Novel Silver Amoxicillin Nano-Structure Preparation by Gamma Irradiation with Outstanding Bactericidal Activity against Multidrug Resistant Enterobacteriacea Isolates

Novel Silver Amoxicillin Nano-Structure Preparation by Gamma Irradiation with Outstanding Bactericidal Activity against Multidrug Resistant Enterobacteriacea Isolates | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Novel Silver Amoxicillin Nano-Structure Preparation by Gamma Irradiation with Outstanding Bactericidal Activity against Multidrug Resistant Enterobacteriacea Isolates Ahmed Ibrahim El-Batal, Nagwan Gammal. El Menofy, Fatema Bahaa El-Din Abdel-Wahab, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1471091/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Infections caused by multidrug-resistant (MDR) Enterobacteriacea bacteria have been reported as one of the most rising problem worldwide that require exploration for new antimicrobials. Amoxicillin Nano-structure (Ag-Amox-Ns) with an antibiotic can synergistically inhibit the drug-resistant bacteria. The aim of the current study was to determine the antimicrobial activity of novel synthesized Silver Amoxicillin Nano-structure (Ag-Amox-Ns) using Gamma-irradiation against MDR Enterobacteriaceae clinical isolates. Aqueous dispersed Silver Amoxicillin Nano-structure (Ag-Amox-Ns) were synthesized using silver ion (Ag + 2 ) as precursor, amoxicillin (Amox.) as stabilizing agent and gamma irradiation as reducing agent. The synthesized Ag-Amox-Ns are characterized by UV–visible spectroscopy, Dynamic light scattering (DLS), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR). The morphology and the particles size and shape of Ag-Amox-Ns were estimated by TEM images, the mean size of Ag-Amox-Ns (45nm), XRD analysis of the Ag-Amox-Ns confirmed the formation of metallic nanoparticles. The nucleation and growth mechanism of Ag-Amox-Ns is also discussed. The size of nanoparticles is influenced by certain parameters such as the choice of stabilizer and silver ion concentration and absorbed dose. Antimicrobial activity of novel synthesized Ag-Amox-Ns against MDR Enterobacteriaceae clinical isolates was detrmined by standard microbiological assays. The MDR isolates include Klebsiella spp. (37.1%), Escherichia coli (35.2%) and Proteus spp. (27.7%). The fold increase % of Ag-Amox-Ns by disk diffusion assay was ranged from 66.6 to 316.6 for all tested isolates, furthermore novel conjugate decreased MICs for all strains. The MIC of amoxicillin decreased from more than 250 µg/ml to reach 7.812 µg/ml for 35% of MDR Klebsiella spp. and 47% of MDR E. coli isolates while it reached 3.906 for 40% of MDR Proteus spp. Ag-Amox-Ns is novel compound give promising inhibitory effect against MDR Enterobacteriaceae providing additional treatment options, and enables the use of inexpensive and unused antibiotics in combating bacterial resistance problem. Silver amoxicillin nano-structure Gamma Irradiation Enterobacteriacea isolates and antimicrobial activity. Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 1. Introduction Accelerating antibiotic resistance is a progressing global public health emergency that restrict treatment options and aggravates clinical outcomes (Choffnes et al. 2010 ; Baym et al. 2016 ). The burden of morbidity and mortality caused by infectous diseases, principally bacterial pathogens, is maximized worldwide and cascades most seriously in developing countries as a result of the misuse of antibiotics which are often available over the counter (Garchitorena et al. 2017 ) Several calls by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) were concerned with the rising incidence of infections caused by MDR Enterobacteriaceae (Control and Prevention 2013), such bacteria express β-lactamases confering resistance to penicillins, cephalosporins and monobactams(Lukac et al. 2015 ). Escherichia coli and Klebsiella pneumoniae are important Enterobacteriaceae human pathogens contributing to nosocomial infections including, urinary tract infections, neonatal meningitis, gastroenteritis, wound and skin infections (Alanis 2005 ). Amoxicillin ( d -(−)- α -Amino- p -hydroxybenzyl penicillin) is a semi-synthetic broad spectrum bactericidal β-lactam antibiotic. (Zagari et al. 2007 )Like other β-lactam antibiotics amoxicillin interacts with a group of penicillin-binding transmembrane enzymes leading to inhibition of cell wall synthesis with subsequent bacterial death (Cho et al. 2014 ). Frequent use of amoxicillin had led to extensive bacterial resistance to such cheap available drugs (Costelloe et al. 2010 ). During the past years, nanomedicine had displayed various nanoconjugates effective against several MDR pathogens(Naqvi et al. 2013 ). Metal nanoparticles especially silver nanoparticles (Ag-Amox-Ns) have been studied extensively because of their unique physicochemical characteristics comprising, antimicrobial activity, optical properties, catalytic activity, magnetic properties and electronic properties(Morones et al. 2005 ). Several studies indicated that Ag-Amox-Ns additively or synergistically strengthen the antibacterial effects of antibiotics. However, the synergistic effects of Ag-Amox-Ns–antibiotics combinations were proven mostly for susceptible bacteria (Markowska et al. 2014 ). The main objective of the present study is to evaluate the bactericidal activity of a novel Ag-Amox-Ns preparation using Gamma-irradiation against MDR clinical Enterobacteriaceae isolates in comparison to Silver nitrate and amoxicillin. 2. Materials And Methods 2.1. Chemicals and Reagents Chemicals (amoxicillin, silver nitrate ) and reagents utilized in the following examinations and biological experiments were received at analytical standard grade (Sigma-Aldrich), and appropriated externally additional purification. 2.2. Silver Amoxicillin Nano-structure (Ag-Amox-Ns) preparation. Silver Amoxicillin Nano-structure (Ag-Amox-Ns) were prepared employing amoxicillin as a stabilizing agent and gamma-ray as reducing agent. The experimental factorial study (Table 1 ) practiced comparing the impact of the concentration and radiation dose on the construction of Ag-Amox-Ns. The investigated factorial study was consists of three variables in two level, amoxicillin was mixed with silver ion at ratio 1:1 v/v with addition of 0.2% isopropanol being a free radical collector. The mixtures were stirred at an ambient temperature and exposed to different gamma ray. UV-visible responses O.D estimated the main influences of parameters on Ag-Amox-Ns synthesis. The statistical software package (Minitab 16, U.S.A) applied for planning the test, regression, interpretation of test data and in planning the association among variables. 2.3. Validation of Ag-Amox-Ns. The size, morphology and stability of the synthesized Ag-Amox-Ns was validated using the following techniques: for the preliminary determination of Ag-Amox-Ns optical properites was used the UV visible spectroscopy (JASCO-Japan-model V- 560). The particle size and surface morphology examinations were carried out using TEM (JEOL electron microscope JEM-100 CX). Size distribution were determined by DLS Technique (PSS-NICOMP 380-ZLS, USA). Fourier transform infrared spectroscopy (FTIR) of the samples were recorded at spectrum region of 400 to 4000cm -1 to identify the possible molecules responsible for the reduction of silver ions and to confirm capped Ag-Amox-Ns. Ray diffraction (XRD study of Ag-Amox-Ns was done to determine the structural characterization of the nanoparticles by using X-ray diffractometer (Shimadzu apparatus using nickel-filter and Cu-K a target, Shimadzu Scientific Instruments (SSI), Kyoto, Japan. Founded in 1875 2.4. Isolation and identification of Enterobactereacea bacterial isolates Two hundred and thirty clinical specimens including, 60 pus, 56 diabetic foot ulcer, 40 sputum and respiratory secretions, 34 urine, 20 blood, 12 burn ulcers and 8 wound swaps were obtained from different wards in three different hospitals (Al Sayed Galal, Al Hussein and Homiat Alabassia, Cairo, Egypt) over a period extended from November 2015 to February 2017. These samples were routinely collected and processed by the dedicated team in the hospitals of study. The specimens were initially inoculated onto blood agar, MacConkey agar (Oxoid® Limited, Basingstoke, UK). The growing colonies were identified on the basis of Gram's stain, colony morphology, and different biochemical tests including triple sugar iron test, oxidase test, citrate utilization test, urease test, methyl red test, Voges–Proskauer test, and Eosin methylene blue agar test etc, according to previously described identification scheme (Procop et al. 2017 ). 2.5. Antimicrobial susceptibility testing: 2.5.1. Disk diffusion method All Enterobacteriacea isolates were investigated for their susceptibility to different classes of antibiotics by the Kirby–Bauer disk diffusion method according to guidelines of the Clinical and Laboratory Standards Institute (CLSI) (Kasithevar et al. 2017 ). E.coli ATCC 25922, Klebsiella pneumonia ATCC 700603, and Proteus vulgaris ATCC 13315 obtained from Egyptian Company for the Production of Sera and Vaccines (VACSERA, Dokki, Giza) were used as the quality control standard strains for antimicrobial susceptibility testing. Antibiotics disks used were; amoxicillin 10µg, cefepime 30µg, cefotaxime 30µg, ceftazidime 30µg, Gentamicin 10µg, Tobramycin 10µg, ciprofloxacin 5µg,Tetracycline 30µg,, imipenem 10µg and meropenem 10µg. In brief, suspensions of isolates were prepared in concentration of 1.5 x10 8 cfu/mL and swabbed on the surface of Muller-Hinton agar plates (MHA) (Oxoid® Limited, Basingstoke, UK). Disks were inoculated onto MHA plates and incubated at 37°C for 24 h. Inhibition zones were measured and compared to standard antibiotics inhibition zones published by CLSI, 2018. Primary screening of antibacterial activity of Silver nitrate and Ag-Amox-Ns was performed by disk diffusion method. Disks of amoxicillin, Silver nitrate and Ag-Amox-Ns were prepared by adding 10µl of amoxicillin (500µg/ml), Silver nitrate (50µg/ml) and Ag-Amox-Ns to 6mm diameter Whatmman paper disks (Sigma- Aldrich, Sant Louis, USA). The disk diffusion assay was processed in triplicate. (Kasithevar et al. 2017 ; Xu et al. 2017 ) The fold increase in the diameter of inhibition zone of antibiotic after combination with Ag-Amox-Ns was calculated according to the equation; The fold increase = (b-a)/a x100, where; (a) is the inhibition zone of antibiotic alone and (b) is the inhibition zone of antibiotic plus nanoparticles (Fayaz et al. 2010 ). 2.5.2. Minimum inhibitory concentration (MIC): Determination of minimum inhibitory concentration were performed for amoxicillin (500 µg/ml) (Eipico company, Cairo, Egypt), Silver nitrate (50 µg/ml), and Ag-Amox-Ns (50 + 500 µg/ml). MIC was determined by microbroth dilution assay in 96 multi-well microtiter plates according to the CLSI reference standards(Kasithevar et al. 2017 ). In brief one hundred microliter of double strength Muller-Hinton broth (MHB) (Oxoid® Limited, Basingstoke, UK) was distributed in all wells, a volume of 100µl from each initially prepared aforementioned solution was pipetted into wells of the first row of microtiter plate, serial dilution was performed from the 1st to the 12th well to achieve two-fold serial dilutions. Finally, 10 µl of 0.5 McFarland matched turbidity of freshly prepared bacterial suspension (1.5 x 10 8 cfu/ml) was added to each well. Two columns in each plate were used as positive and negative controls. Plates were incubated at 37˚C for 18–24 h. The MIC was calculated as the smallest concentration where no visible bacterial growth was observed in comparison to control wells. All the tests were run in duplicate (Yeo and Livermore 1994 ). 2.5.3. Minimum bactericidal concentration (MBC): The minimum bactericidal concentrations (MBC) were determined depending on the absence of visible bacterial growth. Of each clear well, 3 µl were spot-inoculated on MHA plates and were incubated overnight at 37°C for 18–24 h. The MBC was reported as the lowest concentration that showed no bacterial growths (Man et al. 2017 ). 3. Results 3.1. Optical properties of Ag-Amox-Ns The results show the optical density (O.D) of Ag-Amox-Ns, increases the peak intensities (O.D) with concomitant blue shifts. This suggests formation of Ag-Amox-Ns with higher yields and smaller sizes (Liu et al. 2007 ). The strong absorption band at 490nm is the indication of formation of silver nanoparticles. The trial no. 5 (Table 1 ) with conditions (100ppm silver nitrate, 1000µg/ml amoxicillin and 5kGy radiation dose) shows highest O.D (5.0 Ab.) than other trials. That indicate high yield of Ag-Amox-Ns more than other conditions. Figure 1 shows UV-vis spectra of the aqueous amoxicillin (Amox.) and Ag-Amox-Ns solutions synthesized at 0 kGy (non-irradiated) and 5 kGy, spectra being recorded after completion of the reaction. The UV vis spectrum of Ag-Amox-Ns synthesized at 5 kGy clearly shows an intense surface plasmon resonance (SPR) band at 495nm along with O.D (5Ab) higher than non-irradiated Ag-Amox-Ns with sharp head of peak. That indicates formation of silver nanoparticles with high yield and small size. The peak intensity increased proportionately, which is mainly due to the formation of more nanoparticles (Huang and Yang 2004 ; Bar et al. 2009 ). It has been observed that no significant differences in the peak location with increase intensity of the SPR are observed when amoxicillin solution exposed to 5 kGy in compere with non-irradiated amoxicillin (Fig. 1 ). That indicates stability of amoxicillin function moiety. 