1. Introduction
Despite the fact that oncological and cardiovascular diseases have overtaken infectious diseases in terms of mortality, the overcoming of pathogenic bacteria is still an extremely important task. Microorganisms can cause nosocomial infections in a wide variety of medical departments (surgical, intensive care, burn departments), aggravating the condition of patients. Difficulties in the treatment of these infections are caused, among other things, by the development of bacterial resistance to commonly used drugs [
1]. To solve this problem, the current clinical situation is being investigated, new improved approaches are being introduced in the use of existing drugs and new techniques and solutions are being sought.
The main microorganisms that most often cause infections in the hospital environment are Escherichia coli, Klebsiella pneumoniae, Enterococcus spp., Staphylococcus aureus, Staphylococcus epidermidis, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Acinetobacter baumannii, Salmonella spp. and Burkholderia spp. [
1]. In Besides these species, Serratia marcescens and others Staphylococcus species are also mentioned in the Chinese hospital [
2]. In Germany, primarily S. aureus, E. coli, P. aeruginosa and K. pneumoniae caused SARS. These four pathogens covered more than 50% of cases. [
3]. In Spain, K. pneumoniae were the most common, followed by S. aureus and E. coli. [
4] In the burn center in Romania, the most common blood pathogen was P. aeruginosa, S. aureus and Klebsiella spp. [
5]. In all these cases, it is possible to note the bacteria that are included in the so-called ESKAPE list (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp, as well as Escherichia coli). Many authors have noted the multidrug resistance of these bacteria. It was noted that the total number of multidrug-resistant bacteria from various hospital departments in China increased by more than 3 times in 2023 [
2]. S. aureus showed resistance to azithromycin, erythromycin, clarithromycin and penicillin, E. coli showed the highest percentage of ampicillin resistance (80%), P. aeruginosa was resistant to ciprofloxacin, gentamicin, ticarcillin and levofloxacin, and for A. baumannii high resistance too many drugs was observed [
2]. In Spain, the proportion of multidrug resistance in A. baumannii and P. aeruginosa together was 15.4% [
4]. In Romania, 31% of S. aureus strains resistant to oxacillin and 93% of isolated resistant strains of Pseudomonas spp. were identified, in E. coli, the proportion of such strains was lower – 6% [
5]. In Italy, over the past four years, there has been a slight increase in resistance to A. baumannii and P. aeruginosa, K. pneumoniae and Enterobacter spp., S. aureus; and E. faecium [
6]. Anyway, different authors have reported the resistance of bacteria to almost all classes of antibiotics, including aminoglycosides, cephalosporins, fluoroquinolones, β-lactams and colistin, an antimicrobial drug [
1]. For example, Enterobacteria, especially E. coli and K. pneumoniae, can become dangerous pathogens because of the acquisition of resistance phenotypes, such as the production of carbapenemases [
6]. About 90% of infections caused by pathogens with acquired resistance occurred because of empirical antibiotic treatment, with prolonged hospital stay [
1]. Perhaps the increase in the incidence of antimicrobial-resistant pathogens can be explained by their overuse during the 2019 coronavirus pandemic [
6]. Microorganisms are highly adaptable and rapidly evolve under the influence of new antimicrobial treatments. Thus, even new antibiotics are not enough to combat them. [
1]. It is necessary to search for new methods and solutions to combat resistant pathogens.
Fungal infections are also a modern problem, far from being resolved soon in the future. The development of resistance of pathogenic fungi to the antifungal drugs used is of concern. Yeast of the genus
Candida is the causative agent of candidiasis, the diseases of which are widespread. In the hospital environment,
Candida albicans and
Candida tropicalis species are most often noted [
2].
C. albicans has become a serious health problem, especially in immunocompromised patients, due to the antifungal drug resistance that many strains have developed. These yeasts cause 78% of fungal nosocomial infections and more than 10% of all nosocomial infections. [
7]. The other non-albicans
Candida species are also of growing concern in hospital epidemiology [
8]. For example, a wide range of antifungal drugs best knows
Candida auris, first described in 2009, for its strong resistance.
