The Efficacy of Imipenem Conjugated with Synthesized Silver Nanoparticles Against Acinetobacter baumannii Clinical Isolates, Iran

Carbapenem-resistant Acinetobacter baumannii (CRAB) remains as a serious cause of infectious diseases and septic mortality in hospitalized patients worldwide. This study was conducted to evaluate the antimicrobial effect of imipenem conjugated silver nanoparticles (AgNPs) on resistant isolated A. baumannii from nosocomial infections. The antimicrobial susceptibility test of 100 A. baumannii clinical isolates against different antibiotics was performed. PCR was used to confirm bacterial resistance and to identify different genes encoding Ambler class beta-lactamases. The chemically synthesized AgNPs were characterized using UV-vis spectroscopy, X-ray diffraction (XRD), transmission electron microscopy (TEM), and Fourier-transform infrared (FTIR). The stability, drug release kinetic, and cytotoxicity (MTT assay) of AgNPs were also investigated. The imipenem were conjugated with AgNPs, and conjugants were characterized as discussed above. Minimum inhibitory concentration (MIC) of the AgNPs and conjugants were tested against A. baumannii isolates and compared with imipenem alone. The results revealed that among all isolated A. baumannii, 76% showed resistant to imipenem (MIC >= 64 mu g/mL to >= 256 mu g/mL). The bla(OXA-23), bla(PER), bla(OXA-40), and bla(IMP) genes were the most prevalent genes. UV-vis spectroscopy, XRD, TEM, and FTIR analysis confirmed synthesis of AgNPs (average size of 10-40 nm) and conjugation with imipenem. The release of imipenem from AgNPs can be defined as Fickian diffusion model. The MIC values of AgNPs conjugated with imipenem against resistant A. baumannii were decreased in a dose dependent manner and were based on existence of resistant genes. The AgNPs also showed low cytotoxic effects. The results suggest that imipenem-AgNPs has a strong potency as a powerful antibacterial agent against multi-resistant A. baumannii.