Synergistic effect of Zinc Oxide nanoparticles and Vancomycin on Methicillin resistant Staphylococcus aureus



How to Cite

Thamer, R., & Alsammak, E. (2020). Synergistic effect of Zinc Oxide nanoparticles and Vancomycin on Methicillin resistant Staphylococcus aureus. Journal of Life and Bio Sciences Research , 1(3), 93 - 98.


The study was carried out on (120) various clinical samples collected from patients attended Al Salam and Al-Khansa Hospitals and the Public Health Laboratory in the Mosul city during the of 4 months (September - December 2019). Samples were cultured on Mannitol Salt Agar medium, 105 samples give a positive result (grew the bacteria). 50 isolates were fermented mannitol sugar, at a rate of 47.6%, depending on the phenotypic characteristics and production of Coagulase, 14 isolates were identified, at a rate of 13.3%, belonging to Staphylococcus aureus the diagnosis were confirmed using VITEK system. The highest isolation rate from wounds was 57%, then abscesses 21%, blood samples 14%, and urinary tract infections 7%. The sensitivity of the isolates was tested for 16 antibiotics, the isolates showed variation in their resistance to antibiotics. Most of the isolates showed high resistance at 92.8% to each of Oxacillin, Vancomycin, which were diagnosed as MRSA and VRSA. Vancomycin MICs against MRSA and VRSA ranged (2500-5000) g /mL. MIC for nanoparticles sized (30, 20, 50-150) nm ranged (5000-10000) g / mL for isolates that are positive coagulase. In this study the efficacy of vancomycin was improved in combination with ZnO nanoparticles. results showed a decrease in vancomycin MICs from (2500-5000) g / mL to (39-78.125) g \ mL when mixed with ZnO 20 nm.


Abdulrahman, N.B., Nssaif, Z.M. (2016). Antimicrobial Activity of Zinc Oxide, titanium Dioxide and Silver Nanoparticles Against Mithicillin-Resistant Staphylococcus aureus Isolates. Tikrit Journal of Pure Science, 21, 3, 49-53.

Ahmadi Shadmehri, A., Namvar, F., Miri, H., Yaghmaei, P., Nakhaei Moghaddam, M. (2019). Assessment of antioxidant and antibacterial activities of Zinc Oxide nanoparticles, Graphene and Graphene decorated by Zinc Oxide nanoparticles . International Journal of Nano Dimension, 10: 350–358.

Al-Dahbi, AM. And Al-Mathkhury, H.J. (2013). Distribution of Methicillin Resistant Staphylococcus aureus in Iraqi patients and Healthcare Workers. Iraqi Journal of Science, 54 (2), 293-300.

Aleaghil, S.A., Fattahy, E., Baei, B., Saghali, M., Bagheri, H., Javid, N., Ghaemi, E.A. (2016). Antibacterial activity of Zinc oxide nanoparticles on Staphylococcus aureus. International Journal of Advanced Biotechnology and Research , 7, 569-1575.

Al-Geobory, H.A.H. (2011). Comparative Study between Methicillin Resistant Staphylococcus aureus (MRSA) and Methicillin Sensitive Staphylococcus aureus (MSSA), and detect the Antimicrobial Effects of some Plant Extracts on them. Msc. Thesis. College of Science/ Baghdad University. Iraq.

Al-Khafaji, A.N. (2018). Isolation and Identification of Methicillin Resistance Staphylococcus aureus and Detection their Ability to the Production of Virulence Factors. Journal of University of Babylon for Pure and Applied Sciences, 26(8).

Al-Maliki, A.A.A. (2009). A study of some Methicillin-Resistant Staphylococcus aureus (MRSA) and (MRSE) Isolated from Baghdad Hospital Patients. M.Sc. Thesis. College of Science. AL-Mustansiriya University.

Ansari, M.A., Khan, H.M., Khan, A.A., Sultan, A., Azam, A. (2012). Characterization of clinical strains of MSSA‚MRSA and MRSE isolated from skin and soft tissue infestions and the antibacterial activity of ZnO nanoparticles. World Journal of Microbiology and Biotechnology, 28(4), 1605-1613.

Asanin, J., Misic, D., Aksentijevic, K., Tambur, Z., Rakonjac, B., Kovacevic, I., Spergser, J., Loncaric, I. (2019). Genetic Profiling and Comparison of Human and Animal Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Serbia. Antibiotics, 8, 26. doi:10.3390/antibiotics8010026

Banoee, M., Seif, S., Nazari, Z.E., Jafari-Fesharaki, P., Shahverdi, H.R., Moballegh, A., Moghaddam, K.M., Shahverdi, A.R. (2010). ZnO Nanoparticles enhanced antibacterial activity of ciprofloxacin against Staphylococcus aureus and Escherichia coli. Journal of Biomedical Materials Research, 93, 557-561.

Bauer, A.W., Kirby, M.M., Sherris, J.C., Turck, M. (1966). Antibiotic susceptibility testing by standardized single disc method. American Journal of Clinical Pathology ,45(4), 493-496.