C. auris isolates are resistant to fluconazole, amphotericin B and echinocandins. About 90% of C. auris strains have acquired resistance to at least one antifungal drug [
9]. This is manifested in the absence of in vitro growth inhibition, when the minimum inhibitory concentrations of the selected drug cease to effectively suppress colony growth. This may also be evidenced by the clinical deterioration of the patient’s condition and the constant isolation of the pathogen from his clinical samples, despite the administration of an antifungal drug [
8]. The two main factors in the development of clinical resistance are the ability of
Candida spp. to form a biofilm and reduce the concentration of the drug in the infected area, which allows some part of the yeast to survive, which acquire resistance [
8]. In addition, the widespread use of antifungal drugs in the clinic and in agricultural conditions can serve as a possible selective force in creating a reservoir of
Candida spp. strains resistant to antifungal drugs [
9]. Brewer’s yeast (
Saccharomyces cerevisiae) is widely used in the food industry and is considered harmless, which allows them to be used as a convenient model object in research, which can partially replace pathogenic species of the genus
Candida. Compared to other groups of microorganisms,
S. cerevisiae are not considered aggressive pathogens, but they are nevertheless capable of causing human diseases under certain circumstances. Several studies have analyzed the potential virulence of this type of yeast, and it has been suggested that some strains have the potential to cause disease [
10]. For example, at the Center for Kidney Diseases and Transplantation at Baghdad Medical Center, 19 patients with
S. cerevisiae-caused fungemia were found [
11].
Thus, it can be summarized that there is a problem of developing resistance by pathogenic bacteria and yeast, which leads researchers to the need to find new methods and techniques that are effective in conditions when antibiotics and antifungal agents no longer work. Silver nanoparticles (AgNPs) could be such an instrument.
Silver nanoparticles are currently widely used in a variety of fields. They are used for wastewater treatment [
12,
13,
14], in agriculture [
15,
16,
17], as a catalytic agent [
18,
19,
20], as well as in many new studies, which indicates great prospects for this nanomaterial. But most often these nanoparticles are used in biomedicine, the reason for which is the long-known properties of silver to suppress bacterial growth [
21]. They are used directly and in complexes with other substances such as antibacterial agents [
22,
23,
24,
25,
26,
27], fungicides [
28,
29,
30,
31] and antiviral agents [
32,
33]. Considering that, silver can be used to cover surfaces and make biofouling-resistant materials, nanoparticles are also used in dentistry [
34,
35,
36], for the manufacture of wound dressings [
37,
38,
39] and in the manufacture of prostheses and catheters [
40,
41,
42]. There are also examples of their use against cancer, due to their ability to penetrate the cell under certain conditions and induce apoptosis [
43,
44,
45]. These data allow us to consider silver nanoparticles as a promising material that can be investigated as a possible alternative to antibiotics. In this case, the size, shape and other characteristics of the particles, the methodological conditions of their use, and the method of their synthesis are very important.
Silver nanoparticles are currently synthesized in numerous ways: chemical (chemical reduction, microemulsion, and photochemical method), physical (laser ablation, irradiation, evaporation, condensation) and biological (using plants, bacteria or fungi) [
46]. Biological methods are considered to be the most environmentally friendly. In this case, biogenic nanoparticles are even labeled “Bio-AgNPs”. Most often, a plant extract is used for synthesis; the process takes place at a low temperature and does not use any harmful chemicals [
47,
48,
49,
50,
51]. The precursor is silver nitrate, which is reduced by a plant extract, while the nanoparticles “build up” in solution according to the “bottom-up” principle. A film of reducing agent can form on the surface of the particles, which can give them additional properties, for example, an obstacle to the formation of conglomerates [
52]. Given that many researchers expect to create an antimicrobial product, they try to use plant extracts in such a synthesis, which themselves have antibacterial properties. In our study, Sphagnum fallax moss was chosen as such a plant. We used this type of moss as the basis for the preparation of an extract, which was used as a reducing agent in the biogenic synthesis of silver nanoparticles. Sphagnum mosses are known for their wound healing and bacteriostatic properties [
53,
54]; they are even traditionally used as a dressing material [
55]. Recent studies have shown that secondary metabolites of the
S. fallax species have a pronounced antimicrobial effect [
56]. The mechanism of action of this moss on bacteria has not been fully studied, but it seems to be related to a substance contained in it called Sphagnol [
57].