3.2. Mechanism of Ag-Amox-Ns preparation Kinetic studies of the reduction process revealed that the synthesis of Ag-Amox-Ns starts without radiation; this reduction is greatly increased by gamma irradiation especially at 5kGy (Fig. 1 . Table 1 ) suggesting that radiation has role in the synthesis of nanoparticles; The radicals and molecules produced in water upon gamma irradiation are e-aq, OH • , H • , H 2 , and H 2 O 2 (Mosalam 2013 ). We suggest the following provisional mechanism for gamma ray, (Eqs. (1) (7) where amoxicillin molecular formula: C 16 H 19 N 3 O 5 S. Accordingly, the hydroxyl groups, carboxyl, amino and sulfur moiety present in amoxicillin (Fig. 2 ) are responsible for coating and stabilization of Ag-Amox-Ns while inhibiting their excessive aggregations and agglomeration. H 2 O + Gamma ray → e- aq + OH• + H• + H 2 + H 2 O 2 ( 1) Silver nitrate + H 2 O → Ag + + NO 3 (2) Ag + + e − aq → Ag • (4) C 16 H 19 N 3 O 5 S + OH • → (C 16 H 18 N 3 O 5 S) • + H 2 O (5) (C 16 H 18 N 3 O 5 S) • + Ag + + H 2 O → Ag • + H 3 O + + (C 16 H 19 N 3 O 5 S) 2 (6) (C 16 H 19 N 3 O 5 S) + Ag • → (C 16 H 19 N 3 O 5 S) Ag • ( capping and stabilization) (7) 3.3. Particles size, size distribution and stability of Ag-Amox-Ns Figure (3b) shows the mean size of Ag-Amox-Ns (45nm) and figure (3a) shows DLS size distribution of Ag-Amox-Ns (80nm), . Figure 4 shows FTIR spectra of Amoxicillin and Ag-Amox-Ns at 5kGy, this analysis was conducted to determine the molecular interaction between the amoxicillin and the synthesized Ag-Amox-Ns. The spectrum in Fig. 4 shows amoxicillin; transmission at 3467cm − 1 assigned to the overlap of O − H and N − H stretching vibrations; 2329 cm − 1 to C − H bending, 2079 cm − 1 attributed to c-o vibration and 1643 cm − 1 to − C−O skeletal stretching. The same trend as observed in the Ag-Amox-Ns spectrum (Fig. 5 ). The end product in the Ag-Amox-Ns is dark brown precipitate after drying on a glass slide at 40 o C. The XRD spectrum of the Ag-Amox-Ns was showed in Fig. 5 and the appearance of four strong peaks were observed in the spectrum of 2θ values ranging from 10–90º at values at 46.63, 55.1, 68.42, and 76.21 o equivalent to (220), (311), (400) and (420) planes in that order respectively. This result confirms presence of silver nanoparticles. 3.4. Antimicrobial activity of Ag-Amox-Ns 3.4.1. Isolation, identification and antimicrobial susceptibility The Enterobacteriaceae , especially Escherichia coli and Klebsiella pneumoniae , are common causes of hospital and community acquired infections worldwide(Kendall et al. 2012 ). The global dissemination of drug-resistant bacteria is worrying for medical specialists as it limits the available choices for accurate treatment and consequently contributes to higher mortality and morbidity rates (van der Bij and Pitout 2012 ) specimens, 288 bacterial strains were isolated. A total of 190 (65.9%) isolates were Gram-negative, 85 (29.5%) were Gram-positive and 15(4.5%) were fungi. Out of Gram-negative isolates, 142 were related to Enterobactereacea family that comprises Escherichia coli 50(35.2%), Klebsiella pneumonia 42 (29.5%) Klebsiella oxytoca 15 (10.5%), Proteus vulgaris 20 (14.08%) and Proteus mirabilis 15(10.5%) The antibiotic susceptibility results of the Gram-negative isolates showed that 54 (37.1%) were considered MDR isolates being resistant to three or more antibiotic classes. The MDR isolates include Klebsiella spp. 20 (37.1%) isolates, Escherichia coli 19 (35.2%) isolates and Proteus spp. 15(27.7%) isolates Table (2). These results are comparable to other studies in the same geographical area as (Khalifa et al. 2019 ) that confirm the high prevalence of bacterial antimicrobial resistance in Egypt which is extremely concerning and necessities the development of new antimicrobials. 4. Discussions It is well known that silver nanoparticles exhibit a dark red colour in aqueous solution due to the surface plasmon resonance (SPR) of metal nanoparticles (Link and El-Sayed 2003 ). Because the silver nanoparticles are extraordinarily efficient at absorbing and scattering light and, unlike many dyes and pigments, have a color that depends upon the size and the shape of the particle (El-Batal et al. 2013 ). The previous studies have shown that the AgNPs contribute to the absorption bands at around 400 to 550 nm in the UV–visible spectra (Stamplecoskie and Scaiano 2010 ). Characteristics band of Ag-Amox-Ns Were detected around 490nm (Fig. 1 ), which strongly suggests that the Ag-Amox-Ns formation and have been confirmed by the TEM results of this study. Silver nanoparticle solutions that have not agglomerated, the UV/Visible extinction spectra can be used to quantify the nanoparticle concentration. Due to the linear relationship between O.D and concentration, the values of O.D can be used to quantify the concentration of nanoparticle solutions. Optical density, a measure of the amount of light transmitted through a solution, which has positive relation with concentration of nanoparticles (Ghorab et al.). The advantage of gamma irradiation for the synthesis of metallic nanoparticles lies in the fact that desired production of highly reducing free electron without the formation of any byproduct. We have employed free electron as a reducing agent to Ag 2+ ions and amoxicillin as a stabilizer for NPs. The OH and H radicals are capable to abstract hydrogen from the amoxicillin producing a amoxicillin radical (secondary radicals = C 16 H 18 N 3 O 5 S) ● . Under the stated experimental conditions the reduction of silver ions takes place by electron transfer from hydrated electrons and amoxicillin radicals to form zero-valent nanoparticles that stabilized by reduced amoxicillin. The circle isotropic, poly-dispersed particles, this attributed to the amoxicillin structure; that act as capping and stabilizing agents to prevent aggregation and agglomeration of NPs. The DLS measures the hydrodynamic diameter of nanoparticles, where the amphiphilic nanoparticles were surrounded by water molecules (Akhtar et al. 2011) may be attributed to being the cause of the large size of capped formulation. The general decrease or increase in the band with slight shifts; this attributed to stability and incorporation of amoxicillin with Ag-Amox-Ns. which indicates a reaction between the NP surface, and the amoxicillin amino and hydroxyl groups (Cardenas et al. 2002 ). Suggests that AgNPs were capped by the amoxicillin forming Ag-Amox-Ns, suggesting their role in the stabilization of the nanoparticles; It reported earlier that amoxicillin could bind to nanoparticles either through amide groups or via the electrostatic attraction of negatively charged hydroxyl groups (Rastogi and Arunachalam 2011 ) and therefore, stabilization of the nanoparticles and prevent NPs aggregation and precipitation. Nanoantibiotics which have properties of antimicrobial agents and nanomaterials are considered as good alternatives against multi-drug resistant organisms (Huh and Kwon 2011 ) silver nanoparticles (Ag-Amox-Ns) are the most promising nanoantibiotics nowadays [(Borrego et al. 2016 ) Ag-Amox-Ns possess unique advantages as generalized mood of action, activity against many microbial targets and effectiveness against resistant pathogen, furthermore it can be synthesized by cheap and environmental friendly methods, (Dilnawaz et al. 2018 ; Vazquez-Muñoz et al. 2019 ) In the present study synergistic effect of Ag-Amox-Ns was investigated against the MDR Enterobactereacea pathogens by disk diffusion and broth microdilution assays. Diameter of inhibition zones of Ag-Amox-Ns, Silver nitrate as negative and amoxicillin as positive controls are presented in table (3). Ag-Amox-Ns showed great antimicrobial activity compared to amoxicillin which did not show antimicrobial activity. On the other hand Silver nitrate showed moderate antibacterial activity Figure (6). Minimum and maximum inhibition zone of Ag-Amox-Ns for Klebsiella spp. were 11 mm and 25 mm respectively, while the minimum and maximum fold increase percentages were 83.3% and 316.6%, similar results were reported for other pathogen where the minimum and maximum fold increase percentages were 66.6 and 233.3 for E. coli and 66.6 and 200 for Proteus spp . The result revealed that the antibacterial activity of amoxicillin have been intensified when conjugated with Ag-Amox-Ns nanoparticles against tested pathogens. Several studies have been pointed out the antibacterial efficacies of silver nanoparticle-antibiotic combinations (Hassan et al. 2016 ; Fattah et al. 2017 ). The Ag-Amox-Ns is associated with cell membrane potential and integrity alteration lead to increasing microbial cell permeability and facilitate antibiotics cellular entrance, and consequently higher efficiency (Vazquez-Muñoz et al. 2019 ), Additionally the high surface area of Ag-Amox-Ns maximizes its antimicrobial activity compared to silver metal (Lopez-Carrizales et al. 2018 ).‏ Conjugation of nanoparticles with antibiotics enhances their bactericidal properties and reduces the toxicity of both agents. Synergistic effect may be due formation of certain complex that have bactericidal action either by inhibiting the cell wall synthesis or its lysis or death (Allahverdiyev et al. 2011 ). In the present study the results of MIC and MBC of amoxicillin against MDR Enterobactereacea pathogens revealed that all isolates were resistant as the MICs (> 250) were higher than its breakpoint. Tables (4, 5 and 6) summarized the MIC and MBC of novel Ag-Amox-Ns -amoxicillin conjugate, Silver nitrate and amoxicillin against the Klebsiella spp., E. coli and Proteus spp . and revealed that MICs decreased drastically for all strains where novel Ag-Amox-Ns -amoxicillin conjugate reduce the MICs by 4 to 64, 16 to 128 and 16 to 128 fold among Klebsiella spp., E. coli and Proteus spp. Respectively. Enhanced antimicrobial activity of the novel Ag-Amox-Ns -amoxicillin conjugate could be explained by the interaction and arrangement of the molecules in a one compound, which could work in multiple ways (Lopez-Carrizales et al. 2018 ). The MIC decreased to reach 15.62 and 7.812 µg/ml in 301.0% and 35% of MDR Klebsiella spp. and 31% and 47% of MDR E. coli isolates while it was 7.812 and 3.906 in 26.7% and 40%. Our results demonstrated that Ag-Amox-Ns, when combined with amoxicillin, strongly enhanced its activity against the MDR strains which is also confirmed by variable studies (Panáček et al. 2016 ). Ag-Amox-Ns- amoxicillin caused a dramatic growth inhibition For MDR Enterobactereacea strains. Several mechanistic studies (Sotiriou and Pratsinis 2010 ) Reported that Ag-Amox-Ns generate hydroxyl radicals that boost the bacterial inhibition, also Li et al. (Li et al. 2005 ) theorized that both of Ag-Amox-Ns and amoxicillin kill the bacteria individually with dissimilar mechanisms, furthermore they may form a complex where Ag-Amox-Ns core is surrounded by amoxicillin molecules. The release of Ag + is also enhancing the bactericidal activity. Ag + causes bacterium toxicity by binding to the proteins and DNA molecules inside the cells as well as those of cell walls, disabling the bacterial metabolic activity and finally bacterial death (Batarseh 2004 ; Deng et al. 2016 ). Conclusions; Understanding the mechanism of Ag-Amox-Ns combination allows predicting a more efficient therapy, providing additional treatment options, and enables the use of unused antibiotics because of development of bacterial resistance. Abbreviations Ag-Amox-Ns Amoxicillin Nano-structure DLS Dynamic light scattering XRD X-ray diffraction FT-IR Fourier transforms infrared spectroscopy MDR multidrug resistant TEM Transmission electron microscope O.D Optical density MI Minimum inhibitory concentration MBC Minimum bactericidal concentration CDC Centers for Disease Control and Prevention and WHO = World Health Organization Declarations Acknowledgements The authors would like Drug Microbiology Lab, Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egypt. Conflicts of Interest: The authors declare there is no conflict of interest. Ethical approval: The research protocol was approved by the Ethics of National Center for Radiation Research and Technology (NCRRT), Egypt, EAEA Funding Information: No funding provided Author Contributions: All authors have contributed to the (1 and 2) conception and design or the acquisition and analysis of Data and approval of the final submitted version and drafting or critically revising the manuscript Constant of participate and publish: All authors agree to participate and publish References [Akhtar MS, Ameen S, Ansari SA, Yang O (2011) Synthesis and characterization of ZnO nanorods and balls nanomaterials for dye sensitized solar cells. Journal of Nanoengineering and Nanomanufacturing 1:71-76 Alanis AJ (2005) Resistance to antibiotics: are we in the post-antibiotic era? 