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Comparative Study of Antibacterial Effects of Titanium Dioxide Nanoparticles Alone and in Combination with Antibiotics on MDR Pseudomonas aeruginosa Strains

Authors Ahmed FY, Farghaly Aly U, Abd El-Baky RM, Waly NGFM

Received 16 January 2020

Accepted for publication 18 April 2020

Published 14 May 2020 Volume 2020:15 Pages 3393—3404

DOI https://doi.org/10.2147/IJN.S246310

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Anderson Oliveira Lobo


Fatma Y Ahmed,1 Usama Farghaly Aly,2 Rehab M Abd El-Baky,1,3 Nancy G F M Waly1

1Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Minia 61519, Egypt; 2Department of Pharmaceutics, Faculty of Pharmacy, Minia University, Minia 61519, Egypt; 3Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia 11566, Egypt

Correspondence: Usama Farghaly Aly
Faculty of Pharmacy, Minia University, Minia, Egypt
Tel +201001108688
Email us_farghaly@mu.edu.eg

Introduction: The efficacy of several antimicrobial agents has been hindered due to the increasing frequency of multidrug-resistant (MDR) Pseudomonas aeruginosa strains. So, the need for new antibacterial drugs or drug combinations is urgent. Recently, desirable antibacterial effects were reported for many metals nanoparticles such as TiO2 nanoparticles (TDNs).
Purpose: This study aims to investigate the prevalence of MDR P. aeruginosa and assess the efficiency of TDN in the treatment of MDR P. aeruginosa-associated infections.
Materials and Methods: The synthesis of TDN by the sol-gel method was carried out. Particle size measurements and morphology were done using dynamic light scattering (DLS) and high-resolution transmission electron microscopy (HR-TEM). To investigate the physical and chemical changes of drugs due to the combination, the tested drugs, both alone and in combination with TDN, were subjected to differential scanning calorimetry (DSC), infrared (IR) spectroscopy, and X-ray diffraction studies. Antimicrobial susceptibility was detected by agar disc-diffusion assay. The minimum inhibitory concentration (MIC) of TDN and the tested antibiotics were assessed by the agar dilution method. Checkerboard analysis was performed to determine the combined effect of TDN and the tested antibiotics against 25 MDR P. aeruginosa strains.
Results: TDNs were prepared with an average particle size of 64.77 ± 0.14 nm with an accepted polydispersity index (PDI) value of 0.274 ± 0.004. TEM showed that the particles were shaped into irregular spheres. Twenty-five P. aeruginosa isolates that were absolutely resistant to cefepime (100%), highly resistant to ceftriaxone (96%), amikacin (80%), and ciprofloxacin (76%) were selected. Superior antibacterial activity of TDN was observed against the selected 25 MDR P. aeruginosa isolates. The combination of TDN and cefepime were found to show synergistic activity against all tested isolates followed by ceftriaxone (96%), amikacin (88%), and ciprofloxacin (80%).
Conclusion: Using TDN in combination with antibiotics can help in the treatment of MDR P. aeruginosa-associated infections. So, preparation of topical pharmaceutical dosage forms containing a combination of these antibiotics and TDN can be useful against MDR P. aeruginosa.

Keywords: MDR P. aeruginosa, titanium dioxide nanoparticle, checkerboard assay

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