Abstract
Phage therapy is an alternative treatment to antibiotics that can overcome multi-drug resistant bacteria. In this study, we aimed to isolate and characterize lytic bacteriophages targeted against Enterococcus faecalis isolated from root canal infections obtained from clinics at the Faculty of Dentistry, Ismalia, Egypt. Bacteriophage, vB_ZEFP, was isolated from concentrated wastewater collected from hospital sewage. Morphological and genomic analysis revealed that the phage belongs to the Podoviridae family with a linear double-stranded DNA genome, consisting of 18,454, with a G + C content of 32.8%. Host range analysis revealed the phage could infect 10 of 13 E. faecalis isolates exhibiting a range of antibiotic resistances recovered from infected root canals with efficiency of plating values above 0.5. One-step growth curves of this phage showed that it has a burst size of 110 PFU per infected cell, with a latent period of 10 min. The lytic activity of this phage against E. faecalis biofilms showed that the phage was able to control the growth of E. faecalis in vitro. Phage vB_ZEFP could also prevent ex-vivo E. faecalis root canal infection. These results suggest that phage vB_ZEFP has potential for application in phage therapy and specifically in the prevention of infection after root canal treatment.
Highlights
A total of twenty (13.3%) E. faecalis confirmed isolates were recovered from one hundred and fifty samples collected from oral cavity at the clinics at the faculty of Dentistry, Ismailia, Egypt
The susceptibility or resistance of isolates to antibiotics was determined by determining the minimal inhibitory concentration (MIC) using the VITEK system
There is an increasing number of antibiotic-resistant E. faecalis strains encountered in clinical settings, and the protection afforded by biofilm formation make treatments such
Summary
The main goal of endodontic treatment is thorough disinfection of the root canal system, followed by the application of an adequate three-dimensional tight seal to prevent bacterial re-colonization and promote the healing of periradicular tissues [1]. Post-treatment apical periodontitis is an infectious disease in root canal-treated teeth caused mainly by persistent intra-radicular infection. Enterococcus faecalis, a commensal Gram-positive microorganism, is frequently recovered from secondary persistent infections associated with root canal treatment failures [2,3]. Persistent infection can result in invasion of periradicular tissues with the subsequent development of apical periodontitis and /or diffused infection (cellulitis) [4]. The reason for post-treatment disease is largely attributed to the limitations of the present intra-canal disinfection protocols to combat intracanal E. faecalis infection [2,3]
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