The mechanisms of action of silver nanoparticles on a living cell differ from the action of sphagnum extracts and can be different: these are interaction with the cell wall, penetration through the membrane, production of reactive oxygen species, DNA damage and inhibition of protein synthesis [
58,
59]. However, the effect of such an effect on the cell is not always negative. As for mammalian cells, the production of reactive oxygen species, because of exposure to small silver nanoparticles, can enhance the process of adipogenesis of white cells [
60]. Many researchers claim that silver nanoparticles are not toxic to human cells, for example, with respect to peripheral blood mononuclears [
61] or fibroblasts [
62]. These data give hope that nanoparticles that are not dangerous to humans will be able to selectively destroy cells of pathogenic bacteria and yeast, for which they are toxic. Their toxicity depends on their shape, size, and surface modification [
63]. There is evidence that ionic silver is more effective than nanoparticles and the main toxic effect of AgNPs on the bacterium
Pseudomonas putida was caused by a certain amount of Ag
+ ions released into the culture medium [
64]. Moreover, if the particle size is within 10-20 nm, the toxicity is due to the penetration of nanoparticles into the bacterial cell and interaction with intracellular contents. When the size of nanoparticles exceeds 20 nm, the effect is due to silver ions [
65]. Adhesion and accumulation of AgNPs on the cell surface is especially widespread in gram-negative bacteria. Penetration into bacterial cells occurs through water-filled channels called porines in the outer membrane [
66]. It is also beneficial that silver nanoparticles can prevent the formation of bacterial biofilms [
67], and sometimes more effectively than standard antibiotics [
68]. For ESKAPE bacteria, such biofilm inhibition can range from 20 to 70% [
69].
There is evidence of the effect of silver nanoparticles on various fungi. When they were added to the culture of mold fungi, the dry weight of the mycelium changed, silver ions accumulated in it. Shortening and densification of hyphae, numerous changes in organelles and nuclei, and even cell plasmolysis were noted [
70]. In relation to yeast
Candida spp. It was also noted that silver nanoparticles caused swelling and peeling of the cell wall and reduced the enzymatic activity of proteinases and phospholipases [
71]. The fungicidal effect of nanoparticles also depended on their size, and small (from 7 nm) particles showed particular effectiveness [
72].
The use of silver nanoparticles can be considered not only as an alternative to antibiotics or fungicides. One of the possible methods could be a combination of them to achieve a synergistic effect. Such studies have already been conducted, for example, for ampicillin, gentamicin, kanamycin, streptomycin and vancomycin, a synergistic effect with AgNPs has already been shown [
73]. In addition to antibiotics, other reinforcing components can be used, for example, bacterial metabolites, which can improve the fungicidal effect against yeast of the genus
Candida [
74]. Oxidative stress factors, combined with exposure to silver nanoparticles, also demonstrated a synergistic effect against
C. albicans and other yeasts [
75]. It is also promising to use a combination of nanoparticles of various metals, for example, silver and copper. Copper ions contribute to the oxidation of non-oxidized silver, which makes it possible to obtain its more active ionic form, causing a stronger antibacterial effect. It has also been suggested that various effects are combined: silver affects the plasma membrane of bacteria, while copper denatures nucleic acids and other internal biomolecules and cellular structures [
76].
Despite the abundance of promising studies on the use of silver nanoparticles to combat pathogens, their clinical use is very limited. It seems that specific data on minimum inhibitory concentrations and methodological recommendations could change this situation for the better.
4. Conclusions
1) The technique of synthesis of biogenic silver nanoparticles using an aqueous extract of sphagnum moss (Sphagum fallax) was applied for the first time. Stable biogenic silver nanoparticles of rounded and irregular shape, ranging in size from 10 to 50 nm, with pronounced antimicrobial and antifungal effects, have been obtained.
2) The effectiveness of different concentrations of nanoparticles against opportunistic bacteria and yeast was analyzed. For S. aureus and E. coli, the effect appears at 50 μg/ml, growth suppression occurred at 100 μg/ml. For the bacterium S. marcescens, the effect appeared at 25 μg/ml, but growth suppression occurred in the range from 200 to 500 μg/ml. The antifungal effect of nanoparticles on C. albicans appeared at 100 μg/ml, complete suppression occurred at 300 μg/ml.
3) The possibilities of reducing the dosages of antibiotics and silver nanoparticles when used together against opportunistic bacteria were analyzed. When analyzing small concentrations, the greatest synergistic effect was observed at S. aureus and P. putida, an insignificant effect was found at S. marcescens and A. borkumensis, and there was no such effect at E. coli. The most resistant species to silver nanoparticles were S. aureus and S. marcescens, the least – E. coli and A. borkumensis. E. coli turned out to be the species with the greatest vulnerability, both to nanoparticles and to an antibiotic.
