Abstract
The genus Enterococcus comprises a ubiquitous group of Gram-positive bacteria that can cause diverse health care-associated infections. Their genome plasticity enables easy acquisition of virulence factors as well as antibiotic resistances. Urinary tract infections (UTIs) and catheter-associated UTIs are common diseases caused by enterococci. In this study, Enterococcus strains isolated from UTIs were characterized, showing that the majority were E. faecalis and contained several virulence factors associated to a better colonization of the urinary tract. Their susceptibility against the bacteriocin AS-48 and several antibiotics was tested. AS-48 is a potent circular bacteriocin that causes bacterial death by pore formation in the cell membrane. The interest of this bacteriocin is based on the potent inhibitory activity, the high stability against environmental conditions, and the low toxicity. AS-48 was active at concentrations below 10 mg/L even against antibiotic-resistant strains, whereas these strains showed resistance to, at least, seven of the 20 antibiotics tested. Moreover, the effect of AS-48 combined with antibiotics commonly used to treat UTIs was largely synergistic (with up to 100-fold MIC reduction) and only occasionally additive. These data suggest AS-48 as a potential novel drug to deal with or prevent enterococcal infections.
Highlights
Urinary tract infections are one of the most common infections in humans
In hospital environments, complicated Gram-positive urinary catheter-associated infections caused by Enterococcus faecium and Enterococcus faecalis have emerged as an important issue [1,2]
Three strains were identified as E. faecium by multiplex PCR, while the remaining were identified as E. faecalis
Summary
Urinary tract infections are one of the most common infections in humans. In general, they are uncomplicated infections produced by Gram-negative bacteria [1]. The genus Enterococcus (with 58 described species to date) are ubiquitous, nonsporulating, low G+C content, catalase negative, aerotolerant, Gram-positive bacteria. These bacteria can colonize the gastrointestinal tract and disseminate to the bloodstream under particular conditions. Their role in infectious diseases has evolved from a gut and urinary commensal microorganisms to a major pathogen of concern [5]. Their success as pathogens is related to their survival abilities in a hostile antimicrobial-rich environment, together with the presence of numerous virulence factors and the high genetic plasticity that facilitates the acquisition and transmission of genetic elements that confer antibiotic resistance [6]. Novel developments and strategies to treat and prevent enterococcal infections are required and phage therapy or combined application of known antimicrobial families
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