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Colloids and Surfaces B: Biointerfaces 142:392-399 Procop GW, Church D, Hall G, Janda W (2017) Koneman's Color Atlas and Textbook of Diagnostic. Philadelphia: Wolters Kluwer Rastogi L, Arunachalam J (2011) Sunlight based irradiation strategy for rapid green synthesis of highly stable silver nanoparticles using aqueous garlic (Allium sativum) extract and their antibacterial potential. Materials Chemistry and Physics 129:558-563 Sotiriou GA, Pratsinis SE (2010) Antibacterial activity of nanosilver ions and particles. Environmental science & technology 44:5649-5654 Stamplecoskie KG, Scaiano JC (2010) Light emitting diode irradiation can control the morphology and optical properties of silver nanoparticles. Journal of the American Chemical Society 132:1825-1827 van der Bij AK, Pitout JD (2012) The role of international travel in the worldwide spread of multiresistant Enterobacteriaceae. Journal of Antimicrobial Chemotherapy 67:2090-2100 Vazquez-Muñoz R et al. (2019) Enhancement of antibiotics antimicrobial activity due to the silver nanoparticles impact on the cell membrane. PloS one 14 Xu N et al. (2017) Silver-loaded nanotubular structures enhanced bactericidal efficiency of antibiotics with synergistic effect in vitro and in vivo. Int J Nanomedicine 12:731-743 doi: 10.2147/IJN.S123648 Yeo S-F, Livermore DM (1994) Comparative in-vitro activity of biapenem and other carbapenems against Haemophilus influenzae isolates with known resistance mechanisms to ampicillin. Journal of Antimicrobial Chemotherapy 33:861-865 Zagari RM, Bianchi-Porro G, Fiocca R, Gasbarrini G, Roda E, Bazzoli F (2007) Comparison of 1 and 2 weeks of omeprazole, amoxicillin and clarithromycin treatment for Helicobacter pylori eradication: the HYPER Study. Gut 56:475-479 Tables Table 1: Experimental factorial design experiments optical density (O. D) response. Factor 1 Factor 2 Factor 3 Response No. Amox.Conc. (µg/ml) AgNO 3 (PPM) Radiation Dose (kGy) Ag-Amox-Ns O.D (Ab) 1 250 100 1 0.201 2 500 25 5 2.01 3 250 50 5 3.2 4 1000 50 1 0.29 5 1000 100 5 5 6 1000 50 5 3.5 7 250 25 10 0.50 8 500 50 1 0.25 9 500 100 5 3.1 10 250 25 1 0.14 11 1000 50 10 1.4 12 250 50 10 0.53 13 500 25 1 0.17 14 1000 25 1 0.19 15 500 25 10 1.17 16 1000 25 5 2.12 17 250 100 5 2.25 18 1000 100 10 1.8 19 500 100 10 1.4 20 250 25 5 2.001 21 1000 25 10 1.03 22 1000 100 1 0.41 23 250 50 1 0.38 24 250 100 10 0.81 25 500 100 1 0.081 26 500 50 5 1.131 27 500 50 10 1.037 Table (2): Antibiotic Susceptibility profiles of MDR Enterobacteriaceae isolates Antibiotics Klebsiella spp. (N =20; 37.1%) E. coli (N = 19; 35.2%) Proteus spp. N ( 15; 27.7%) Total resistance (%) R S R S R S Amoxicillin (AX) 20(100) 0(0) 19(100) 0(0) 14(93.3) 1(6.67) 53 (98.1) Cefotaxime( CTX) 20(100) 0(0) 18(94.7) 1(5.3) 14(93.3) 1(6.67) 52 (96.3) Ceftazidime (C AZ) 20(100) 0(0) 18(94.7) 1(5.3) 14(93.3) 1(6.67) 52 (96.3) Cefepime ( FEP) 20(100) 0(0) 19(100) 0(0) 15(100) 0(0) 54 (100) Ciprofloxacin(CEP) 18(90) 2(10) 18(94.7) 1(5.3) 14(93.3) 1(6.67) 50 (92.6) Gentamicin (CN) 18(90) 2(10) 18(94.7) 1(5.3) 12(80) 3(20) 48 (88.9) Tobramycin (TOP) 18(90) 2(10) 18(94.7) 1(5.3) 12(80) 3(20) 48 (88.9) Imipenem (IMP) 12(60) 8(40) 10(52.6) 9(47.4) 14(93.3) 1(6.67) 36 (66.6) Meropenem(MEM) 13(65) 7(35) 15(78.9) 4(21.1) 11(73.3) 4(26.6) 39 (72.2) Tetracycline (TE) 18(90) 2(10) 17(89.5) 2(10.5) 13(86.7) 2(13.3) 48 (88.9) N; number Table (3): The Mean Inhibition Zone in mm and Fold increase percentage of Amoxicillin, AgNO3, and Ag-Amox.Ns Klebsiella spp. code AgNO3(50 µg/ ml) Amox. (10µg/ml) Ag-Amox-Ns(50/500 µg/ml) Fold increase % [(b- a)/a] x 100 E. coli code AgNO3 (50 µg) Amox. (10) µg Ag-Amox-Ns (50/500 µg/ml) conjugate Ffold increase % [(b- a)/a] x 100 Proteus spp. code AgNO3 (50 µg) Amox. (10) µg AgNPs/ AX (50/500 µg/ml) conjugate Fold increase % [(b- a)/a] x 100 K01 7 NIL (6mm) 11 83.3 EC01 10 NIL (6mm) 16 166.6 P01 9 NIL (6mm) 14 133.3 K02 8 NIL (6mm) 14 133.3 EC02 8 NIL (6mm) 18 200 P02 9 NIL (6mm) 18 200 K03 7 NIL (6mm) 10 66.6 EC03 8 NIL (6mm) 15 150 P03 12 NIL (6mm) 17 183.3 K04 8 NIL (6mm) 10 66.6 EC04 8 NIL (6mm) 20 233.3 P04 9 NIL (6mm) 14 133.3 K05 14 NIL (6mm) 20 233.3 EC05 13 NIL (6mm) 20 233.3 P05 10 NIL (6mm) 17 183.3 K06 12 NIL (6mm) 16 166.6 EC06 10 NIL (6mm) 10 66.6 P06 8 NIL (6mm) 14 133.3 K07 10 NIL (6mm) 15 150 EC07 10 NIL (6mm) 10 66.6 P07 8 NIL (6mm) 14 133.3 K08 10 NIL (6mm) 16 166.6 EC08 8 NIL (6mm) 11 83.3 P08 8 NIL (6mm) 14 133.3 K09 8 NIL (6mm) 12 100 EC09 10 NIL (6mm) 16 166.6 P09 7 NIL (6mm) 10 66.6 K10 7 NIL (6mm) 11 83.3 EC10 9 NIL (6mm) 16 166.6 P10 7 NIL (6mm) 14 133.3 K11 8 NIL (6mm) 14 133.3 EC11 9 NIL (6mm) 15 150 P11 8 NIL (6mm) 13 116.6 K12 9 NIL (6mm) 13 116.6 EC12 9 NIL (6mm) 14 133.3 P12 9 NIL (6mm) 12 100 K13 9 NIL (6mm) 12 100 EC13 10 NIL (6mm) 16 166.6 P13 9 NIL (6mm) 12 100 K14 9 NIL (6mm) 15 150 EC14 10 NIL (6mm) 15 150 P14 7 NIL (6mm) 12 100 K15 9 NIL (6mm) 12 100 EC15 10 NIL (6mm) 17 183.3 P15 8 NIL (6mm) 14 133.3 K16 9 NIL (6mm) 12 100 EC16 9 NIL (6mm) 16 166.6 Proteus vulgaris ATCC 13315 12 12 15 25 K17 12 NIL (6mm) 19 216.6 EC17 9 NIL (6mm) 14 133.3 K18 14 NIL (6mm) 23 283.3 EC18 9 NIL (6mm) 15 150 K19 16 NIL (6mm) 25 316.6 EC19 9 NIL (6mm) 15 150 K20 16 NIL (6mm) 23 283.3 E.coli ATCC 25922 13 10 15 50 Klebsiella pneumonia ATCC 700603 10 10 13 30 AX ; Amoxicillin, Ag-Amox-Ns ; silver amoxicillin Nano-conjugate, MIC; Minimum inhibitory concentration , MBC; Minimum bactericidal concentration. Table (4): Synergistic effect of Amoxicillin, AgNO3, and Ag-Amox-Ns against Klebsiella spp. by MIC and MBC Amox. (500 µg/ml) Positive Control Dilutions MIC (%) MBC (%) AgNO3 (50 µg/ml) Negative Control Dilutions MIC (%) MBC (%) Ag-Amox-Ns (50/500 µg/ml) Dilutions MIC (%) MBC (%) Fold Change >250 20 (100) 20 (100) >25 5 (25) 19 (95) >25 /250 0 (0) 2 (10) - 125 0 (0) 0 (0) 12.5 9 (45) 1 (5) 12.5 /125 0 (0) 2 (10) - 62.5 0 (0) 0 (0) 6.25 4 (20) 0 (0) 6.25 / 62.5 1 (5) 8 (40) 4 31.25 0 (0) 0 (0) 3.125 2 (10) 0 (0) 3.125 / 31.25 2 (10) 2 (10) 8 15.625 0 (0) 0 (0) 1.562 0 (0) 0 (0) 1.56 2 /15.62 6 (30) 3 (15) 16 7.8125 0 (0) 0 (0) 0.781 0 (0) 0 (0) 0.781 / 7.812 7 (35) 3 (15) 32 3.90625 0 (0) 0 (0) 0.390 0 (0) 0 (0) 0.390 / 3.906 4 (20) 0 (0) 64 1.95313 0 (0) 0 (0) 0.195 0 (0) 0 (0) 0.195 / 1.953 0 (0) 0 (0) - 0.97656 0 (0) 0 (0) 0.097 0 (0) 0 (0) 0.097 /0.976 0 (0) 0 (0) - AX Klebsiella pneumonia ATCC 700603 62.5 125 AgNO3 Klebsiella pneumonia ATCC 700603 3.125 12.5 AgNPs+ AX Klebsiella pneumonia ATCC 700603 0.391 /3.91 6.25 + 62.5 16 AX ; Amoxicillin, Ag-Amox-Ns ; silver amoxicillin Nano-conjugate, MIC; Minimum inhibitory concentration , MBC; Minimum bactericidal concentration. Table (5): Synergistic effect of Amoxicillin, AgNO3, and Ag-Amox-Ns against E. coli by MIC and MBC Amox. (500 µg/ml) Positive Control Dilutions MIC (%) MBC (%) AgNO3 (50 µg/ml) Negative Control Dilutions MIC (%) MBC (%) Ag-Amox-Ns (50+500 µg/ml) Conjugate Dilutions MIC (%) MBC (%) Fold Change >250 19 (100) 19 (100) >25 8 (42.1) 17 (89.5) >25 /250 0 (0) 1 (5.3) - 125 0 (0) 0 (0) 12.5 9 (47.4) 2 (10.5) 12.5 / 125 0 (0) 0 (0) - 62.5 0 (0) 0 (0) 6.25 0 (0) 0 (0) 6.25 / 62.5 0 (0) 11 (57.9) - 31.25 0 (0) 0 (0) 3.125 2 (10.5) 0 (0) 3.125 /31.25 0 (0) 3 (15.8) - 15.625 0 (0) 0 (0) 1.562 0 (0) 0 (0) 1.562 / 15.62 6 (31.6) 2 (10.5) 16 7.8125 0 (0) 0 (0) 0.781 0 (0) 0 (0) 0.781 /7.812 9 (47.4) 2 (10.5) 32 3.90625 0 (0) 0 (0) 0.390 0 (0) 0 (0) 0.390 /3.906 2 (10.5) 0 (0) 64 1.95313 0 (0) 0 (0) 0.195 0 (0) 0 (0) 0.195/ 1.953 2 (10.5) 0 (0) 128 0.97656 0 (0) 0 (0) 0.097 0 (0) 0 (0) 0.097 / 0.976 0 (0) 0 (0) - AX E. coli ATCC 25922 31.25 >250 AgNO3 E. coli ATCC 25922 3.906 15.62 AgNPs+ AX E. coli ATCC 25922 0.048+ 0.488 6.25 + 62.5 64 AX ; Amoxicillin, Ag-Amox-Ns ; silver amoxicillin Nano-conjugate, MIC; Minimum inhibitory concentration , MBC; Minimum bactericidal concentration. Table (6): Synergistic effect of Amoxicillin, AgNO3, and Ag-Amox-Ns against Proteus spp. by MIC and MBC Amox. (500 µg/ml) Positive Control Dilutions MIC (%) MBC (%) AgNO3 (50 µg/ml) Negative Control Dilutions MIC (%) MBC (%) Ag-Amox-Ns (50+500 µg/ml) Dilutions MIC (%) MBC (%) Fold Change >250 14 (93.3) 15 (100) >25 8 (53.3) 13 (86.7) >25 / 250 0 (0) 2 (13.3) - 125 1 (6.7) 0 (0) 12.5 4 (26.7) 2 (13.3) 12.5 / 125 0 (0) 0 (0) - 62.5 0 (0) 0 (0) 6.25 3 (20) 0 (0) 6.25 / 62.5 0 (0) 12 (80) - 31.25 0 (0) 0 (0) 3.125 0 (0) 0 (0) 3.125 / 31.25 0 (0) 1 (6.7) - 15.625 0 (0) 0 (0) 1.562 0 (0) 0 (0) 1.562 / 15.62 3 (20) 0 (0) 16 7.8125 0 (0) 0 (0) 0.781 0 (0) 0 (0) 0.781 / 7.812 4 (26.7) 0 (0) 32 3.90625 0 (0) 0 (0) 0.390 0 (0) 0 (0) 0.390 / 3.906 6 (40) 0 (0) 64 1.95313 0 (0) 0 (0) 0.195 0 (0) 0 (0) 0.195 / 1.953 2 (13.3) 0 (0) 128 0.97656 0 (0) 0 (0) 0.097 0 (0) 0 (0) 0.097 / 0.976 0 (0) 0 (0) - 0.48828 0 (0) 0 (0) 0.048 0 (0) 0 (0) 0.048 / 0.488 0 (0) 0 (0) - AX Proteus vulgaris ATCC 13315 15.625 62.5 AgNO3 Proteus vulgaris ATCC 13315 3.125 3.125 AgNPs+ AX Proteus vulgaris ATCC 13315 0.781 / 7.81 3.125 / 31.25 2 AX ; Amoxicillin, Ag-Amox-Ns ; silver amoxicillin Nano-conjugate, MIC; Minimum inhibitory concentration , MBC; Minimum bactericidal concentration. 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University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Abeer","middleName":"Khairy","lastName":"Abdulall","suffix":""}],"badges":[],"createdAt":"2022-03-20 15:14:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1471091/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1471091/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":19628688,"identity":"a6cfc138-53a2-49a4-a32e-7c81be18e9b4","added_by":"auto","created_at":"2022-03-25 20:09:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":102639,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eUV-scan of irradiated and non-irradiated amoxicillin and Ag-Amox-Ns\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-1471091/v1/a4cd3b70ac2e9a5221703f41.png"},{"id":19629122,"identity":"a329ab2a-c55e-4574-9508-59a0a90cad25","added_by":"auto","created_at":"2022-03-25 20:14:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":56121,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAmoxicillin formula.\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-1471091/v1/f83c7d4d048c3a2da15e8d23.png"},{"id":19628691,"identity":"113e9760-3501-462c-a0f1-b31d2b5cbe98","added_by":"auto","created_at":"2022-03-25 20:09:39","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":558577,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ea: DLS size distribution of Ag-Amox-Ns\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eb: TEM image of Ag-Amox-Ns\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"fig3.png","url":"https://assets-eu.researchsquare.com/files/rs-1471091/v1/aba0027d7c6914e4c21cea01.png"},{"id":19628694,"identity":"84e0138c-4eac-4f5c-954d-deeccc9646cd","added_by":"auto","created_at":"2022-03-25 20:09:40","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":108719,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFT-IR spectrum of amoxicillin and Ag-Amox-Ns\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"fig4.png","url":"https://assets-eu.researchsquare.com/files/rs-1471091/v1/2bf3c8f02ebd8dcfab2eb066.png"},{"id":19628689,"identity":"94f5e3d2-afc7-467e-a85a-a5fffce537fb","added_by":"auto","created_at":"2022-03-25 20:09:39","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":67047,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eXRD spectrum of Ag-Amox-Ns\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"fig5.png","url":"https://assets-eu.researchsquare.com/files/rs-1471091/v1/5170d88c96ef7329912684e5.png"},{"id":19629123,"identity":"2e0185f2-1d59-4a84-8f82-9e2b8bab313a","added_by":"auto","created_at":"2022-03-25 20:14:39","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":967420,"visible":true,"origin":"","legend":"\u003cp\u003eMinimum and maximum inhibition zone of Ag-Amox-Ns for \u003cem\u003eKlebsiella spp\u003c/em\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"fig6.png","url":"https://assets-eu.researchsquare.com/files/rs-1471091/v1/2dad4b7f20198fa7da8ac585.png"},{"id":19629124,"identity":"3a3613cc-35f0-42d3-a40d-c4c7154cb29f","added_by":"auto","created_at":"2022-03-25 20:14:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2707361,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1471091/v1/94191451-dd20-418b-9c2f-d657797e4c9e.pdf"},{"id":19628692,"identity":"850428fd-ed7f-472c-b1bf-2f0320230ead","added_by":"auto","created_at":"2022-03-25 20:09:39","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":34803,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementrydata1.docx","url":"https://assets-eu.researchsquare.com/files/rs-1471091/v1/ceaac1377c62868381d0eb2b.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eNovel Silver Amoxicillin Nano-Structure Preparation by Gamma Irradiation with Outstanding Bactericidal Activity against Multidrug Resistant Enterobacteriacea Isolates\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eAccelerating antibiotic resistance is a progressing global public health emergency that restrict treatment options and aggravates clinical outcomes (Choffnes et al. \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Baym et al. \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). The burden of morbidity and mortality caused by infectous diseases, principally bacterial pathogens, is maximized worldwide and cascades most seriously in developing countries as a result of the misuse of antibiotics which are often available over the counter (Garchitorena et al. \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2017\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eSeveral calls by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) were concerned with the rising incidence of infections caused by MDR \u003cem\u003eEnterobacteriaceae\u003c/em\u003e (Control and Prevention 2013), such bacteria express β-lactamases confering resistance to penicillins, cephalosporins and monobactams(Lukac et al. \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cem\u003eEscherichia coli\u003c/em\u003e and \u003cem\u003eKlebsiella pneumoniae\u003c/em\u003e are important \u003cem\u003eEnterobacteriaceae\u003c/em\u003e human pathogens contributing to nosocomial infections including, urinary tract infections, neonatal meningitis, gastroenteritis, wound and skin infections (Alanis \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2005\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmoxicillin (\u003cspan type=\"SmallCaps\" class=\"SmallCaps\" name=\"Emphasis\"\u003ed\u003c/span\u003e-(\u0026minus;)-\u003cem\u003eα\u003c/em\u003e-Amino-\u003cem\u003ep\u003c/em\u003e-hydroxybenzyl penicillin) is a semi-synthetic broad spectrum bactericidal β-lactam antibiotic. (Zagari et al. \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2007\u003c/span\u003e)Like other β-lactam antibiotics amoxicillin interacts with a group of penicillin-binding transmembrane enzymes leading to inhibition of cell wall synthesis with subsequent bacterial death (Cho et al. \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Frequent use of amoxicillin had led to extensive bacterial resistance to such cheap available drugs (Costelloe et al. \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). During the past years, nanomedicine had displayed various nanoconjugates effective against several MDR pathogens(Naqvi et al. \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Metal nanoparticles especially silver nanoparticles (Ag-Amox-Ns) have been studied extensively because of their unique physicochemical characteristics comprising, antimicrobial activity, optical properties, catalytic activity, magnetic properties and electronic properties(Morones et al. \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). Several studies indicated that Ag-Amox-Ns additively or synergistically strengthen the antibacterial effects of antibiotics. However, the synergistic effects of Ag-Amox-Ns\u0026ndash;antibiotics combinations were proven mostly for susceptible bacteria (Markowska et al. \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe main objective of the present study is to evaluate the bactericidal activity of a novel Ag-Amox-Ns preparation using Gamma-irradiation against MDR clinical \u003cem\u003eEnterobacteriaceae\u003c/em\u003e isolates in comparison to Silver nitrate and amoxicillin.