Recent Advances in Nanotechnology for the Management of Klebsiella pneumoniae-Related Infections

TiO2 Nanocomposite Coatings and Inactivation of Carbapenemase-Producing Klebsiella Pneumoniae Biofilm-Opportunities and Challenges

The worldwide increase of multidrug-resistant Gram-negative bacteria is a global threat. The emergence and global spread of Klebsiella pneumoniae carbapenemase- (KPC-) producing Klebsiella pneumoniae represent a particular concern. This pathogen has increased resistance and abilities to persist in human reservoirs, in hospital environments, on medical devices, and to generate biofilms. Mortality related to this microorganism is high among immunosuppressed oncological patients and those with multiple hospitalizations and an extended stay in intensive care. There is a severe threat posed by the ability of biofilms to grow and resist antibiotics. Various nanotechnology-based strategies have been studied and developed to prevent and combat serious health problems caused by biofilm infections. The aim of this review was to evaluate the implications of nanotechnology in eradicating biofilms with KPC-producing Klebsiella pneumoniae, one of the bacteria most frequently associated with nosocomial infections in intensive care units, including in our department, and to highlight studies presenting the potential applicability of TiO2 nanocomposite materials in hospital practice. We also described the frequency of the presence of bacterial biofilms on medical surfaces, devices, and equipment. TiO2 nanocomposite coatings are one of the best long-term options for antimicrobial efficacy due to their biocompatibility, stability, corrosion resistance, and low cost; they find their applicability in hospital practice due to their critical antimicrobial role for surfaces and orthopedic and dental implants. The International Agency for Research on Cancer has recently classified titanium dioxide nanoparticles (TiO2 NPs) as possibly carcinogenic. Currently, there is an interest in the ecological, non-toxic synthesis of TiO2 nanoparticles via biological methods. Biogenic, non-toxic nanoparticles have remarkable properties due to their biocompatibility, stability, and size. Few studies have mentioned the use of nanoparticle-coated surfaces as antibiofilm agents. A literature review was performed to identify publications related to KPC-producing Klebsiella pneumoniae biofilms and antimicrobial TiO2 photocatalytic nanocomposite coatings. There are few reviews on the antibacterial and antibiofilm applications of TiO2 photocatalytic nanocomposite coatings. TiO2 nanoparticles demonstrated marked antibiofilm activity, but being nano in size, these nanoparticles can penetrate cell membranes and may initiate cellular toxicity and genotoxicity. Biogenic TiO2 nanoparticles obtained via green, ecological technology have less applicability but are actively investigated.

Prevalence of medication errors and its related factors in Iranian nurses: an updated systematic review and meta-analysis

BACKGROUND

Nurses may make medication errors during the implementation of therapeutic interventions, which initially threaten the patient's health and safety and prolong their hospital stay. These errors have always been a challenge for healthcare systems. Given that factors such as the timing, type, and causes of medication errors can serve as suitable predictors for their occurrence, we have decided to conduct a review study aiming to investigate the prevalence of medication errors and the associated factors among Iranian nurses.

METHODS

In this systematic review and meta-analysis, studies were searched on PubMed, Web of Science, Scopus, Google Scholar, IranMedex, Magiran, and SID databases using a combination of keywords and Boolean functions. The study that reported the prevalence of medication errors among nurses in Iran without time limitation up to May 2023 was included in this study.

RESULTS

A total of 36 studies were included in the analysis. The analysis indicates that 54% (95% CI: 43, 65; I2 = 99.3%) of Iranian nurses experienced medication errors. The most common types of medication errors by nurses were wrong timing 27.3% (95% CI: 19, 36; I2 = 95.8%), and wrong dosage 26.4% (95% CI: 20, 33; I2 = 91%). Additionally, the main causes of medication errors among nurses were workload 43%, fatigue 42.7%, and nursing shortage 38.8%. In this study, just 39% (95% CI: 27, 50; I2 = 97.1%) of nurses with medication errors did report their errors. Moreover, the prevalence of medication errors was more in the night shift at 41.1%. The results of the meta-regression showed that publication year and the female-to-male ratio are good predictors of medical errors, but they are not statistically significant(p > 0.05).

