Abstract

Antibacterial therapy is of paramount importance in treatment of several acute and chronic infectious diseases caused by pathogens. Over the years extensive use and misuse of antimicrobial agents has led to emergence of multidrug resistant (MDR) and extensive drug resistant (XDR) pathogens. This drastic escalation in resistant phenotype has limited the efficacy of available therapeutic options. Thus, the need of the hour is to look for alternative therapeutic approaches to mitigate healthcare concerns caused due to MDR bacterial infections. Nanoparticles have gathered much attention as potential candidates for antibacterial therapy. Equipped with advantages of, wide spectrum bactericidal activity at very low dosage, inhibitor of biofilm formation and ease of permeability, nanoparticles have been considered as leading therapeutic candidates to curtail infections resulting from MDR bacteria. However, substrate non-specificity of efflux pumps, particularly those belonging to resistance nodulation division super family, have been reported to reduce efficacy of many potent antibacterial therapeutic drugs. Previously, we had reported antibacterial activity of polysaccharide-capped silver nanoparticles (AgNPs) toward MDR bacteria. We showed that AgNPs inhibits biofilm formation and alters expression of cytoskeletal proteins FtsZ and FtsA, with minimal cytotoxicity toward mammalian cells. In the present study, we report no reduction in antibacterial efficacy of silver nanoparticles in presence of AcrAB-TolC efflux pump proteins. Antibacterial tests were performed according to CLSI macrobroth dilution method, which revealed that both silver nanoparticles exhibited bactericidal activity at very low concentrations. Further, immunoblotting results indicated that both the nanoparticles modulate the transporter AcrB protein expression. However, expression of the membrane fusion protein AcrA did show a significant increase after exposure to AgNPs. Our results indicate that both silver nanoparticles are effective in eliminating MDR Enterobacter cloacae isolates and their action was not inhibited by AcrAB-TolC efflux protein expression. As such, the above nanoparticles have strong potential to be used as effective and alternate therapeutic candidates to combat MDR gram-negative Enterobacterial pathogens.

Highlights

  • The drastic escalation in the proportion of multiple antibiotic resistant bacteria is recognized as a serious health care concern globally (WHO, 2014)

  • The results clearly indicated that a newly developed silver-metal-carbohydrate nanoparticle (Ag-MCNP) was more efficient in killing the multidrug resistant (MDR) E. cloacae compared to AgNPs alone

  • As reported from the literature, success of potential antibacterial agents rested upon their efficacy to be retained in the cell vis-àvis being effluxed out. We investigated this by studying the effect of silver nanoparticles on expression of multidrug efflux pump proteins AcrAB-TolC

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Summary

Introduction

The drastic escalation in the proportion of multiple antibiotic resistant bacteria is recognized as a serious health care concern globally (WHO, 2014). The Enterobacter spp., E. aerogenes and E. cloacae are often associated with nosocomial infections like urinary tract infection ( catheter related), abdominal cavity/intestinal infections, wound infections, pneumonia, and septicemia (Sanders and Sanders, 1997; Fraser and Arnett, 2010). These two clinically predominant species display one or more resistance mechanisms toward antimicrobials like β-lactams, cephalosporins, aminoglycosides. E. aerogenes and E. cloacae are exhibiting trends of increased resistance toward the last resort antimicrobial agents – carbapenems and colistin (Davin-Regli and Pagès, 2015). Well-equipped with armory of antibiotic resistance strategies such as, outer membrane permeability barrier, efflux pumps and antibiotic degrading enzymes, Enterobacter spp. form an interesting infectious model to explore (Grimont and Grimont, 2006; Mezzatesta et al, 2012; Davin-Regli and Pagès, 2015)

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