Abstract
Background: Methicillin resistance in Staphylococcus aureus (MRSA) is creating crises in therapeutic options for the treatment of S. aureus associated infections, worldwide. Nevertheless, Zinc oxide nanoparticles (ZnO-NPs) are providing a source of an attractive broad-spectrum antibiotic. The aim of the present study was to investigate the synergistic effects of ZnO-NPs and antibiotics against mecA positive MRSA isolates. Methods: Antibiogram of S. aureus was determined by Kirby Baur disc diffusion assay. The minimum inhibitory concentration (MIC) of antibiotics and ZnO-NPs was determined by using the broth dilution method. The mecA gene in S. aureus was detected by PCR amplification with gene specific forward and reverse primers. The effects of subinhibitory concentration of ZnO-NPs on conventional antibiotics was determined by combined disk diffusion assay. Results: Out of two hundred clinical specimens, twenty-eight showed the growth of S. aureus. Antibiogram of the isolates showed that S. aureus have acquired resistance to the majority of the conventional antibiotics. However, no isolate showed resistance to vancomycin. The confirmed methicillin resistant S. aureus isolates were sensitive to ZnO-NPs. The antibacterial activity of ZnO-NPs appeared in a dose and time dependent manner since higher dose produced stronger effects in two hours than the effects produced from lower dose in three hours. Furthermore, ZnO-NPs enhanced the antibacterial activity of levofloxacin significantly (p < 0.001). Conclusions: S. aureus has acquired strong resistance to multiple antibiotics. ZnO-NPs have potential synergism with levofloxacin antibiotic against the multiple drug resistant S. aureus including MRSA.

Munazza Sharif, Sarfraz Ali Tunio, Shaista Bano. (2020-2021) Synergistic effects of Zinc oxide nanoparticles and conventional antibiotics against methicillin resistant Staphylococcus aureus, Advancements in Life Sciences, Volume-8, Issue-2.
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