CONCLUSIONS

To reduce medication errors, nurses need to work in a calm environment that allows for proper nursing interventions and prevents overcrowding in departments. Additionally, considering the low reporting of medication errors to managers, support should be provided to nurses who report medication errors, in order to promote a culture of reporting these errors among Iranian nurses and ensure patient safety is not compromised.

Antibacterial ZnO@CeO2 nanocrystals: Prospective material for control of foodborne pathogens

Foodborne microbial infections are leading cause of many deadly illnesses. As a result, there is an anticipated need for the development of innovative packaging materials with effective antibacterial potential. This article describes preparation and characterization of innovative ZnO@CeO2 nanocrystals through a facile hydrothermal method, as well as their outstanding antibacterial properties. The ZnO@CeO2 nanocrystals used were prepared using precursors zinc acetate and cerium nitrate at 180°C. Various sophisticated physicochemical parameters were used to assess nanocrystals. The antibacterial activity was examined using minimum inhibitory concentration technique against four major foodborne pathogenic bacteria, namely Staphylococcus aureus (Gram positive), Escherichia coli, Salmonella typhimurium and Klebsiella pneumoniae (Gram negative) at four distinct concentrations (0-400 µg/mL). The in vitro cell compatibility test was done on fibroblasts. According to our findings, the lowest concentration of ZnO@CeO2 nanocrystals limiting development of tested strains is 100 µg/mL. Additionally, the results show that the combination of ZnO and CeO2 can be synergistic, resulting in ZnO@CeO2 nanocrystals with enhanced antibacterial activity. To summarize, unique ZnO@CeO2 nanocrystals with a high surface-to-volume ratio with outstanding antibacterial activity and no harmful impact to mouse fibroblasts were shaped. The ZnO@CeO2 can be utilized to competently suppress microbial growth spoiling the food and could be utilized as economical and efficient future packaging material for food industries.

Plant extract-mediated synthesis Cobalt doping in zinc oxide nanoparticles and their in vitro cytotoxicity and antibacterial performance

In this research, zinc oxide (ZnO) nanoparticles doped with different percentages of produced cobalt using the green synthesis method. ZnO nanoparticles showed good cellular and microbial toxicity due to their high surface-to-volume ratio. Adding cobalt metal to the nanostructure can lead to the appearance of a new feature. To investigate the effect of adding cobalt metal, synthesized ZnO nanoparticles containing 3 and 6% cobalt were synthesized using plant extract. The resulting nanostructures were characterized by a Raman spectroscopy, UV-Visible spectrometer, X-ray diffraction, and Field emission scanning electron microscopy. Ultimately, the synthesized samples' cytotoxicity and antimicrobial tests were performed. XRD confirmed the formation of a hexagonal wurtzite ZnO structure. XRD and electron imaging showed that doping resulted in a decrease in average crystal size. The results showed that with cobalt doping, the particle size decreased slightly. The cytotoxicity and antimicrobial effects results showed that in all three studies, cobalt doping leads to an increase in the toxicity of this nanostructure compared to non-doped nanoparticles.

Nanosilver: An Old Antibacterial Agent with Great Promise in the Fight against Antibiotic Resistance

Antibiotic resistance in bacteria is a major problem worldwide that costs 55 billion USD annually for extended hospitalization, resource utilization, and additional treatment expenditures in the United States. This review examines the roles and forms of silver (e.g., bulk Ag, silver salts (AgNO3), and colloidal Ag) from antiquity to the present, and its eventual incorporation as silver nanoparticles (AgNPs) in numerous antibacterial consumer products and biomedical applications. The AgNP fabrication methods, physicochemical properties, and antibacterial mechanisms in Gram-positive and Gram-negative bacterial models are covered. The emphasis is on the problematic ESKAPE pathogens and the antibiotic-resistant pathogens of the greatest human health concern according to the World Health Organization. This review delineates the differences between each bacterial model, the role of the physicochemical properties of AgNPs in the interaction with pathogens, and the subsequent damage of AgNPs and Ag+ released by AgNPs on structural cellular components. In closing, the processes of antibiotic resistance attainment and how novel AgNP-antibiotic conjugates may synergistically reduce the growth of antibiotic-resistant pathogens are presented in light of promising examples, where antibiotic efficacy alone is decreased.

