcastle Upon Tyne, UK; 11Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle Upon Tyne, NE2 4HH UKCorrespondence: Hafez Al-Momani, Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan, Email [email protected]: Given the increasing frequency of drug-resistant bacteria and the limited progress in developing new antibiotics, it is necessary to explore new methods of combating microbial infections. Nanoparticles, particularly silver nanoparticles (Ag-NPs), have shown exceptional antibacterial characteristics; however, elevated concentrations of Ag-NPs can produce noticeable levels of toxicity in mammalian cells.Aim: This study examined the potential synergistic effect of combining a low dosage of Ag-NPs and anti-pseudomonas drugs against Pseudomonas aeruginosa (ATCC strain) and eleven clinical isolates from cystic fibrosis patients.Methods: The Ag-NPs were chemically produced by utilizing a seed extract from Peganum Harmala and characterized via ultraviolet-visible spectroscopy and scanning electron microscopy. The broth microdilution technique was utilized to investigate the minimum inhibitory concentration (MIC) of Ag-NPs and eight antibiotics (Piperacillin, Ciprofloxacin, Levofloxacin, Meropenem, Amikacin, Ceftazidime, Gentamicin, Aztreonam). The fractional inhibitory concentration index (FICI) was determined via the checkerboard method to evaluate the synergistic effects of Ag-NPs and various antibiotics.Results: The biosynthesized Ag-NPs were uniformly spherical and measured around 15 nm in size. When combined with antibiotics, Ag-NP produced statistically significant reductions in the amount of antibiotics required to completely prevent P. aeruginosa growth for all strains. The findings revealed that the MIC of Ag-NPs was 15 ug/mL for all strains which decreased substantially when administered with antibiotics at a dose of 1.875– 7.5 ug/mL. The majority of Ag-NP and antibiotic combinations exhibited a synergistic or partially synergistic impact. This was particularly noticeable in combinations containing Meropenem, Ciprofloxacin, and Aztreonam (in which the FIC index was less than or equal to 0.5).Conclusion: The findings revealed that combining Ag-NPs with antibiotics was more effective than using Ag-NPs or antibiotics in isolation and that combinations of Ag-NPs and antimicrobial agents displayed synergistic activity against the majority of strains assessed.Keywords: cystic fibrosis CF, biofilm, Pseudomonas aeruginosa, nanoparticles, silver nanoparticles, antibiotic resistance, synergy

Keywords

• cystic fibrosis cf
• biofilm
• pseudomonas aeruginosa
• nanoparticles
• silver nanoparticles
• antibiotic resistance
• synergy