Antibacterial Effect of Zinc Oxide Nanoparticles on Acinetobacter Baumannii Isolated from Patients with Hospital Acquired Infections in Sohag University Hospitals, Egypt

A. baumannii is known as the most frequently isolated organism in intensive care units (ICUs), causing a variety of nosocomial infections, including pneumonia, urinary tract infections (UTIs), bacteremia as well as skin and soft tissue infections. These infections are usually associated with high mortality rates ranging between 26% among hospitalized patients and 43% among ICU patients.

Study Overview

• Status: Not yet recruiting
• Conditions: Infections, Respiratory Tract; Infections, Nosocomial
• Intervention / Treatment: Diagnostic test: Culture specific antibiotic therapy; Diagnostic test: Antibiotic; Diagnostic test: Biofilm assessment; Diagnostic test: nanoparticle zinc oxide; Diagnostic test: Molecular detection of antibiotic resistance

Detailed Description

Acinetobacter baumannii (A. baumannii) is Gram- negative, aerobic, glucose non-fermentative, non-motile coccobacillus, ubiquitous in nature, and persistent in healthcare settings. It is regarded as a significant opportunistic human pathogen.

This bacterium become a growing problem in hospitals as a predominant multidrug-resistant (MDR) bacterium. Horizontal acquisition of resistance genes is the main factor involved in the emergence of MDR .

There are many mechanisms to confer resistance to different classes of antibiotics in A. baumannii, one of them is multidrug efflux pumps. These efflux pumps are important source of MDR, which export antibiotics from the cell, increasing their antibiotic resistance.

AdeABC is one of the most important efflux systems, belonging to the RND family in Acinetobacter, which plays an important role in the resistance to a broad group of antibiotics; its genes are chromosomal and encode three genes, i.e., AdeB, AdeA, and AdeC, forming an operon in the vicinity. In addition, the expression of AdeABC is done by a two-component system, which includes a response regulator (AdeR) and a sensor kinase (AdeS) .

The ability of Acinetobacter spp. to form biofilm that enables bacterial survival in hospital settings, especially in ICUs, is the most significant contributing factor to their virulence, and this trait is also responsible for their notable antibiotic resistance. Several biofilm-related genes influence antimicrobial susceptibility, suggesting an association between the biofilm-forming ability of Acinetobacter spp. and their antibiotic resistance patterns (MDR/XDR)

Zinc oxide nanoparticles (ZnO NPs) are one of the most important nanoparticles of metal oxides; it is a unique and inorganic materials that can be used in several biological applications (anti-bacterial, anti-inflammatory). ZnO NPs exhibit distinctive properties other than other nanoparticles such as higher solubility, better biofilm penetration and effective drug delivery . ZnO NPs have been reported to have antimicrobial properties such as disrupting the cell membrane of pathogens, accumulating in the cell and producing toxic H2O2 (hydrogen peroxide)

• Study Type: Observational
• Enrollment (Estimated): 150

Contacts and Locations

• Study Contact: Name: Shimaa Anwar Ahmed, Assistant Lecturer; Phone Number: +201092533978; Email: shaymaa_abdelgaber@med.sohag.edu.eg
• Study Contact Backup: Name: Noha Saber Shafik, lecturer; Email: Nohasaber@med.sohag.edu.eg

Study Locations

• Egypt
  • Sohag, Egypt, 534568
    • Sohag University, Faculty of Medicine
    • Contact: sohag University, professor; Phone Number: 0201009222054; Email: Sohaguniversity@med.sohag.edu.eg
    • Contact: Mona Fatooh mohmad, professor
    • Contact: Noha Saber Shafik, lecturer
    • Contact: Mohammed Ahmed Mahmoud, lecturer
    • Contact: Shimaa Anwar Ahmed, lecturer

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

This study will be carried out at Department of Medical Microbiology and Immunology, Sohag Faculty of Medicine and Sohag University Hospitals.

Description

Inclusion Criteria:

• All patients suffering from infections that can be caused by A. baumannii.

Exclusion Criteria:

• All patients suffering from infections that aren't caused by A. baumannii.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
A. baumannii antibiotic susceptibility profile	A. baumannii antibiotic susceptibility profile will be done using modified kirbybeur method	October 2024 to December 2025
Isolation and identification of A. baumannii from different clinical samples	Isolation and identification of A. baumannii from different clinical samples using MacConKey medium, oxidase test. TSI, And automated identification ViteK system	October 2024 to December 2025
A. baumannii strains which produce biofilm	Detection of A. baumannii strains which produce biofilm using tissue culture plates and Gram stain	October 2024 to December 2025
Ability of ZnO NPs to inhibit the phenomenon of biofilm formation by MDR A. baumannii strains	Assessment of ability of ZnO NPs to inhibit the phenomenon of biofilm formation by MDR A. baumannii strains using ZnO NPs to be applied by different concentrations on tissue culture plates and measure the degree of Biofilm formation using ELISA	October 2024 to December 2025
The effect of ZnO NPs on the expression of some efflux pump genes and biofilm related genes in MDR A. baumannii strains	Evaluation the effect of ZnO NPs on the expression of some efflux pump genes and biofilm related genes in MDR A. baumannii strains using real time PCR(Polymerase Chain reaction)	October 2024 to December 2025

Collaborators and Investigators

• Sponsor: Sohag University

Publications and helpful links

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Estimated): October 10, 2024
• Primary Completion (Estimated): October 10, 2024
• Study Completion (Estimated): December 30, 2025

Study Registration Dates

• First Submitted: September 26, 2024
• First Submitted That Met QC Criteria: October 3, 2024
• First Posted (Actual): October 4, 2024

Study Record Updates

• Last Update Posted (Actual): October 4, 2024
• Last Update Submitted That Met QC Criteria: October 3, 2024
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Keywords: Biofilm; A. baumannii.; ZnO NPs; hospital aquired infections
• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Disease Attributes; Iatrogenic Disease; Infections; Communicable Diseases; Respiratory Tract Infections; Cross Infection; Physiological Effects of Drugs; Anti-Infective Agents; Protective Agents; Dermatologic Agents; Antitubercular Agents; Radiation-Protective Agents; Sunscreening Agents; Anti-Bacterial Agents; Antibiotics, Antitubercular; Zinc Oxide
• Other Study ID Numbers: Soh-Med-24-9-1MD

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No