\u003c/p\u003e"},{"header":"2. Materials And Methods","content":"\u003cdiv class=\"Section2\" id=\"Sec3\"\u003e\n \u003ch2\u003e2.1. Chemicals and Reagents\u003c/h2\u003e\n \u003cp\u003eChemicals (amoxicillin, silver nitrate ) and reagents utilized in the following examinations and biological experiments were received at analytical standard grade (Sigma-Aldrich), and appropriated externally additional purification.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec4\"\u003e\n \u003ch2\u003e2.2. Silver Amoxicillin Nano-structure (Ag-Amox-Ns) preparation.\u003c/h2\u003e\n \u003cp\u003eSilver Amoxicillin Nano-structure (Ag-Amox-Ns) were prepared employing amoxicillin as a stabilizing agent and gamma-ray as reducing agent. The experimental factorial study (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) practiced comparing the impact of the concentration and radiation dose on the construction of Ag-Amox-Ns. The investigated factorial study was consists of three variables in two level, amoxicillin was mixed with silver ion at ratio 1:1 v/v with addition of 0.2% isopropanol being a free radical collector. The mixtures were stirred at an ambient temperature and exposed to different gamma ray. UV-visible responses O.D estimated the main influences of parameters on Ag-Amox-Ns synthesis. The statistical software package (Minitab 16, U.S.A) applied for planning the test, regression, interpretation of test data and in planning the association among variables.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec5\"\u003e\n \u003ch2\u003e2.3. Validation of Ag-Amox-Ns.\u003c/h2\u003e\n \u003cp\u003eThe size, morphology and stability of the synthesized Ag-Amox-Ns was validated using the following techniques: for the preliminary determination of Ag-Amox-Ns optical properites was used the UV visible spectroscopy (JASCO-Japan-model V- 560). The particle size and surface morphology examinations were carried out using TEM (JEOL electron microscope JEM-100 CX). Size distribution were determined by DLS Technique (PSS-NICOMP 380-ZLS, USA). Fourier transform infrared spectroscopy (FTIR) of the samples were recorded at spectrum region of 400 to 4000cm\u003csup\u003e-1\u003c/sup\u003e to identify the possible molecules responsible for the reduction of silver ions and to confirm capped Ag-Amox-Ns. Ray diffraction (XRD study of Ag-Amox-Ns was done to determine the structural characterization of the nanoparticles by using X-ray diffractometer (Shimadzu apparatus using nickel-filter and Cu-K a target, Shimadzu Scientific Instruments (SSI), Kyoto, Japan. Founded in 1875\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec6\"\u003e\n \u003ch2\u003e2.4. Isolation and identification of Enterobactereacea bacterial isolates\u003c/h2\u003e\n \u003cp\u003eTwo hundred and thirty clinical specimens including, 60 pus, 56 diabetic foot ulcer, 40 sputum and respiratory secretions, 34 urine, 20 blood, 12 burn ulcers and 8 wound swaps were obtained from different wards in three different hospitals (Al Sayed Galal, Al Hussein and Homiat Alabassia, Cairo, Egypt) over a period extended from November 2015 to February 2017. These samples were routinely collected and processed by the dedicated team in the hospitals of study. The specimens were initially inoculated onto blood agar, MacConkey agar (Oxoid\u0026reg; Limited, Basingstoke, UK). The growing colonies were identified on the basis of Gram\u0026apos;s stain, colony morphology, and different biochemical tests including triple sugar iron test, oxidase test, citrate utilization test, urease test, methyl red test, Voges\u0026ndash;Proskauer test, and Eosin methylene blue agar test etc, according to previously described identification scheme (Procop et al. \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec7\"\u003e\n \u003ch2\u003e2.5. Antimicrobial susceptibility testing:\u003c/h2\u003e\n \u003cdiv class=\"Section3\" id=\"Sec8\"\u003e\n \u003ch2\u003e2.5.1. Disk diffusion method\u003c/h2\u003e\n \u003cp\u003eAll Enterobacteriacea isolates were investigated for their susceptibility to different classes of antibiotics by the Kirby\u0026ndash;Bauer disk diffusion method according to guidelines of the Clinical and Laboratory Standards Institute (CLSI) (Kasithevar et al. \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e). \u003cem\u003eE.coli\u003c/em\u003e ATCC 25922, \u003cem\u003eKlebsiella pneumonia\u003c/em\u003e ATCC 700603, and \u003cem\u003eProteus vulgaris\u003c/em\u003e ATCC 13315 obtained from Egyptian Company for the Production of Sera and Vaccines (VACSERA, Dokki, Giza) were used as the quality control standard strains for antimicrobial susceptibility testing. Antibiotics disks used were; amoxicillin 10\u0026micro;g, cefepime 30\u0026micro;g, cefotaxime 30\u0026micro;g, ceftazidime 30\u0026micro;g, Gentamicin 10\u0026micro;g, Tobramycin 10\u0026micro;g, ciprofloxacin 5\u0026micro;g,Tetracycline 30\u0026micro;g,, imipenem 10\u0026micro;g and meropenem 10\u0026micro;g. In brief, suspensions of isolates were prepared in concentration of 1.5 x10\u003csup\u003e8\u003c/sup\u003e cfu/mL and swabbed on the surface of Muller-Hinton agar plates (MHA) (Oxoid\u0026reg; Limited, Basingstoke, UK). Disks were inoculated onto MHA plates and incubated at 37\u0026deg;C for 24 h. Inhibition zones were measured and compared to standard antibiotics inhibition zones published by CLSI, 2018.\u003c/p\u003e\n \u003cp\u003ePrimary screening of antibacterial activity of Silver nitrate and Ag-Amox-Ns was performed by disk diffusion method. Disks of amoxicillin, Silver nitrate and Ag-Amox-Ns were prepared by adding 10\u0026micro;l of amoxicillin (500\u0026micro;g/ml), Silver nitrate (50\u0026micro;g/ml) and Ag-Amox-Ns to 6mm diameter Whatmman paper disks (Sigma- Aldrich, Sant Louis, USA). The disk diffusion assay was processed in triplicate. (Kasithevar et al. \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e; Xu et al. \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e) The fold increase in the diameter of inhibition zone of antibiotic after combination with Ag-Amox-Ns was calculated according to the equation; The fold increase = (b-a)/a x100, where; (a) is the inhibition zone of antibiotic alone and (b) is the inhibition zone of antibiotic plus nanoparticles (Fayaz et al. \u003cspan class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv class=\"Section3\" id=\"Sec9\"\u003e\n \u003ch2\u003e2.5.2. Minimum inhibitory concentration (MIC):\u003c/h2\u003e\n \u003cp\u003eDetermination of minimum inhibitory concentration were performed for amoxicillin (500 \u0026micro;g/ml) (Eipico company, Cairo, Egypt), Silver nitrate (50 \u0026micro;g/ml), and Ag-Amox-Ns (50\u0026thinsp;+\u0026thinsp;500 \u0026micro;g/ml). MIC was determined by microbroth dilution assay in 96 multi-well microtiter plates according to the CLSI reference standards(Kasithevar et al. \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e). In brief one hundred microliter of double strength Muller-Hinton broth (MHB) (Oxoid\u0026reg; Limited, Basingstoke, UK) was distributed in all wells, a volume of 100\u0026micro;l from each initially prepared aforementioned solution was pipetted into wells of the first row of microtiter plate, serial dilution was performed from the 1st to the 12th well to achieve two-fold serial dilutions. Finally, 10 \u0026micro;l of 0.5 McFarland matched turbidity of freshly prepared bacterial suspension (1.5 x 10\u003csup\u003e8\u003c/sup\u003e cfu/ml) was added to each well. Two columns in each plate were used as positive and negative controls. Plates were incubated at 37˚C for 18\u0026ndash;24 h.\u003c/p\u003e\n \u003cp\u003eThe MIC was calculated as the smallest concentration where no visible bacterial growth was observed in comparison to control wells. All the tests were run in duplicate (Yeo and Livermore \u003cspan class=\"CitationRef\"\u003e1994\u003c/span\u003e).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv class=\"Section3\" id=\"Sec10\"\u003e\n \u003ch2\u003e2.5.3. Minimum bactericidal concentration (MBC):\u003c/h2\u003e\n \u003cp\u003eThe minimum bactericidal concentrations (MBC) were determined depending on the absence of visible bacterial growth. Of each clear well, 3 \u0026micro;l were spot-inoculated on MHA plates and were incubated overnight at 37\u0026deg;C for 18\u0026ndash;24 h. The MBC was reported as the lowest concentration that showed no bacterial growths (Man et al. \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv class=\"Section2\" id=\"Sec12\"\u003e\n \u003ch2\u003e3.1. Optical properties of Ag-Amox-Ns\u003c/h2\u003e\n \u003cp\u003eThe results show the optical density (O.D) of Ag-Amox-Ns, increases the peak intensities (O.D) with concomitant blue shifts. This suggests formation of Ag-Amox-Ns with higher yields and smaller sizes (Liu et al. \u003cspan class=\"CitationRef\"\u003e2007\u003c/span\u003e). The strong absorption band at 490nm is the indication of formation of silver nanoparticles. The trial no. 5 (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) with conditions (100ppm silver nitrate, 1000\u0026micro;g/ml amoxicillin and 5kGy radiation dose) shows highest O.D (5.0 Ab.) than other trials. That indicate high yield of Ag-Amox-Ns more than other conditions.\u003c/p\u003e\n \u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e shows UV-vis spectra of the aqueous amoxicillin (Amox.) and Ag-Amox-Ns solutions synthesized at 0 kGy (non-irradiated) and 5 kGy, spectra being recorded after completion of the reaction. The UV vis spectrum of Ag-Amox-Ns synthesized at 5 kGy clearly shows an intense surface plasmon resonance (SPR) band at 495nm along with O.D (5Ab) higher than non-irradiated Ag-Amox-Ns with sharp head of peak. That indicates formation of silver nanoparticles with high yield and small size. The peak intensity increased proportionately, which is mainly due to the formation of more nanoparticles (Huang and Yang \u003cspan class=\"CitationRef\"\u003e2004\u003c/span\u003e; Bar et al. \u003cspan class=\"CitationRef\"\u003e2009\u003c/span\u003e). It has been observed that no significant differences in the peak location with increase intensity of the SPR are observed when amoxicillin solution exposed to 5 kGy in compere with non-irradiated amoxicillin (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). That indicates stability of amoxicillin function moiety.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec13\"\u003e\n \u003ch2\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003e3.2. Mechanism of\u003c/span\u003e \u003cstrong\u003eAg-Amox-Ns\u003c/strong\u003e \u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003epreparation\u003c/span\u003e\u003c/h2\u003e\n \u003cp\u003eKinetic studies of the reduction process revealed that the synthesis of Ag-Amox-Ns starts without radiation; this reduction is greatly increased by gamma irradiation especially at 5kGy (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) suggesting that radiation has role in the synthesis of nanoparticles; The radicals and molecules produced in water upon gamma irradiation are e-aq, OH\u003csup\u003e\u0026bull;\u003c/sup\u003e, H\u003csup\u003e\u0026bull;\u003c/sup\u003e, H\u003csub\u003e2\u003c/sub\u003e, and H\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e (Mosalam \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eWe suggest the following provisional mechanism for gamma ray, (Eqs.\u0026nbsp;(1) (7) where amoxicillin molecular formula: C\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e19\u003c/sub\u003eN\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003eS. Accordingly, the hydroxyl groups, carboxyl, amino and sulfur moiety present in amoxicillin (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e) are responsible for coating and stabilization of Ag-Amox-Ns while inhibiting their excessive aggregations and agglomeration.\u003c/p\u003e\n \u003cp\u003eH\u003csub\u003e2\u003c/sub\u003eO\u0026thinsp;+\u0026thinsp;Gamma ray \u0026rarr; e-\u003csub\u003eaq\u003c/sub\u003e + OH\u0026bull; + H\u0026bull; + H\u003csub\u003e2\u003c/sub\u003e\u0026thinsp;+\u0026thinsp;H\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e ( 1)\u003c/p\u003e\n \u003cp\u003eSilver nitrate\u0026thinsp;+\u0026thinsp;H\u003csub\u003e2\u003c/sub\u003eO \u0026rarr; Ag\u0026thinsp;+\u0026thinsp;+\u0026thinsp;NO\u003csub\u003e3\u003c/sub\u003e (2)\u003c/p\u003e\n \u003cp\u003eAg\u0026thinsp;+\u0026thinsp;+\u0026thinsp;e\u003csub\u003e\u0026minus;\u0026thinsp;aq\u003c/sub\u003e \u0026rarr; Ag \u0026bull; (4)\u003c/p\u003e\n \u003cp\u003eC\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e19\u003c/sub\u003eN\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003eS\u0026thinsp;+\u0026thinsp;OH\u003csup\u003e\u0026bull;\u003c/sup\u003e \u0026rarr; (C\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e18\u003c/sub\u003eN\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003eS)\u003csup\u003e\u0026bull;\u003c/sup\u003e + H\u003csub\u003e2\u003c/sub\u003eO (5)\u003c/p\u003e\n \u003cp\u003e(C\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e18\u003c/sub\u003eN\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003eS)\u003csup\u003e\u0026bull;\u003c/sup\u003e + Ag\u003csup\u003e+\u003c/sup\u003e + H\u003csub\u003e2\u003c/sub\u003eO \u0026rarr; Ag \u0026bull; + H\u003csub\u003e3\u003c/sub\u003eO\u003csup\u003e+\u003c/sup\u003e + (C\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e19\u003c/sub\u003eN\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003eS)\u003csub\u003e2\u003c/sub\u003e (6)\u003c/p\u003e\n \u003cp\u003e(C\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e19\u003c/sub\u003eN\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003eS)\u0026thinsp;+\u0026thinsp;Ag \u0026bull; \u0026rarr; (C\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e19\u003c/sub\u003eN\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003eS) Ag \u0026bull; ( capping and stabilization) (7)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec14\"\u003e\n \u003ch2\u003e3.3. Particles size, size distribution and stability of Ag-Amox-Ns\u003c/h2\u003e\n \u003cp\u003eFigure (3b) shows the mean size of Ag-Amox-Ns (45nm) and figure (3a) shows DLS size distribution of Ag-Amox-Ns (80nm), .