Cho,WS., Duffin, R., Howie, SE., Scotton, CJ., Wallace, WA., Macnee, W., Bradley, M., Megson, IL., Donaldson, K. (2011). Progressive severe lung injury by zinc oxide nanoparticles,the role of Zn2+ dissolution inside lysosomes. Part Fibre Toxicol 8:27.

Clinical and Laboratory Standards Institute, CLSI (2019). Performance Standards for Antimicrobial Susceptibility Testing.29th ed. CLSI supplement M100., 39(1), 42-45,58-67.

Collee, J.G., Fraser, A.G., Marmion, B.P., Simmon, S.A. (1996). Mackie and McCartney Practical Medical Microbiology. (14thEd.) Churchill Livingston, U.S.A.

Duran, N., Ozer, B., Duran G. G., Onlen, Y., Demir, C. (2012). “Antibiotic resistance genes & susceptibility patterns in Staphylococci,” Indian Journal of Medical Research,135(3), 389–396.

Ekrami, A., Samarbafzadeh, A.R., Alavi, M., Kalantar, E., Hamzeloi, F. (2010). Prevalence of methicillin resistant Staphylococcus sp. isolated from burn patients in a burn center, Ahvaz, Iran. Jundishapur Journal of Microbiology , 3,84-91.

Fayaz, A.M., Balaji, K., Girilal, M., Yadav, R., Kalaichelvan, P.T., Venkete¬san, R. (2010). Biogenic synthesis of silver nanoparticles and their syn¬ergistic effect with antibiotics: a study against gram-positive and gram-negative bacteria. Nanomedicine, 6(1),103–9. doi: 10.1016/j.nano.2009.04.006.

Gonzalez-Zom, B., Courvalin, P. (2003). “Van Amediated high level”. Glycopeptide resistance in MRSA. The Lancet Infectious Diseases, 3, 67-68.

Goudarzi, G., Tahmasbi, F., Anbari, K., Ghafarzadeh, M. (2016). Distribution of genes encoding resistance to macrolides among staphylococci isolated from the nasal cavity of hospital employees in Khorramabad, Iran. Iranian Red Crescent Medical Journal, 18, 25701.

Hajipour, M.J., Fromm, K.M., Ashkarran, A.A., Aberasturi, D.J., Larramendi, I.R., Rojo,T., Serpooshan,V., Parak, W.J., Mahmoudi, M. (2012). Antibacterial properties of nanoparticles. Trends in Biotechnology, 30(10),499–511.

Kandala, N.J., Abdulateef, A., Imad, N. (2017). Genotyping of Staphylococcus aureus Isolated Based on Methicillin –Resistant Genes and its Relatedness to some Putative Virulence Factors.Iraqi Journal of Science,58(2A), 626-638.

Kolar, M., Bardon, J., Hanulik, V., Sauer, P., Babak, V., and Schlegelova, J. (2010). “Resistance to methicillin in coagulase-negative Staphylococci and Its Detection”. Acta Veterinaria Brno,79,261-267.

Kolodziejczak-Radzimska, A., Jesionowski, T. (2014). Zinc oxide - from synthesis to application: a review. Materials,7,2833–2881.

Kuroda, M., Kuwahara-Arai, K., Hiramatsu, K. (2000). “Identification of the up and down-regulated genes in vancomycin-resistant Staphylococcus aureus strains Mu3 and Mu50 by cDNA differential hybridization method”.Biochemical and Biophysical Research Communications, 269, 485-490.

Maruthupandy, M., Anand, M., Maduraiveeran, G., Suresh, S., Beevi1, A.S., Priya1, R.J. (2016). Investigation on the electrical conductivity of ZnO nanoparticles-decorated bacterial nanowires. Advances in Natural Sciences,7(9),045011.

McDonald, R.R., Antonishyn, N.A., Hansen, T., Snook, L.A., Nagle, E., Mulvey, M.R., Levett, P.N., Horsman, G.B. (2005). Development of a triplex real-time PCR assay for detection of Panton-Valentine leukocidin toxin genes in clinical isolates of methicillin-resistant Staphylococcus aureus. Journal of Clinical Microbiology,43(12), 6147–6149.doi:10.1128/JCM .43 .12.6147-6149.

Meyer, F., Girardot, R., Piemont, Y., Prévost, G., Colin, D.A. (2009). Analysis of the specificity of Panton-Valentine leucocidin and gamma-hemolysin F component binding. Infection and Immunity,77(1), 266–273.

Mohammed, L.S., Flayyih, M.T. (2017). Patterns of Phenotypic and Genotypic Resistance to Macrolides, Lincosamides and Streptogramins Group of Antibiotics by Efflux Pump and Enzymatic Modification in Methicillin Resistant Staphylococcus aureus .Iraqi Journal of Science,58(2B):815-819.

Nazoori, E.S., Kariminik, A. (2018). In vitro Evaluation of Antibacterial Properties of Zinc Oxide Nanoparticles on Pathogenic Prokaryotes. Journal of Applied Biotechnology Reports,5(4),162-165.