4) In three species of yeast (C. albicans, C. lipolytica and S. cerevisiae), a synergistic effect was observed with the combined use of silver nanoparticles and a fungicide, the most effect was at the brewer’s yeast. The most resistant species to silver nanoparticles turned out to be C. albicans, the least resistant was C. lipolytica.
5) Silver nanoparticles were much more effective in the thickness of the suspension, when stirred, than at rest, concentrated in the bottom layer. When developing methods for their application, it is necessary to take this property into account and strive in various ways to increase the contact area of particles with pathogens.
As a result, it can be concluded that silver nanoparticles obtained by the presented method can be used as an independent remedy against E. coli and A. borkumensis. It is possible to enhance the effect of an antibiotic against P. putida and S. aureus using nanoparticles. An increased concentration of nanoparticles should be applied to S. marcescens. The use of silver nanoparticles in conjunction with a fungicide against opportunistic candida seems to be quite effective. The obtained data can become the basis for the development of methods for the combined use of various agents against pathogens based on their synergistic effect.
Figure 1.
Changes in the color of the reaction mixture of moss extract and silver nitrate, from transparent, at the beginning of synthesis (A), to yellow-brown, after 7 days (B).
Figure 1.
Changes in the color of the reaction mixture of moss extract and silver nitrate, from transparent, at the beginning of synthesis (A), to yellow-brown, after 7 days (B).
Figure 2.
Absorption spectra in the UV-visible range of nanoparticle suspensions: biogenic silver nanoparticles (a); sphagnum extract (b).
Figure 2.
Absorption spectra in the UV-visible range of nanoparticle suspensions: biogenic silver nanoparticles (a); sphagnum extract (b).
Figure 3.
Visualization of AgNPs using transmission electron microscopy – A. The shape of the particles is irregularly spherical Elemental analysis of silver nanoparticles using transmission electron microscopy – B.
Figure 3.
Visualization of AgNPs using transmission electron microscopy – A. The shape of the particles is irregularly spherical Elemental analysis of silver nanoparticles using transmission electron microscopy – B.
Figure 4.
Microscopic photographs of planktonic yeast forms from fresh nocturnal cultures. Bright field microscopy.
Figure 4.
Microscopic photographs of planktonic yeast forms from fresh nocturnal cultures. Bright field microscopy.
Figure 5.
The results of replication of silver nanoparticles (of different concentrations) and sphagnum extract on the formation of biofilms of
S. marcescens [
1] and
P. putida [
2].
Figure 5.
The results of replication of silver nanoparticles (of different concentrations) and sphagnum extract on the formation of biofilms of
S. marcescens [
1] and
P. putida [
2].
Figure 6.
Determination of the antibacterial activity of biogenic silver nanoparticles and sphagnum extract against S. aureus and E. coli by the method of constructing growth curves. The concentrations of nanoparticles are given in the captions.
Figure 6.
Determination of the antibacterial activity of biogenic silver nanoparticles and sphagnum extract against S. aureus and E. coli by the method of constructing growth curves. The concentrations of nanoparticles are given in the captions.
Figure 7.
Determination of the antibacterial activity of biogenic silver nanoparticles and sphagnum extract against S. marcescens and C. albicans by constructing growth curves. The concentrations of nanoparticles are given in the captions.
Figure 7.
Determination of the antibacterial activity of biogenic silver nanoparticles and sphagnum extract against S. marcescens and C. albicans by constructing growth curves. The concentrations of nanoparticles are given in the captions.
Figure 8.
Visualization of the results of disco diffusion analysis of inhibition of 5 bacterial species by 6 antibiotics. 1 – streptomycin, 2 – tetracycline, 3 – ceftriaxone, 5 – ciprofloxacin, 6 – erythromycin, 7—amoxicillin, K – control.
Figure 8.
Visualization of the results of disco diffusion analysis of inhibition of 5 bacterial species by 6 antibiotics. 1 – streptomycin, 2 – tetracycline, 3 – ceftriaxone, 5 – ciprofloxacin, 6 – erythromycin, 7—amoxicillin, K – control.
Figure 9.
Visualization of the results of the disco-diffusion analysis of the effect of three fungicides on three types of yeast. M – copper sulfate, MM – 10-fold copper sulfate, X – chloramine, XX – 10-fold chloramine, Δ – desgrane, Δ Δ – 10-fold desgrane, K – control.
Figure 9.
Visualization of the results of the disco-diffusion analysis of the effect of three fungicides on three types of yeast. M – copper sulfate, MM – 10-fold copper sulfate, X – chloramine, XX – 10-fold chloramine, Δ – desgrane, Δ Δ – 10-fold desgrane, K – control.