\u003c/p\u003e\n \u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e shows FTIR spectra of Amoxicillin and Ag-Amox-Ns at 5kGy, this analysis was conducted to determine the molecular interaction between the amoxicillin and the synthesized Ag-Amox-Ns. The spectrum in Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e shows amoxicillin; transmission at 3467cm\u003csup\u003e\u0026minus;\u0026thinsp;1\u003c/sup\u003e assigned to the overlap of O\u0026thinsp;\u0026minus;\u0026thinsp;H and N\u0026thinsp;\u0026minus;\u0026thinsp;H stretching vibrations; 2329 cm\u003csup\u003e\u0026minus;\u0026thinsp;1\u003c/sup\u003e to C\u0026thinsp;\u0026minus;\u0026thinsp;H bending, 2079 cm\u003csup\u003e\u0026minus;\u0026thinsp;1\u003c/sup\u003e attributed to c-o vibration and 1643 cm\u003csup\u003e\u0026minus;\u0026thinsp;1\u003c/sup\u003e to \u0026minus;\u0026thinsp;C\u0026minus;O skeletal stretching. The same trend as observed in the Ag-Amox-Ns spectrum (Fig. \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eThe end product in the Ag-Amox-Ns is dark brown precipitate after drying on a glass slide at 40 \u003csup\u003eo\u003c/sup\u003eC. The XRD spectrum of the Ag-Amox-Ns was showed in Fig. \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e and the appearance of four strong peaks were observed in the spectrum of 2\u0026theta; values ranging from 10\u0026ndash;90\u0026ordm; at values at 46.63, 55.1, 68.42, and 76.21\u003csup\u003eo\u003c/sup\u003e equivalent to (220), (311), (400) and (420) planes in that order respectively. This result confirms presence of silver nanoparticles.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec15\"\u003e\n \u003ch2\u003e3.4. Antimicrobial activity of Ag-Amox-Ns\u003c/h2\u003e\n \u003cdiv class=\"Section3\" id=\"Sec16\"\u003e\n \u003ch2\u003e3.4.1. Isolation, identification and antimicrobial susceptibility\u003c/h2\u003e\n \u003cp\u003eThe \u003cem\u003eEnterobacteriaceae\u003c/em\u003e, especially \u003cem\u003eEscherichia\u003c/em\u003e coli \u003cem\u003eand Klebsiella pneumoniae\u003c/em\u003e, are common causes of hospital and community acquired infections worldwide(Kendall et al. \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e). The global dissemination of drug-resistant bacteria is worrying for medical specialists as it limits the available choices for accurate treatment and consequently contributes to higher mortality and morbidity rates (van der Bij and Pitout \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e) specimens, 288 bacterial strains were isolated. A total of 190 (65.9%) isolates were Gram-negative, 85 (29.5%) were Gram-positive and 15(4.5%) were fungi. Out of Gram-negative isolates, 142 were related to \u003cem\u003eEnterobactereacea\u003c/em\u003e family that comprises \u003cem\u003eEscherichia coli\u003c/em\u003e 50(35.2%), \u003cem\u003eKlebsiella pneumonia\u003c/em\u003e 42 (29.5%) \u003cem\u003eKlebsiella oxytoca\u003c/em\u003e 15 (10.5%), \u003cem\u003eProteus vulgaris\u003c/em\u003e 20 (14.08%) and \u003cem\u003eProteus mirabilis\u003c/em\u003e 15(10.5%)\u003c/p\u003e\n \u003cp\u003eThe antibiotic susceptibility results of the Gram-negative isolates showed that 54 (37.1%) were considered MDR isolates being resistant to three or more antibiotic classes. The MDR isolates include \u003cem\u003eKlebsiella spp.\u003c/em\u003e 20 (37.1%) isolates, \u003cem\u003eEscherichia coli\u003c/em\u003e 19 (35.2%) isolates and \u003cem\u003eProteus spp.\u003c/em\u003e 15(27.7%) isolates Table (2). These results are comparable to other studies in the same geographical area as (Khalifa et al. \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e) that confirm the high prevalence of bacterial antimicrobial resistance in Egypt which is extremely concerning and necessities the development of new antimicrobials.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"4. Discussions","content":"\u003cp\u003eIt is well known that silver nanoparticles exhibit a dark red colour in aqueous solution due to the surface plasmon resonance (SPR) of metal nanoparticles (Link and El-Sayed \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). Because the silver nanoparticles are extraordinarily efficient at absorbing and scattering light and, unlike many dyes and pigments, have a color that depends upon the size and the shape of the particle (El-Batal et al. \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe previous studies have shown that the AgNPs contribute to the absorption bands at around 400 to 550 nm in the UV\u0026ndash;visible spectra (Stamplecoskie and Scaiano \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Characteristics band of Ag-Amox-Ns Were detected around 490nm (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), which strongly suggests that the Ag-Amox-Ns formation and have been confirmed by the TEM results of this study. Silver nanoparticle solutions that have not agglomerated, the UV/Visible extinction spectra can be used to quantify the nanoparticle concentration. Due to the linear relationship between O.D and concentration, the values of O.D can be used to quantify the concentration of nanoparticle solutions. Optical density, a measure of the amount of light transmitted through a solution, which has positive relation with concentration of nanoparticles (Ghorab et al.).\u003c/p\u003e \u003cp\u003eThe advantage of gamma irradiation for the synthesis of metallic nanoparticles lies in the fact that desired production of highly reducing free electron without the formation of any byproduct. We have employed free electron as a reducing agent to Ag\u003csup\u003e2+\u003c/sup\u003e ions and amoxicillin as a stabilizer for NPs. The OH and H radicals are capable to abstract hydrogen from the amoxicillin producing a amoxicillin radical (secondary radicals\u0026thinsp;=\u0026thinsp;C\u003csub\u003e16\u003c/sub\u003eH\u003csub\u003e18\u003c/sub\u003eN\u003csub\u003e3\u003c/sub\u003eO\u003csub\u003e5\u003c/sub\u003eS)\u003csup\u003e\u003cb\u003e●\u003c/b\u003e\u003c/sup\u003e. Under the stated experimental conditions the reduction of silver ions takes place by electron transfer from hydrated electrons and amoxicillin radicals to form zero-valent nanoparticles that stabilized by reduced amoxicillin.\u003c/p\u003e \u003cp\u003eThe circle isotropic, poly-dispersed particles, this attributed to the amoxicillin structure; that act as capping and stabilizing agents to prevent aggregation and agglomeration of NPs. The DLS measures the hydrodynamic diameter of nanoparticles, where the amphiphilic nanoparticles were surrounded by water molecules (Akhtar et al. 2011) may be attributed to being the cause of the large size of capped formulation.\u003c/p\u003e \u003cp\u003eThe general decrease or increase in the band with slight shifts; this attributed to stability and incorporation of amoxicillin with Ag-Amox-Ns. which indicates a reaction between the NP surface, and the amoxicillin amino and hydroxyl groups (Cardenas et al. \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). Suggests that AgNPs were capped by the amoxicillin forming Ag-Amox-Ns, suggesting their role in the stabilization of the nanoparticles; It reported earlier that amoxicillin could bind to nanoparticles either through amide groups or via the electrostatic attraction of negatively charged hydroxyl groups (Rastogi and Arunachalam \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) and therefore, stabilization of the nanoparticles and prevent NPs aggregation and precipitation.\u003c/p\u003e \u003cp\u003eNanoantibiotics which have properties of antimicrobial agents and nanomaterials are considered as good alternatives against multi-drug resistant organisms (Huh and Kwon \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) silver nanoparticles (Ag-Amox-Ns) are the most promising nanoantibiotics nowadays [(Borrego et al. \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) Ag-Amox-Ns possess unique advantages as generalized mood of action, activity against many microbial targets and effectiveness against resistant pathogen, furthermore it can be synthesized by cheap and environmental friendly methods, (Dilnawaz et al. \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Vazquez-Mu\u0026ntilde;oz et al. \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2019\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eIn the present study synergistic effect of Ag-Amox-Ns was investigated against the MDR \u003cem\u003eEnterobactereacea\u003c/em\u003e pathogens by disk diffusion and broth microdilution assays. Diameter of inhibition zones of Ag-Amox-Ns, Silver nitrate as negative and amoxicillin as positive controls are presented in table (3).\u003c/p\u003e \u003cp\u003eAg-Amox-Ns showed great antimicrobial activity compared to amoxicillin which did not show antimicrobial activity. On the other hand Silver nitrate showed moderate antibacterial activity Figure (6). Minimum and maximum inhibition zone of Ag-Amox-Ns for \u003cem\u003eKlebsiella spp.\u003c/em\u003e were 11 mm and 25 mm respectively, while the minimum and maximum fold increase percentages were 83.3% and 316.6%, similar results were reported for other pathogen where the minimum and maximum fold increase percentages were 66.6 and 233.3 for \u003cem\u003eE. coli\u003c/em\u003e and 66.6 and 200 for \u003cem\u003eProteus spp\u003c/em\u003e.\u003c/p\u003e \u003cp\u003eThe result revealed that the antibacterial activity of amoxicillin have been intensified when conjugated with Ag-Amox-Ns nanoparticles against tested pathogens. Several studies have been pointed out the antibacterial efficacies of silver nanoparticle-antibiotic combinations (Hassan et al. \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Fattah et al. \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The Ag-Amox-Ns is associated with cell membrane potential and integrity alteration lead to increasing microbial cell permeability and facilitate antibiotics cellular entrance, and consequently higher efficiency (Vazquez-Mu\u0026ntilde;oz et al. \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), Additionally the high surface area of Ag-Amox-Ns maximizes its antimicrobial activity compared to silver metal (Lopez-Carrizales et al. \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u0026rlm; Conjugation of nanoparticles with antibiotics enhances their bactericidal properties and reduces the toxicity of both agents. Synergistic effect may be due formation of certain complex that have bactericidal action either by inhibiting the cell wall synthesis or its lysis or death (Allahverdiyev et al. \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the present study the results of MIC and MBC of amoxicillin against MDR \u003cem\u003eEnterobactereacea\u003c/em\u003e pathogens revealed that all isolates were resistant as the MICs (\u0026gt;\u0026thinsp;250) were higher than its breakpoint. Tables\u0026nbsp;(4, 5 and 6) summarized the MIC and MBC of novel Ag-Amox-Ns -amoxicillin conjugate, Silver nitrate and amoxicillin against the \u003cem\u003eKlebsiella spp., E. coli\u003c/em\u003e and \u003cem\u003eProteus spp\u003c/em\u003e. and revealed that MICs decreased drastically for all strains where novel Ag-Amox-Ns -amoxicillin conjugate reduce the MICs by 4 to 64, 16 to 128 and 16 to 128 fold among \u003cem\u003eKlebsiella spp., E. coli\u003c/em\u003e and \u003cem\u003eProteus spp.\u003c/em\u003e Respectively. Enhanced antimicrobial activity of the novel Ag-Amox-Ns -amoxicillin conjugate could be explained by the interaction and arrangement of the molecules in a one compound, which could work in multiple ways (Lopez-Carrizales et al. \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe MIC decreased to reach 15.62 and 7.812 \u0026micro;g/ml in 301.0% and 35% of MDR \u003cem\u003eKlebsiella spp.\u003c/em\u003e and 31% and 47% of MDR \u003cem\u003eE. coli\u003c/em\u003e isolates while it was 7.812 and 3.906 in 26.7% and 40%. Our results demonstrated that Ag-Amox-Ns, when combined with amoxicillin, strongly enhanced its activity against the MDR strains which is also confirmed by variable studies (Pan\u0026aacute;ček et al. \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAg-Amox-Ns- amoxicillin caused a dramatic growth inhibition For MDR \u003cem\u003eEnterobactereacea\u003c/em\u003e strains. Several mechanistic studies (Sotiriou and Pratsinis \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) Reported that Ag-Amox-Ns generate hydroxyl radicals that boost the bacterial inhibition, also Li et al. (Li et al. \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2005\u003c/span\u003e) theorized that both of Ag-Amox-Ns and amoxicillin kill the bacteria individually with dissimilar mechanisms, furthermore they may form a complex where Ag-Amox-Ns core is surrounded by amoxicillin molecules. The release of Ag\u0026thinsp;+\u0026thinsp;is also enhancing the bactericidal activity. Ag\u0026thinsp;+\u0026thinsp;causes bacterium toxicity by binding to the proteins and DNA molecules inside the cells as well as those of cell walls, disabling the bacterial metabolic activity and finally bacterial death (Batarseh \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Deng et al. \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Conclusions; Understanding the mechanism of Ag-Amox-Ns combination allows predicting a more efficient therapy, providing additional treatment options, and enables the use of unused antibiotics because of development of bacterial resistance.