Response of Group B Streptococcus to the Combination of Gold Nanoparticles-Erythromycin as a Nanoweapon

Background: Group B Streptococcus (GBS) causes a wide range of adverse effects in both mothers and infants during pregnancy and after delivery. Objectives: This study aimed to evaluate the effects of erythromycin either alone or in combination with gold nanoparticles (AuNPs) on the clinical GBS isolated from pregnant women. Methods: This descriptive cross-sectional study was performed on 106 women aged 16 - 48 years. After identification of GBS strains by phenotypic and genotypic methods (PCR), erythromycin-resistant isolates were identified using the Kirby-Bauer test and broth microdilution method according to CLSI-2015 guidelines. The antibacterial properties and minimum inhibitory concentration (MIC) of erythromycin (either alone or combined with AuNPs) were assessed by the agar well-diffusion and broth microdilution methods, respectively. Results: The frequency of GBS isolates was significantly high in the pregnant women aged less than 40 years (73.9%) (P = 0.0251), those with a history of abortion (60.9%) (P = 0.038), and residents of rural areas (60%) (P = 0.038). Moreover, 65.2% of the isolates were resistant to erythromycin. The MIC of AuNPs-erythromycin combination required to inhibit the growth of 50% of GBS isolates (MIC50 = 0.25 μg/mL) was significantly lower than the concentration of AuNP-erythromycin required to inhibit the growth of 90% of the isolates (MIC90 = 1 μg/mL) (P = 0.02), indicating a 16-fold lower dose than the values for erythromycin and AuNPs alone. In the agar well-diffusion method, the average diameter of the growth inhibition zone of AuNPs-erythromycin was 2.5-fold greater than that of free erythromycin (P = 0.037). Conclusions: The results showed that the combination of erythromycin with AuNPs increased the antibacterial effects of erythromycin against GBS isolates.