Figure 10.
Growth curves of P. putida and A. borkumensis cultivated in the presence of the antibiotic (ciprofloxacin or ceftriaxone) and silver nanoparticles.
Figure 10.
Growth curves of P. putida and A. borkumensis cultivated in the presence of the antibiotic (ciprofloxacin or ceftriaxone) and silver nanoparticles.
Figure 11.
Growth curves of E. coli, S. marcescens and S. aureus cultivated in the presence of the antibiotic (ciprofloxacin or amoxicillin) and silver nanoparticles.
Figure 11.
Growth curves of E. coli, S. marcescens and S. aureus cultivated in the presence of the antibiotic (ciprofloxacin or amoxicillin) and silver nanoparticles.
Figure 12.
Growth curves of C. albicans, C. lipolytica and S. cerevisiae cultivated in the presence of tetramethylenediethylenetetramine and silver nanoparticles.
Figure 12.
Growth curves of C. albicans, C. lipolytica and S. cerevisiae cultivated in the presence of tetramethylenediethylenetetramine and silver nanoparticles.
Figure 13.
Images of S. marcescens biofilms obtained by atomic force microscopy, cultured in the presence of silver and ciprofloxacin nanoparticles. 1 – control sample, 2 – biogenic silver nanoparticles, 3 – chemically synthesized silver nanoparticles, 4 – antibiotic, 5 – biogenic silver nanoparticles with the addition of an antibiotic, 6 – chemically synthesized silver nanoparticles with the addition of an antibiotic.
Figure 13.
Images of S. marcescens biofilms obtained by atomic force microscopy, cultured in the presence of silver and ciprofloxacin nanoparticles. 1 – control sample, 2 – biogenic silver nanoparticles, 3 – chemically synthesized silver nanoparticles, 4 – antibiotic, 5 – biogenic silver nanoparticles with the addition of an antibiotic, 6 – chemically synthesized silver nanoparticles with the addition of an antibiotic.
Figure 14.
Images of the general appearance and surface of E. coli cells cultured in the presence of silver nanoparticles and sphagnum extract obtained using atomic force microscopy. 1, 4 – control sample, 2, 5 – silver nanoparticles, 3, 6 – sphagnum extract.
Figure 14.
Images of the general appearance and surface of E. coli cells cultured in the presence of silver nanoparticles and sphagnum extract obtained using atomic force microscopy. 1, 4 – control sample, 2, 5 – silver nanoparticles, 3, 6 – sphagnum extract.
Figure 15.
Images of the general appearance and surface of S. marcescens cells cultured in the presence of silver nanoparticles and sphagnum extract obtained using atomic force microscopy. 1, 4 – control sample, 2, 5 – silver nanoparticles, 3, 6 – sphagnum extract.
Figure 15.
Images of the general appearance and surface of S. marcescens cells cultured in the presence of silver nanoparticles and sphagnum extract obtained using atomic force microscopy. 1, 4 – control sample, 2, 5 – silver nanoparticles, 3, 6 – sphagnum extract.
Table 1.
Results of the disco-diffusion analysis of the antibacterial and antifungal effect of silver nanoparticles of various concentrations, in comparison with sphagnum extract and control samples containing no substances. The numbers show the thickness of the inhibition zone, in millimeters.
Table 1.
Results of the disco-diffusion analysis of the antibacterial and antifungal effect of silver nanoparticles of various concentrations, in comparison with sphagnum extract and control samples containing no substances. The numbers show the thickness of the inhibition zone, in millimeters.
Active substance |
E. coli
|
S. marcescens
|
S. aureus
|
C. albicans |
Сontrol sample (water) |
0 |
0 |
0 |
0 |
AgNPs (25 μg/ml) |
0 |
0 |
0 |
0 |
AgNPs (50 μg/ml) |
0.5 |
0 |
0 |
0 |
AgNPs (75 μg/ml) |
1 |
1 |
1 |
0 |
AgNPs (100 μg/ml) |
2 |
1 |
2 |
0 |
AgNPs (200 μg/ml) |
3 |
2 |
3 |
1 |
AgNPs (500 μg/ml) |
3 |
3 |
3.5 |
5 |
AgNPs (1000 μg/ml) |
3 |
3 |
3.5 |
6 |
Sphagnum extract |
0 |
0 |
0 |
0 |