Functionalization of ZnO Nanoparticles by Glutamic Acid and Conjugation with Thiosemicarbazide Alters Expression of Efflux Pump Genes in Multiple Drug-Resistant Staphylococcus aureus Strains.

Efflux-mediated drug resistance in bacterial strains is regarded as a major cause of drug resistance. In this study, we aimed to evaluate the expression of some major facilitator superfamily class efflux pump genes (EPGs) in the presence of ZnO nanoparticles (NPs) conjugated to thiosemicarbazide (TSC) under amine functionalization by glutamic acid (ZnO@Glu-TSC) as well as ciprofloxacin (CIP) among multiple drug-resistant Staphylococcus aureus. Synthesized NPs were characterized by ultraviolet-visible spectroscopy, X-ray diffraction pattern, and transmission electron microscopy. Antibiogram and ethidium bromide agar cartwheel method were used to determine the efflux-mediated multidrug-resistant phenotype of clinical strains. Then, expression of EPGs, including norA, norB, norC, and tet38 among the strains, exposed to ZnO@Glu-TSC and CIP was evaluated using quantitative real-time PCR (qPCR). According to the results, the strains resistant to CIP showed minimum inhibitory concentration (MIC) values ranging from 256 to 1,024 μg/mL, while ZnO@Glu-TSC NPs showed MICs from 8 to 256 μg/mL against bacterial strains, which indicates stronger antibacterial activity of NPs (2-8-fold) compared to CIP. ZnO@Glu-TSC NPs showed a good bacterial inhibitory potential with average inhibition zones of 11, 15, and 20 mm for concentrations of 50, 100, and 150 μg/mL, respectively. Moreover, simultaneous use of ZnO@Glu-TSC NPs (1/2 MIC) in combination with CIP (1/2 MIC) significantly reduced the expression of norA, norB, norC, and tet38 by 5.4-, 3.8-, 2.1-, and 3.4-fold, respectively, compared to the CIP alone. Therefore, ZnO@Glu-TSC NPs with their potent antimicrobial effects could be used as an antimicrobial agent against S. aureus for preventive and/or therapeutic approaches.