BackgroundSilver nanoparticles (AgNPs) are potential antimicrobials agents, which can be considered as an alternative to antibiotics for the treatment of infections caused by multi-drug resistant bacteria. The antimicrobial effects of double and triple combinations of AgNPs, visible blue light, and the conventional antibiotics amoxicillin, azithromycin, clarithromycin, linezolid, and vancomycin, against ten clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) were investigated.MethodsThe antimicrobial activity of AgNPs, applied in combination with blue light, against selected isolates of MRSA was investigated at 1/2–1/128 of its minimal inhibitory concentration (MIC) in 24-well plates. The wells were exposed to blue light source at 460 nm and 250 mW for 1 h using a photon emitting diode. Samples were taken at different time intervals, and viable bacterial counts were determined. The double combinations of AgNPs and each of the antibiotics were assessed by the checkerboard method. The killing assay was used to test possible synergistic effects when blue light was further combined to AgNPs and each antibiotic at a time against selected isolates of MRSA.ResultsThe bactericidal activity of AgNPs, at sub-MIC, and blue light was significantly (p < 0.001) enhanced when both agents were applied in combination compared to each agent alone. Similarly, synergistic interactions were observed when AgNPs were combined with amoxicillin, azithromycin, clarithromycin or linezolid in 30–40 % of the double combinations with no observed antagonistic interaction against the tested isolates. Combination of the AgNPs with vancomycin did not result in enhanced killing against all isolates tested. The antimicrobial activity against MRSA isolates was significantly enhanced in triple combinations of AgNPs, blue light and antibiotic, compared to treatments involving one or two agents. The bactericidal activities were highest when azithromycin or clarithromycin was included in the triple therapy compared to the other antibiotics tested.ConclusionsA new strategy can be used to combat serious infections caused by MRSA by combining AgNPs, blue light, and antibiotics. This triple therapy may include antibiotics, which have been proven to be ineffective against MRSA. The suggested approach would be useful to face the fast-growing drug-resistance with the slow development of new antimicrobial agents, and to preserve last resort antibiotics such as vancomycin.

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Silver nanoparticles (AgNPs) have been used as potential antimicrobial agents against resistant pathogens. We investigated the possible therapeutic use of AgNPs in combination with visible blue light against a multidrug resistant clinical isolate of Pseudomonas aeruginosa in vitro and in vivo. The antibacterial activity of AgNPs against P. aeruginosa (1×10 5 colony forming unit/mL) was investigated at its minimal inhibitory concentration (MIC) and sub-MIC, alone and in combination with blue light at 460 nm and 250 mW for 2 hours. The effect of this combined therapy on the treated bacteria was then visualized using transmission electron microscope. The therapy was also assessed in the prevention of biofilm formation by P. aeruginosa on AgNP-impregnated gelatin biopolymer discs. Further, in vivo investigations were performed to evaluate the efficacy of the combined therapy to prevent burn-wound colonization and sepsis in mice and, finally, to treat a real infected horse with antibiotic-unresponsive chronic wound. The antimicrobial activity of AgNPs and visible blue light was significantly enhanced ( P <0.001) when both agents were combined compared to each agent alone when AgNPs were tested at MIC, 1/2, or 1/4 MIC. Transmission electron microscope showed significant damage to the cells that were treated with the combined therapy compared to other cells that received either the AgNPs or blue light. In addition, the combined treatment significantly ( P <0.001) inhibited biofilm formation by P. aeruginosa on gelatin discs compared to each agent individually. Finally, the combined therapy effectively treated a horse suffering from a chronic wound caused by mixed infection, where signs of improvement were observed after 1 week, and the wound completely healed after 4 weeks. To our knowledge, this combinatorial therapy has not been investigated before. It was proved efficient and promising in managing infections caused by multidrug resistant bacteria and could be used as an alternative to conventional antibiotic therapy.

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In this work, we present the successful field implementation of using Photodynamic modality to control Malaria, Filaria and Dengue Fever vectors in infested epidemic swamps in Uganda, Ethiopia and Sudan. As the Photodynamic technique has become a major approach for the control of human parasites and noxious insects.Field investigations were carried out based on laboratory and semi-field results. In these trials, chlorophyll derivatives were added to the infested swamps to be taken by the mosquito larvae and the accumulated photoactive compound (photosensitizer) inside the larvae body induces upon sunlight exposure an oxidation stress, that results in organism death.As example in Kasangati and Namanve cities of Wakiso a district in Uganda , chlorophyll derivatives , as sunlight active photosensitizers was applied to cover 250 000 square meter of infected swamps and sand pits (4 gm/ m 2 ). The infected cities were mapped for this field study using Geographical Positioning System (GPS). All the biotic and a-biotic factors were measured before and after treatment. Confocal laser scanning microscopy measurements were used to monitor the concentration and the dynamic distribution of chlorophyll derivatives inside the larvae of Anopheles gambiae mosquito.The results reveal that from 85% to 100% mortality of larvae population are obtained at different concentrations of Chlorophyll derivatives (0.1 -100µM). Other biological beneficiary organisms, such as the dragon fly larvae and mosquito predator larvae, which were present in the same treated swamps were not affected (target selectivity).The field trials are the result of three years continuous and persistent work, which showed promising success in controlling Malaria, Filaria and Dengue Fever vectors by cutting the mosquito's life cycle without new generation, formation, or reinfestation.