Enterococcus Phage vB_EfaS_HEf13 as an Anti-Biofilm Agent Against Enterococcus faecalis

Area of Science:

• Microbiology
• Endodontics
• Bacteriophage Therapy

Background:

• Enterococcus faecalis is a primary pathogen in apical periodontitis, forming biofilms resistant to endodontic treatments.
• Bacteriophage therapy offers a promising strategy against antibiotic-resistant bacteria.
• Previous studies confirmed the bactericidal activity of Enterococcus phage vB_EfaS_HEf13 (phage HEf13) against E. faecalis.

Purpose of the Study:

• To investigate the effect of phage HEf13 on E. faecalis biofilm formation and pre-formed biofilms.
• To evaluate the synergistic effect of phage HEf13 in combination with endodontic treatments (chlorhexidine and penicillin).

Main Methods:

• In vitro assessment of phage HEf13's impact on E. faecalis biofilm formation and disruption.
• Analysis of phage HEf13's effect on biofilm exopolysaccharide (EPS).
• Evaluation of combined treatments using confocal laser scanning microscopy.

Main Results:

• Phage HEf13 inhibited E. faecalis biofilm formation and disrupted pre-formed biofilms in a dose- and time-dependent manner.
• Phage HEf13 degraded E. faecalis biofilm exopolysaccharide (EPS).
• Combined treatment with phage HEf13 and chlorhexidine or penicillin showed enhanced biofilm inhibition and disruption compared to monotherapy.

Conclusions:

• Phage HEf13 demonstrates significant efficacy against E. faecalis biofilms, likely due to its EPS-degrading properties.
• Combination therapy with phage HEf13 and conventional endodontic agents offers a potent strategy to suppress E. faecalis biofilms.
• Phage HEf13 holds potential as an adjunctive therapy for refractory apical periodontitis caused by E. faecalis infections.