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAg-Amox-Ns\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAmoxicillin Nano-structure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDLS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDynamic light scattering\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eXRD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eX-ray diffraction\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFT-IR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFourier transforms infrared spectroscopy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMDR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emultidrug resistant\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTEM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTransmission electron microscope\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eO.D\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOptical density\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMinimum inhibitory concentration\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMBC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMinimum bactericidal concentration\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCDC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCenters for Disease Control and Prevention and WHO\u0026thinsp;=\u0026thinsp;World Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like Drug Microbiology Lab, Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egypt.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e The authors declare there is no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval:\u003c/strong\u003e The research protocol was approved by the Ethics of National Center for Radiation Research and Technology (NCRRT), Egypt, EAEA\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Information:\u003c/strong\u003e\u0026nbsp; No funding provided\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e All authors have contributed to the (1 and 2) conception and design or the acquisition and analysis of Data and approval of the final submitted version and drafting or critically revising the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConstant of participate and publish:\u003c/strong\u003e All authors agree to participate and publish\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003e [Akhtar MS, Ameen S, Ansari SA, Yang O (2011) Synthesis and characterization of ZnO nanorods and balls nanomaterials for dye sensitized solar cells. 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Antibiotics 7:50\u003c/li\u003e\n \u003cli\u003eLukac PJ, Bonomo RA, Logan LK (2015) Extended-spectrum \u0026beta;-lactamase\u0026ndash;producing Enterobacteriaceae in children: old foe, emerging threat. Clinical Infectious Diseases 60:1389-1397\u003c/li\u003e\n \u003cli\u003eMan A, G\u0026acirc;z AŞ, Mare AD, Berţa L (2017) Effects of low-molecular weight alcohols on bacterial viability. Revista Romana de Medicina de Laborator 25:335-343\u003c/li\u003e\n \u003cli\u003eMarkowska K, Grudniak AM, Krawczyk K, Wr\u0026oacute;bel I, Wolska KI (2014) Modulation of antibiotic resistance and induction of a stress response in Pseudomonas aeruginosa by silver nanoparticles. Journal of medical microbiology 63:849-854\u003c/li\u003e\n \u003cli\u003eMorones JR et al. (2005) The bactericidal effect of silver nanoparticles. Nanotechnology 16:2346\u003c/li\u003e\n \u003cli\u003eMosalam FMM (2013) Effect of Gamma Radiation on the Microbial Synthesis of Metal Nanoparticles. Al-Azhar University\u003c/li\u003e\n \u003cli\u003eNaqvi SZH et al. (2013) Combined efficacy of biologically synthesized silver nanoparticles and different antibiotics against multidrug-resistant bacteria. International journal of nanomedicine 8:3187\u003c/li\u003e\n \u003cli\u003ePan\u0026aacute;ček A et al. (2016) Silver nanoparticles strongly enhance and restore bactericidal activity of inactive antibiotics against multiresistant Enterobacteriaceae. Colloids and Surfaces B: Biointerfaces 142:392-399\u003c/li\u003e\n \u003cli\u003eProcop GW, Church D, Hall G, Janda W (2017) Koneman\u0026apos;s Color Atlas and Textbook of Diagnostic. Philadelphia: Wolters Kluwer\u003c/li\u003e\n \u003cli\u003eRastogi L, Arunachalam J (2011) Sunlight based irradiation strategy for rapid green synthesis of highly stable silver nanoparticles using aqueous garlic (Allium sativum) extract and their antibacterial potential. Materials Chemistry and Physics 129:558-563\u003c/li\u003e\n \u003cli\u003eSotiriou GA, Pratsinis SE (2010) Antibacterial activity of nanosilver ions and particles. Environmental science \u0026amp; technology 44:5649-5654\u003c/li\u003e\n \u003cli\u003eStamplecoskie KG, Scaiano JC (2010) Light emitting diode irradiation can control the morphology and optical properties of silver nanoparticles. Journal of the American Chemical Society 132:1825-1827\u003c/li\u003e\n \u003cli\u003evan der Bij AK, Pitout JD (2012) The role of international travel in the worldwide spread of multiresistant Enterobacteriaceae. Journal of Antimicrobial Chemotherapy 67:2090-2100\u003c/li\u003e\n \u003cli\u003eVazquez-Mu\u0026ntilde;oz R et al. (2019) Enhancement of antibiotics antimicrobial activity due to the silver nanoparticles impact on the cell membrane. PloS one 14\u003c/li\u003e\n \u003cli\u003eXu N et al. (2017) Silver-loaded nanotubular structures enhanced bactericidal efficiency of antibiotics with synergistic effect in vitro and in vivo. Int J Nanomedicine 12:731-743 doi: 10.2147/IJN.S123648\u003c/li\u003e\n \u003cli\u003eYeo S-F, Livermore DM (1994) Comparative in-vitro activity of biapenem and other carbapenems against Haemophilus influenzae isolates with known resistance mechanisms to ampicillin. Journal of Antimicrobial Chemotherapy 33:861-865\u003c/li\u003e\n \u003cli\u003eZagari RM, Bianchi-Porro G, Fiocca R, Gasbarrini G, Roda E, Bazzoli F (2007) Comparison of 1 and 2 weeks of omeprazole, amoxicillin and clarithromycin treatment for Helicobacter pylori eradication: the HYPER Study. Gut 56:475-479\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1:\u0026nbsp;\u003c/strong\u003eExperimental factorial design experiments optical density (O. D) response.\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactor 1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactor 2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactor 3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eNo.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmox.Conc. (\u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO\u003csub\u003e3\u003c/sub\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(PPM)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eRadiation Dose\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(kGy)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAg-Amox-Ns\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eO.D\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Ab)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e2.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e2.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e2.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e2.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1.131\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e1.037\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (2):\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eAntibiotic Susceptibility profiles of MDR \u003cem\u003eEnterobacteriaceae\u003c/em\u003e isolates\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntibiotics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"21.13144758735441%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKlebsiella\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003espp.\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(N =20;\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e37.1%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" width=\"22.296173044925126%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(N = 19;\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e35.2%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"22.96173044925125%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eProteus\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003cem\u003espp.\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eN\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e(\u003cem\u003e15;\u003c/em\u003e 27.7%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal resistance (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"16.791979949874687%\"\u003e\n \u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.037593984962406%\"\u003e\n \u003cp\u003e\u003cstrong\u003eS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.04260651629073%\"\u003e\n \u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.541353383458645%\"\u003e\n \u003cp\u003e\u003cstrong\u003eS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.045112781954888%\"\u003e\n \u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.541353383458645%\"\u003e\n \u003cp\u003e\u003cstrong\u003eS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmoxicillin (AX)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e20(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e19(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e14(93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(6.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e53 (98.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCefotaxime(\u003c/strong\u003e\u003cstrong\u003eCTX)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e20(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e18(94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e14(93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(6.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e52 (96.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCeftazidime (C\u003c/strong\u003e\u003cstrong\u003eAZ)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e20(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e18(94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e14(93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(6.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e52 (96.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCefepime (\u003c/strong\u003e\u003cstrong\u003eFEP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e20(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e19(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e15(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e54 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCiprofloxacin(CEP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e18(90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e2(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e18(94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e14(93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(6.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e50 (92.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eGentamicin (CN)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e18(90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e2(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e18(94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e12(80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e3(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e48 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTobramycin (TOP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e18(90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e2(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e18(94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e12(80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e3(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e48 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eImipenem (IMP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e12(60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e8(40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e10(52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e9(47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e14(93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e1(6.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e36 (66.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMeropenem(MEM)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e13(65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e7(35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e15(78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e4(21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e11(73.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e4(26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e39 (72.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20.632279534109816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTetracycline\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e(TE)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.148086522462563%\"\u003e\n \u003cp\u003e18(90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"9.983361064891847%\"\u003e\n \u003cp\u003e2(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.314475873544094%\"\u003e\n \u003cp\u003e17(89.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e2(10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"11.980033277870216%\"\u003e\n \u003cp\u003e13(86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"10.98169717138103%\"\u003e\n \u003cp\u003e2(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" width=\"12.9783693843594%\"\u003e\n \u003cp\u003e48 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eN; number\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (3):\u0026nbsp;\u003c/strong\u003eThe Mean Inhibition Zone in mm and Fold increase percentage of Amoxicillin, AgNO3, and Ag-Amox.Ns\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKlebsiella spp. code\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3(50 \u0026micro;g/ ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmox. \u0026nbsp;(10\u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAg-Amox-Ns(50/500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFold increase % [(b- a)/a] x 100\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ecode\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3 \u0026nbsp; (50 \u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmox. \u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(10) \u0026micro;g\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAg-Amox-Ns\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(50/500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003econjugate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFfold increase %\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e[(b- a)/a] x 100\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eProteus\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003espp. code\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3\u003csub\u003e\u0026nbsp;\u003c/sub\u003e (50 \u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmox.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(10) \u0026micro;g\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAgNPs/ AX\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(50/500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003econjugate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFold increase %\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e[(b- a)/a] x 100\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e83.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e166.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e133.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e200\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e200\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e66.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e150\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e183.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK04\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e66.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC04\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e233.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP04\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e233.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e233.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e183.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK06\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e166.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC06\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e66.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP06\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK07\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC07\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e66.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP07\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK08\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e166.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC08\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e83.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP08\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK09\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC09\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e166.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP09\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e66.6\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e83.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e166.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e133.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e150\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e116.6\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK12\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e116.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC12\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP12\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e100\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e166.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e100\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e150\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e100\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e183.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.891156462585034%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.489795918367347%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.8979591836734695%\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.170068027210885%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.700680272108844%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.442176870748299%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.251700680272108%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.802721088435374%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e166.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" width=\"6.122448979591836%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eProteus vulgaris\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 13315\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" width=\"6.802721088435374%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" width=\"5.442176870748299%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" width=\"9.251700680272108%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" width=\"6.802721088435374%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.033195020746888%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.846473029045643%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.298755186721992%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.846473029045643%\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.468879668049793%\"\u003e\n \u003cp\u003e216.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8838174273858925%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.842323651452283%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.298755186721992%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.107883817427386%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.37344398340249%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e133.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.033195020746888%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.846473029045643%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.298755186721992%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.846473029045643%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.468879668049793%\"\u003e\n \u003cp\u003e283.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8838174273858925%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC18\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.842323651452283%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.298755186721992%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.107883817427386%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.37344398340249%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e150\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.033195020746888%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK19\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.846473029045643%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.298755186721992%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.846473029045643%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.468879668049793%\"\u003e\n \u003cp\u003e316.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8838174273858925%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEC19\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.842323651452283%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.298755186721992%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.107883817427386%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.37344398340249%\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e150\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.033195020746888%\"\u003e\n \u003cp\u003e\u003cstrong\u003eK20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.846473029045643%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.298755186721992%\"\u003e\n \u003cp\u003eNIL (6mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.846473029045643%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.468879668049793%\"\u003e\n \u003cp\u003e283.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"7.8838174273858925%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eE.coli\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 25922\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"17.842323651452283%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"8.298755186721992%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"14.107883817427386%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" width=\"10.37344398340249%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"29%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKlebsiella pneumonia\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 700603\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.5%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.5%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18%\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAX\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e;\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eAmoxicillin,\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eAg-Amox-Ns\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e;\u003c/em\u003e\u003cem\u003e\u0026nbsp;silver amoxicillin Nano-conjugate,\u003c/em\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;MIC;\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eMinimum inhibitory concentration\u003cstrong\u003e, MBC;\u0026nbsp;\u003c/strong\u003eMinimum bactericidal concentration.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (4):\u0026nbsp;\u003c/strong\u003eSynergistic effect of Amoxicillin, AgNO3, and Ag-Amox-Ns against \u003cem\u003eKlebsiella spp.\u0026nbsp;\u003c/em\u003eby\u003cem\u003e\u0026nbsp;\u003c/em\u003eMIC and MBC\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmox.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePositive Control\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMIC\u0026nbsp;\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBC\u0026nbsp;\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(50 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNegative Control Dilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMIC (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 5.6805%;\" valign=\"top\" width=\"9.048361934477379%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBC (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAg-Amox-Ns\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(50/500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 6.1745%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003eMIC\u0026nbsp;\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp; \u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.4429%;\" valign=\"top\" width=\"8.580343213728549%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003eMBC\u0026nbsp;\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFold\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eChange\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;250\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e20 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e20 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e5 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e19 (95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;25 /250\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e9 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e1 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.5 /125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e62.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e4 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.25 / 62.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e1 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e8 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e31.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.125 / 31.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e15.625\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.562\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.56\u003c/strong\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e2\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e/15.62\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e6 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e3 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.8125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.781\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.781 / 7.812\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e7 (35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e3 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.90625\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.390\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.390 / 3.906\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e4 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.95313\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.195\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.195 / 1.953\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.97656\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.097\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.097 /0.976\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.012480499219969%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAX\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKlebsiella pneumonia\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 700603\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.6805%;\" valign=\"top\" width=\"8.112324492979718%\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.0355%;\" valign=\"top\" width=\"8.268330733229329%\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6746%;\" valign=\"top\" width=\"12.168486739469579%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKlebsiella pneumonia\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 700603\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.7988%;\" valign=\"top\" width=\"8.424336973478939%\"\u003e\n \u003cp\u003e3.125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4.8521%;\" valign=\"top\" width=\"8.892355694227769%\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.6443%;\" valign=\"top\" width=\"14.976599063962558%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNPs+ AX\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eKlebsiella pneumonia\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 700603\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.4362%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e0.391 /3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7.2484%;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp\u003e6.25 + 62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.2189%;\" valign=\"top\" width=\"9.204368174726989%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eAX\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e;\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eAmoxicillin,\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eAg-Amox-Ns\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e;\u003c/em\u003e\u003cem\u003e\u0026nbsp;silver amoxicillin Nano-conjugate,\u003c/em\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;MIC;\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eMinimum inhibitory concentration\u003cstrong\u003e, MBC;\u0026nbsp;\u003c/strong\u003eMinimum bactericidal concentration.