Characteristics of Enterococcus Faecalis in Periodontitis and Secondary Root Canal Infections in Northern Jordanians-A Pilot Study

Abstract

Background: Enterococcus faecalis has been found to be related to periodontitis and secondary endodontic infections. In this study, we aimed to study samples of E. faecalis to determine their incidence and virulence in Jordanian patients. Methods: A total of 167 samples were collected from patients with periodontitis and secondary endodontic infections. The Kirby-Bauer method was used to determine the antimicrobial susceptibility. Biofilm formation was studied using the microtiter plate assay and congo red agar assay. Polymerase chain reaction (PCR) was used to detect the presence of E. faecalis virulence genes, namely; asa1, gelE, cylA, esp, hyl, efaA, and ace. Gelatinase and cytolysin activity were also tested using phenotypic methods. Results: Twenty-three (13.8%) samples were positive for E. faecalis. The highest resistance rates were observed against ampicillin (87%), followed by penicillin (82.6%), and erythromycin (60.9%). The highest susceptibility was for levofloxacin (100%), followed by gentamycin and chloramphenicol, each with 95.7%. Most isolates were able to produce biofilm (78.3%). Gelatinase and cytolysin activity were detected in 21.7% and 56.5% of isolates, respectively. efaA was significantly associated with asa1 and gelE (P < 0.05), and esp was significantly associated with cylA, gelE, ace, efaA and asa1 ( P < 0.05). In addition, the gelE. gene was significantly associated with gelatinase production (P < 0.01). Conclusion: In conclusion, we have shown that E. faecalis is involved with periodontal disease and secondary root canal infection with several virulence genes detected. Clinical Relevance: Around 13% of the periodontitis and secondary root canal infection patients were positive for E. faecalis and isolates were resistant to commonly used antibiotics.