Special Issue in "Nanomaterials and Their Applications in Sensing and Biosensing"

The identification of the target molecule is required for rapid and reliable clinical diagnosis and disease monitoring [...].

Phytochemical-Based Nanomaterials against Antibiotic-Resistant Bacteria: An Updated Review

Antibiotic-resistant bacteria (ARB) is a growing global health threat, leading to the search for alternative strategies to combat bacterial infections. Phytochemicals, which are naturally occurring compounds found in plants, have shown potential as antimicrobial agents; however, therapy with these agents has certain limitations. The use of nanotechnology combined with antibacterial phytochemicals could help achieve greater antibacterial capacity against ARB by providing improved mechanical, physicochemical, biopharmaceutical, bioavailability, morphological or release properties. This review aims to provide an updated overview of the current state of research on the use of phytochemical-based nanomaterials for the treatment against ARB, with a special focus on polymeric nanofibers and nanoparticles. The review discusses the various types of phytochemicals that have been incorporated into different nanomaterials, the methods used to synthesize these materials, and the results of studies evaluating their antimicrobial activity. The challenges and limitations of using phytochemical-based nanomaterials, as well as future directions for research in this field, are also considered here. Overall, this review highlights the potential of phytochemical-based nanomaterials as a promising strategy for the treatment against ARB, but also stresses the need for further studies to fully understand their mechanisms of action and optimize their use in clinical settings.

Antibacterial activity of metallic-core gold and silver nanoparticles against some animal pathogens

The current work aimed to find substitutes for antibiotics because of the side effects of antibacterial agents and the expansion of bacterial resistance to these agents. The scope of this study was to evaluate the antibacterial activity of gold and silver nanoparticles (AuNPs and AgNPs) against selected animal pathogens (Staphylococcus aureus, Klebsiella pneumonia, Streptococcus pneumoniae, Escherichia coli, Bacillus abortus and Mycobacterium bovis). The synthesized nanoparticles were distinguished by scanning electron microscopy (SEM) analysis and tested for antibacterial activity with the broth microdilution method, well diffusion assay, and minimum bactericidal concentration procedure. Results showed that both AuNPs and AgNPs displayed good antibacterial activity against all tested bacteria. The strongest antibacterial action of AgNPS (18 mm) was contra E. coli. AuNPs displayed good antibacterial activity against S. aureus and B. bovis with a suppression area of 14 mm. Therefore, it is suggested that AgNPs and AuNPs could be effectively used against animal pathogens and may contribute to reducing antibiotic resistance. However, there is a need for further research on the in vivo toxicity and mechanisms of action of AuNPs and AgNPs.

Trichoderma-Mediated ZnO Nanoparticles and Their Antibiofilm and Antibacterial Activities

Antimicrobial resistance is a major global health concern and one of the gravest challenges to humanity today. Antibiotic resistance has been acquired by certain bacterial strains. As a result, new antibacterial drugs are urgently required to combat resistant microorganisms. Species of Trichoderma are known to produce a wide range of enzymes and secondary metabolites that can be exploited for the synthesis of nanoparticles. In the present study, Trichoderma asperellum was isolated from rhizosphere soil and used for the biosynthesis of ZnO NPs. To examine the antibacterial activity of ZnO NPs against human pathogens, Escherichia coli and Staphylococcus aureus were used. The obtained antibacterial results show that the biosynthesized ZnO NPs were efficient antibacterial agents against the pathogens E. coli and S. aureus, with an inhibition zone of 3-9 mm. The ZnO NPs were also effective in the prevention of S. aureus biofilm formation and adherence. The current work shows that the MIC dosages of ZnO NPs (25, 50, and 75 μg/mL) have effective antibacterial activity and antibiofilm action against S. aureus. As a result, ZnO NPs can be used as a part of combination therapy for drug-resistant S. aureus infections, where biofilm development is critical for disease progression.