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (5):\u0026nbsp;\u003c/strong\u003eSynergistic effect of Amoxicillin, AgNO3, and Ag-Amox-Ns against \u003cem\u003eE. coli\u003c/em\u003e by MIC and MBC\u003c/p\u003e\n\u003ctable align=\"left\" border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmox.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePositive Control\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMIC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(50 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNegative Control Dilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMIC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAg-Amox-Ns\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(50+500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eConjugate\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Dilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMIC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFold\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eChange\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;250\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e19 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e19 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e8 (42.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e17 (89.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;25 /250\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e1 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e9 (47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.5 / 125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e62.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.25 / 62.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e11 (57.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e31.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.125 /31.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e3 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e15.625\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.562\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.562 / 15.62\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e6 (31.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.8125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.781\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.781 /7.812\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e9 (47.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.90625\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.390\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.390 /3.906\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.95313\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.195\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.195/ 1.953\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.97656\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.097\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.097 / 0.976\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.51840942562592%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAX\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eE. coli\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 25922\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e31.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;250\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 25922\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e3.906\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.836524300441827%\"\u003e\n \u003cp\u003e15.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.487481590574374%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNPs+ AX\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 25922\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.720176730486008%\"\u003e\n \u003cp\u003e0.048+ 0.488\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.603829160530191%\"\u003e\n \u003cp\u003e6.25 + 62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.952871870397644%\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eAX\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e;\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eAmoxicillin,\u0026nbsp;\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eAg-Amox-Ns\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e;\u003c/em\u003e\u003cem\u003e\u0026nbsp;silver amoxicillin Nano-conjugate,\u003c/em\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;MIC;\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eMinimum inhibitory concentration\u003cstrong\u003e, MBC;\u0026nbsp;\u003c/strong\u003eMinimum bactericidal concentration.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (6):\u0026nbsp;\u003c/strong\u003eSynergistic effect of Amoxicillin, AgNO3, and Ag-Amox-Ns against \u003cem\u003eProteus spp.\u0026nbsp;\u003c/em\u003eby MIC\u003cem\u003e\u0026nbsp;\u003c/em\u003eand MBC\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmox.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePositive Control\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMIC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(50 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNegative Control Dilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMIC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAg-Amox-Ns\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(50+500 \u0026micro;g/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDilutions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMIC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBC\u003cbr\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFold\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eChange\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;250\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e14 (93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e15 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e8 (53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e13 (86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;25 / 250\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e2 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e1 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e4 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e2 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.5 / 125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e62.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e3 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.25 / 62.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e12 (80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e31.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.125 / 31.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e1 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e15.625\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.562\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.562 / 15.62\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e3 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.8125\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.781\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.781 / 7.812\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e4 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.90625\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.390\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.390 / 3.906\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e6 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.95313\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.195\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.195 / 1.953\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e2 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.97656\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.097\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.097 / 0.976\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.48828\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.048\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.048 / 0.488\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.422960725075528%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAX\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eProteus vulgaris\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 13315\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.027190332326285%\"\u003e\n \u003cp\u003e15.625\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.214501510574019%\"\u003e\n \u003cp\u003e\u003cstrong\u003e62.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.969788519637461%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNO3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eProteus vulgaris\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 13315\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.120845921450151%\"\u003e\n \u003cp\u003e3.125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.27190332326284%\"\u003e\n \u003cp\u003e3.125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.386706948640484%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgNPs+ AX\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eProteus vulgaris\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;ATCC 13315\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.06344410876133%\"\u003e\n \u003cp\u003e0.781 / 7.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.91238670694864%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.125 / 31.25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.610271903323262%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAX\u003c/strong\u003e\u003cstrong\u003e;\u0026nbsp;\u003c/strong\u003eAmoxicillin, \u003cstrong\u003eAg-Amox-Ns\u003c/strong\u003e;\u0026nbsp;silver amoxicillin Nano-conjugate,\u003cstrong\u003e\u0026nbsp;MIC;\u0026nbsp;\u003c/strong\u003eMinimum inhibitory concentration\u003cstrong\u003e, MBC;\u0026nbsp;\u003c/strong\u003eMinimum bactericidal concentration.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Silver amoxicillin nano-structure, Gamma Irradiation, Enterobacteriacea isolates and antimicrobial activity.","lastPublishedDoi":"10.21203/rs.3.rs-1471091/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1471091/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eInfections caused by multidrug-resistant (MDR) \u003cem\u003eEnterobacteriacea\u003c/em\u003e bacteria have been reported as one of the most rising problem worldwide that require exploration for new antimicrobials. Amoxicillin Nano-structure (Ag-Amox-Ns) with an antibiotic can synergistically inhibit the drug-resistant bacteria. The aim of the current study was to determine the antimicrobial activity of novel synthesized Silver Amoxicillin Nano-structure (Ag-Amox-Ns) using Gamma-irradiation against MDR \u003cem\u003eEnterobacteriaceae\u003c/em\u003e clinical isolates. Aqueous dispersed Silver Amoxicillin Nano-structure (Ag-Amox-Ns) were synthesized using silver ion (Ag\u003csup\u003e+\u0026thinsp;2\u003c/sup\u003e) as precursor, amoxicillin (Amox.) as stabilizing agent and gamma irradiation as reducing agent. The synthesized Ag-Amox-Ns are characterized by UV\u0026ndash;visible spectroscopy, Dynamic light scattering (DLS), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR). The morphology and the particles size and shape of Ag-Amox-Ns were estimated by TEM images, the mean size of Ag-Amox-Ns (45nm), XRD analysis of the Ag-Amox-Ns confirmed the formation of metallic nanoparticles. The nucleation and growth mechanism of Ag-Amox-Ns is also discussed. The size of nanoparticles is influenced by certain parameters such as the choice of stabilizer and silver ion concentration and absorbed dose. Antimicrobial activity of novel synthesized Ag-Amox-Ns against MDR \u003cem\u003eEnterobacteriaceae\u003c/em\u003e clinical isolates was detrmined by standard microbiological assays. The MDR isolates include \u003cem\u003eKlebsiella spp.\u003c/em\u003e (37.1%), \u003cem\u003eEscherichia coli\u003c/em\u003e (35.2%) and \u003cem\u003eProteus spp.\u003c/em\u003e (27.7%). The fold increase % of Ag-Amox-Ns by disk diffusion assay was ranged from 66.6 to 316.6 for all tested isolates, furthermore novel conjugate decreased MICs for all strains. The MIC of amoxicillin decreased from more than 250 \u0026micro;g/ml to reach 7.812 \u0026micro;g/ml for 35% of MDR \u003cem\u003eKlebsiella spp.\u003c/em\u003e and 47% of MDR \u003cem\u003eE. coli\u003c/em\u003e isolates while it reached 3.906 for 40% of MDR \u003cem\u003eProteus spp.\u003c/em\u003e Ag-Amox-Ns is novel compound give promising inhibitory effect against MDR \u003cem\u003eEnterobacteriaceae\u003c/em\u003e providing additional treatment options, and enables the use of inexpensive and unused antibiotics in combating bacterial resistance problem.\u003c/p\u003e","manuscriptTitle":"Novel Silver Amoxicillin Nano-Structure Preparation by Gamma Irradiation with Outstanding Bactericidal Activity against Multidrug Resistant Enterobacteriacea Isolates","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-03-25 20:09:38","doi":"10.21203/rs.3.rs-1471091/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"01746db2-e146-4773-b0fe-7e54666c09aa","owner":[],"postedDate":"March 25th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2022-03-25T20:09:39+00:00","versionOfRecord":[],"versionCreatedAt":"2022-03-25 20:09:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1471091","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1471091","identity":"rs-1471091","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}