Pati, R., Mehta, R.K., Mohanty, S., Padhi, A., Sengupta, M., Vaseeharan, B., Goswami, C., Sonawane, A. (2014). Topical application of zinc oxide nanoparticles reduces bacterial skin infection in mice and exhibits antibacterial activity by inducing oxidative stress response and cell membrane disintegration in macrophages. Nanomedicine, 10,1195–1208.

Peck, K.R., Baek, J.Y., Song, J-H., Ko, K.S. (2009).“Comparison of genotypes and enterotoxin genes between Staphylococcus aureus isolates from blood and nasal colonizers in Korean hospitals”. Journal of Korean Medical Science, 24,585-591.

Rao, K.A., Deepa, S., Venkatsha, D. (2014). Screening for nasal colonizer: Mandatory to prevent surgical site infections. International Journal of Scientific Study,2(5),1-5.

Reddy, P.N., Srirama, K., Dirisala, V.R. (2017). An Update on Clinical Burden, Diagnostic Tools, and Therapeutic Options of Staphylococcus aureus. Infectious Diseases: Research and Treatment, 10,1–15.

Reipert, A., Ehlert, K., Kast, T., Bierbaum, G. (2003). Morphological and genetic differences in two isogenic Staphylococcus aureus strains with decreased susceptibilities to vancomycin. Antimicrobial Agents and Chemotherapy, 47(2), 568-576.

Saginur, R., Denis, M.S., Ferris, W., Aron, S.D., Chan, F., Lee, C., Ramotar, K. (2006). Multiple Combination bactericidal testing of Staphylococcal biofilms from implant-associated infections .Antimicrobial Agents and Chemotherapy,50(1),55-61.

Salih, R.M.H., Rafiq, S.N., Hamed, P.A. (2017). Vancomycin Resistance among Methicillin Resistant Staphylococcus aureus isolated from Clinical Samples in Erbil City, Iraq. Kirkuk University Journal Scientific Studies (KUJSS),12(2),1-14.

Siddiqi, K.S., Rahman, A., Tajuddin, Husen, A. (2018). Properties of Zinc Oxide Nanoparticles and Their Activity Against Microbes. Nanoscale Research Letters, 13,141.

Slomberg, D.L., Lu, Y., Broadnax, A.D., Hunter, R.A., Carpenter, A.W., Schoenfisch, M.H. (2013). Role of size and shape on biofilm eradication for nitric oxide-releasing silica nanoparticles. ACS Applied Materials & Interface.,5(19), 9322–9329.

Talebi, G., Hashemia, A., Goudarzi, H., Shariati, A., Bostanghadiri, N., Sharahi, J.Y., Abbsi, E. (2019). Survey of ermA, ermB, ermC and mecA genes among Staphylococcus aureus isolates isolated from patients admitted to hospitals in Tehran, Iran by PCR and sequencing. Biomedical Research, 30.

Tille, P.M. (2017). Baily and Scott's Diagnostic Microbiology.14thed. St.Louis, Missouri: Elsevier.

Tong, SY., Davis,JS., Eichenberger,E., Holland, TL., Fowler, VG.(2015). Staphylococcus aureus infections: Epidemiology, path physiology, clinical manifestations and management. Clinical Microbiology Reviews, 28(3), 603-661.

Tortora, G.J., Funke, R., Case, C.L. (2018). Microbiology: an introduction.13th ed. Pearson Education, Inc. U. S.

Wang, C., Lu, J., Zhou, L., Li, J., Xu, J., Li, W., Zhang, L., Zhong, X., Wang, T. (2016). Effects of long-term exposure to zinc oxide nanoparticles on development,zinc metabolism and biodistribution of minerals (Zn, Fe, Cu, Mn) in mice.PLoS One., 11,e0164434.

Winn, W., Allen, S., Janda, W., Koneman, E., Procop, G., Schreckenberger, P., Woods, G. (2006). Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 6th Ed., Lippincott, Williams&Wilkins.

Xie, Y., He, Y., Irwin, P.L., Jin, T., Shi, X. (2011). Antibacterial activity and mechanism of action of zinc oxide nanoparticles against Campylobacter jejuni.Applied and EnvironmentalMicrobiology,77(7), 2325–2331.

Yamamoto, O. (2001)."Influence of particle size on the antibacterial activity of Zinc oxide". International Journal of Inorganic Materials, 3(7), 643-646.

Yamamoto, O., Komatsu, M., Sawai, J., Nakagawa, ZE. (2004). Effect of lattice constant of zinc oxide on antibacterial characteristics .Journal of Materials Science: Materials in Medicine, 15, 847–851

Zhang, H. and Chen, G. (2009). Potent Antibacterial Activities of Ag/TiO2 Nan composite Powders Synthesized by a One-Pot Sol-Gel Method.Environmental Science & Technology, 43(8), 2905-2910.

Zhang, L., Jiang, Y., Ding, Y., Povey, M., York, D. (2007). Investigation into the antibacterial behaviour of suspensions of ZnO nanoparticles (ZnO nanofluids). Journal of Nanoparticle Research ,9(3), 479-489.

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