title: Targeting Enterococcus faecalis biofilms with phage therapy.
abstract: Phage therapy has been proven to be more effective, in some cases, than conventional antibiotics, especially regarding multidrug-resistant biofilm infections. The objective here was to isolate an anti-Enterococcus faecalis bacteriophage and to evaluate its efficacy against planktonic and biofilm cultures. E. faecalis is an important pathogen found in many infections, including endocarditis and persistent infections associated with root canal treatment failure. The difficulty in E. faecalis treatment has been attributed to the lack of anti-infective strategies to eradicate its biofilm and to the frequent emergence of multidrug-resistant strains. To this end, an anti-E. faecalis and E. faecium phage, termed EFDG1, was isolated from sewage effluents. The phage was visualized by electron microscopy. EFDG1 coding sequences and phylogeny were determined by whole genome sequencing (GenBank accession number KP339049), revealing it belongs to the Spounavirinae subfamily of the Myoviridae phages, which includes promising candidates for therapy against Gram-positive pathogens. This analysis also showed that the EFDG1 genome does not contain apparent harmful genes. EFDG1 antibacterial efficacy was evaluated in vitro against planktonic and biofilm cultures, showing effective lytic activity against various E. faecalis and E. faecium isolates, regardless of their antibiotic resistance profile. In addition, EFDG1 efficiently prevented ex vivo E. faecalis root canal infection. These findings suggest that phage therapy using EFDG1 might be efficacious to prevent E. faecalis infection after root canal treatment.
authors: Faculty of Dental Sciences, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel Department of Prosthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
authors: Leron
authors: L
authors: Khalifa
authors: Faculty of Dental Sciences, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel Department of Prosthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
authors: Yair
authors: Y
authors: Brosh
authors: Faculty of Dental Sciences, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
authors: Daniel
authors: D
authors: Gelman
authors: Faculty of Dental Sciences, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
authors: Shunit
authors: S
authors: Coppenhagen-Glazer
authors: Department of Orthopedic Surgery, Hebrew University-Hadassah Medical Center, Jerusalem, Israel.
authors: Shaul
authors: S
authors: Beyth
authors: Department of Infectious Diseases of Sourasky Medical Center and Tel-Aviv University, Tel-Aviv, Israel.
authors: Ronit
authors: R
authors: Poradosu-Cohen
authors: Department of Intensive Care Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors: Yok-Ai
authors: YA
authors: Que
authors: Department of Prosthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
authors: Nurit
authors: N
authors: Beyth
authors: Faculty of Dental Sciences, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel The Israeli Institute for Advanced Research, Rehovot, Israel ronenh@ekmd.huji.ac.il.
authors: Ronen
authors: R
authors: Hazan
mesh_terms: D018441:Biofilms; D003786:Dental Pulp Cavity / Q000382:microbiology*; D003788:Dental Pulp Diseases / Q000382:microbiology / Q000517:prevention & control*; D013293:Enterococcus faecalis / Q000502:physiology* / Q000821:virology; D016679:Genome, Viral; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D008969:Molecular Sequence Data; D017900:Myoviridae / Q000235:genetics / Q000502:physiology*; D010933:Plankton / Q000502:physiology / Q000821:virology; D017422:Sequence Analysis, DNA; D012722:Sewage / Q000821:virology
chemical_list: D012722:Sewage