Comparative Study of Antibacterial Effects of Titanium Dioxide Nanoparticles Alone and in Combination with Antibiotics on MDR Pseudomonas aeruginosa Strains

Figures & data

Figure 1 Particle size distribution of the formed titanium dioxide nanoparticles measured by dynamic light scattering analysis.

Figure 2 High-resolution transmission electron microscopy images at different magnifications (A: ×5000, C: ×15,000 D: ×100,000) showing the prepared titanium dioxide nanoparticles as spherical shape with an irregular edges. (B) Particle size distribution of it.

Figure 3 Diffraction scanning calorimetry analysis of (A) TDN, amikacin and its physical mixture; (B) TDN, ciprofloxacin and its physical mixture; (C) TDN, ceftriaxone and its physical mixture; (D) TDN, cefpime and its physical mixture.

Abbreviations: TDN, titanium dioxide nanoparticles; AK, amikacin; CP, ciprofloxacin; CT, ceftriaxone; CF, cefpime; PM, physical mixture.

Figure 4 Fourier transform infrared spectra of (A) TDN, amikacin and its physical mixture; (B) TDN, ciprofloxacin and its physical mixture; (C) TDN, ceftriaxone and its physical mixture; (D) TDN, cefpime and its physical mixture.

Abbreviations: TDN, titanium dioxide nanoparticles; AK, amikacin; CP, ciprofloxacin; CT, ceftriaxone; CF, cefpime; PM, physical mixture.

Figure 5 X-ray diffraction pattern of (A) TDN, amikacin and its physical mixture; (B) TDN, ciprofloxacin and its physical mixture; (C) TDN, ceftriaxone and its physical mixture; (D) TDN, cefpime and its physical mixture.

Abbreviations: TDN, titanium dioxide nanoparticles; AK, amikacin; CP, ciprofloxacin; CT, ceftriaxone; CF, cefpime; PM, physical mixture.

Table 1 Minimum Inhibitory Concentrations of Titanium Dioxide Nanoparticles and Different Antibiotics Against 25 Pseudomonas aeruginosa Isolates

No.**	Type*	CP	CF	CT	AK	TDN
1	W	8	256	32	512	8
2	W	32	512	1024	512	64
3	W	32	32	512	128	64
4	U	32	512	>1024	>1024	64
5	ER	32	512	>1024	128	64
6	U	8	256	64	512	64
7	U	4	256	128	512	64
8	U	4	128	256	64	16
9	U	32	64	256	64	64
10	U	<1	512	256	16	64
11	U	8	256	128	512	<1
12	W	16	256	64	128	64
13	W	32	512	>1024	1024	16
14	W	4	512	256	128	16
15	U	<1	64	256	16	<1
16	U	8	256	32	512	16
17	U	8	256	256	512	64
18	W	<1	64	16	512	16
19	W	4	32	32	32	32
20	U	4	32	32	16	<1
21	ER	4	32	32	64	64
22	W	4	32	32	512	64
23	U	<1	256	64	64	64
24	U	<1	256	64	64	64
25	ER	<1	64	256	16	16

Notes: Type*, type of clinical specimen of isolate; No.**, serial number of specimens.

Abbreviations: U, urine specimen; W, wound exudate; ER, ear discharge; CP, ciprofloxacin; CF, cefpime; CT, ceftriaxone; AK, amikacin; TDN, titanium dioxide nanoparticles.

Table 2 Antibiotic Susceptibility of Pseudomonas aeruginosa Isolates

Antibiotic	Sensitive		Intermediate		Resistant
	no**	%*	no**	%*	no**	%*
Ceftriaxone	0	0	1	4	24	96
Cefepime	0	0	0	0	100	100
Amikacin	4	16	1	4	20	80
Ciprofloxacin	6	24	0	0	19	76

Notes: no**, number of Pseudomonas aeruginosa isolates; *Percentages were correlated with total number of the selected Pseudomonas aeruginosa isolates (25).

Table 3 Checkerboard Results of Combination of Titanium Dioxide Nanoparticles and Antibiotics to 25 MDR Pseudomonas aeruginosa Isolates

Drugs	Synergistic		Additive		ND
	no**	%*	no**	%*	no**	%*
AK\TDN	22	88%	3	12%	0	0
CP\TDN	20	80%	3	12%	2	8%
CT\TDN	24	96%	1	4%	0	0
CF\TDN	25	100%	0	0	0	0

Notes: *Percentages were correlated with number of MDR Pseudomonas aeruginosa isolates (N= 25); AK\TDN, combination of amikacin and titanium dioxide nanoparticles; no**, number of Pseudomonas aeruginosa isolates.

Abbreviations: MDR, multidrug-resistant; ND, not determined; CP, ciprofloxacin; CF, cefpime; CT, ceftriaxone; AK, amikacin; TDN, titanium dioxide nanoparticles; CP\TDN, combination of ciprofloxacin and titanium dioxide nanoparticles; CT\TDN, combination of ceftriaxone and titanium dioxide nanoparticles; CF\TDN, combination of cefpime and titanium dioxide nanoparticle.