Investigation of the effect of silver nanoparticles alone and their combination with clarithromycin on H. pylori isolates

Abstract

Helicobacter pylori is a common bacterial pathogen responsible for gastrointestinal diseases worldwide. Clarithromycin has been considered the best tolerable and safe antibiotic in treating H. pylori infection, but increased levels of clarithromycin resistance have reduced the effectiveness of the recommended treatment regimens. So alternative treatment approaches such as nanotechnology have been considered recently. This study aimed to determine the effect of silver nanoparticles (Ag-NP) alone and their combination with clarithromycin on H. pylori isolates. Gastric biopsy specimens were collected from 163 patients with different gastrointestinal signs referred to the endoscopy ward of Beheshti Hospital in Kashan, Iran. H. Pylori strains were isolated from 40 patients out of 163 (24.5%). Minimum inhibitory concentration (MIC) of clarithromycin on H. pylori isolates was determined by the Epsilometer test. The effect of the combination of Ag-NP with clarithromycin on the growth inhibition of clarithromycin-sensitive and resistant H. pylori isolates was determined by the checkerboard titration method. The clarithromycin resistance rate to H. pylori was 42.5%. The MIC of Ag-NP in clarithromycin-sensitive was 31.25-125 µg/ml and resistant H. pylori isolates ranged from 62.5-250 µg/ml. Due to the combination of Ag-NP with clarithromycin, 70.58% of clarithromycin-resistant isolates and 78.26% of clarithromycin-sensitive isolates showed a synergistic effect. A significant difference was observed in comparing the MIC of clarithromycin in combination with Ag-NP and clarithromycin or Ag-NP alone. The MIC clarithromycin was decreased in the presence of Ag-NP against clarithromycin sensitive, and resistant H. Pylori isolates.

Implications of silver nanoparticles for H. pylori infection: modulation of CagA function and signaling

“…Growth curves provide a dynamic representation of bacterial growth over time (48 hours), whereas CFU assays provide a quantitative measure of bacterial killing, identifying the concentration at which bacterial survival is significantly reduced within only two hours of exposure time. The MIC values determined in this study are consistent with those reported for silver nanoparticles by several other research groups ( Amin et al., 2014 ; Saravanakumar et al., 2019 ; Mansouri et al., 2022 ). The action of AgNPs in the stomach is influenced by their size distribution, the formulation and to a significant extent, gastric pH.…”

Helicobacter Pylori-Induced Gastric Infections: From Pathogenesis to Novel Therapeutic Approaches Using Silver Nanoparticles

“…Currently, due to the lack of an efficient strategy for eradicating H. pylori infection in the context of drug resistance, one of the focuses of research for a better therapeutic approach is on alternative and complementary methods, including AgNPs per se [ 97 ], AgNPs embedded in polymeric nanocarriers [ 98 ], or AgNPs combination with classical antibiotics [ 99 ].…”

“…The results showed a small degree of growth inhibition of the bacterium compared with the studies conducted in vitro where the AgNP/clay complex showed a more obvious inhibitory effect. A study conducted in 2022 demonstrated a good efficacy of AgNPs in combination with clarithromycin compared with clarithromycin treatment only [ 99 ].…”

How Combined Macrolide Nanomaterials are Effective Against Resistant Pathogens? A Comprehensive Review of the Literature

“… 64 , 73 More importantly, AgNPs have multi-target activities and interactions inside the bacterial cell which helps them escape resistance that can enhance antibacterial activities and reduce the microbial resistance when they are functionalized with macrolides. 97 , 99 The diverse mechanisms of antimicrobial action of AgNPs are summarized in Figure 4 . 3 , 81 In one study, azithromycin was functionalized with silver NPs and nanoprisms (AgNPs & AgNPrs).…”