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Updated: Jan 8, 2026

Population and Single-Cell Analysis of Antibiotic Persistence in Escherichia coli
Published on: March 24, 2023
Enterococcus faecalis persists and replicates intracellularly within neutrophils
Claudia J Stocks1,2, Ronni A G da Silva1,3, Haris Antypas1
1Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore, Singapore.
Enterococcus faecalis evades immune cells by surviving and replicating inside neutrophils, prolonging chronic wound infections. This neutrophil protection mechanism may contribute to persistent inflammation and biofilm infections.
Area of Science:
- Microbiology
- Immunology
- Wound Healing
Background:
- Chronic wound infections pose a significant global health challenge.
- Enterococcus faecalis is a common pathogen in chronic wounds.
- The interaction between E. faecalis and neutrophils is not well understood.
Purpose of the Study:
- To investigate the interaction between E. faecalis and neutrophils in the context of chronic wound infections.
- To determine if neutrophils eliminate E. faecalis or provide a niche for its survival and replication.
Main Methods:
- Murine wound models and ex vivo wound cells were used to study E. faecalis-neutrophil interactions.
- Neutrophil lifespan assays were performed in vitro.
- Intracellular bacterial load was quantified using colony-forming units (CFU).
- Bacterial replication was assessed using fluorescent D-amino acid staining.
- Transmission electron microscopy and confocal microscopy were employed for visualization.
Main Results:
- Neutrophils harbored intracellular E. faecalis in murine wound beds and ex vivo wound cells.
- E. faecalis infection prolonged the lifespan of both murine and human neutrophils.
- E. faecalis replicated within neutrophils between 6 and 18 hours post-infection.
- Infected neutrophils remained immunologically active, secreting pro-inflammatory cytokines.
Conclusions:
- Neutrophils provide a niche for E. faecalis intracellular persistence and replication, rather than eliminating the pathogen.
- This intracellular lifestyle may contribute to the chronicity of E. faecalis wound infections and biofilm formation.
- Understanding this interaction could lead to novel therapeutic strategies for chronic wound infections.
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