Therapeutic potential of a newly isolated bacteriophage against multi-drug resistant Enterococcus faecalis infections: in vitro and in vivo characterization

Abstract Background In nosocomial settings, vancomycin-resistant Enterococcus faecalis is a major health threat leading to increased morbidities, mortalities, and treatment costs. Nowadays, several approaches are under investigation to enhance the activity of or replace the traditional antibiotics....

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Main Authors: Zienab Ali, Karim Abdelkader, Maha M. Abdel-Fattah, Ahmed Farag Azmy, Ahmed O. El-Gendy, Tarek Dishisha
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Microbiology
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Online Access:https://doi.org/10.1186/s12866-025-03785-z
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author Zienab Ali
Karim Abdelkader
Maha M. Abdel-Fattah
Ahmed Farag Azmy
Ahmed O. El-Gendy
Tarek Dishisha
author_facet Zienab Ali
Karim Abdelkader
Maha M. Abdel-Fattah
Ahmed Farag Azmy
Ahmed O. El-Gendy
Tarek Dishisha
author_sort Zienab Ali
collection DOAJ
description Abstract Background In nosocomial settings, vancomycin-resistant Enterococcus faecalis is a major health threat leading to increased morbidities, mortalities, and treatment costs. Nowadays, several approaches are under investigation to enhance the activity of or replace the traditional antibiotics. Bacteriophage therapy was sought as a potential approach for combating E. faecalis infections. The present study focuses on isolating and characterizing bacteriophage against clinical multi-drug resistant (MDR) E. faecalis strain Lb-1492. The phage stability, lytic activity, host-range, latent period, burst size, the ability to detach the pre-formed biofilm and destroy entrapped cells were investigated. The phage genome was purified, sequenced, and subjected to bioinformatics analysis for identifying and characterizing its features, as well as, the suitability for clinical application. Finally, the ability of the phage to rescue mice from deadly, experimentally induced E. faecalis bacteremia was evaluated. Results A virulent phage was isolated from sewage water against a clinical MDR E. faecalis isolate. Morphological and genomic studies indicated that the phage belongs to the Efquatrovirus genus, with a long tail, icosahedral head and a linear double-stranded DNA genome of approximately 42.9 kbp. The phage was named vB_Efa_ZAT1 (shortly ZAT1). It demonstrated a shorter latent period and larger burst size than regular-tailed phages, and a characteristic stability over a wide range of pH and temperatures, with the optimum activity at pH 7.4 and 37 °C, respectively. Phage ZAT1 showed a narrow spectrum of activity and a characteristic biofilm disruption ability. The phage managed successfully to control E. faecalis-induced bacteremia in mice models, which was lethal within 48 h in the control group. An intraperitoneal injection of 3 × 108 PFU of the phage solution given 1 h after the bacterial challenge was sufficient to save all the animals, completely reversing the trend of 100% mortality caused by this bacterium. Conclusions Phage therapy can be a promising alternative to traditional antibiotics in the post-antibiotic era with a significant antimicrobial and antibiofilm activities against MDR E. faecalis.
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spelling doaj-art-5d6973820d0b4e839e466022937b82bb2025-08-20T03:10:55ZengBMCBMC Microbiology1471-21802025-02-0125111910.1186/s12866-025-03785-zTherapeutic potential of a newly isolated bacteriophage against multi-drug resistant Enterococcus faecalis infections: in vitro and in vivo characterizationZienab Ali0Karim Abdelkader1Maha M. Abdel-Fattah2Ahmed Farag Azmy3Ahmed O. El-Gendy4Tarek Dishisha5Department of Pharmaceutical Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef UniversityDepartment of Pharmaceutical Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef UniversityDepartment of Pharmacology and Toxicology, Faculty of Pharmacy, Beni-Suef UniversityDepartment of Pharmaceutical Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef UniversityDepartment of Pharmaceutical Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef UniversityDepartment of Pharmaceutical Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef UniversityAbstract Background In nosocomial settings, vancomycin-resistant Enterococcus faecalis is a major health threat leading to increased morbidities, mortalities, and treatment costs. Nowadays, several approaches are under investigation to enhance the activity of or replace the traditional antibiotics. Bacteriophage therapy was sought as a potential approach for combating E. faecalis infections. The present study focuses on isolating and characterizing bacteriophage against clinical multi-drug resistant (MDR) E. faecalis strain Lb-1492. The phage stability, lytic activity, host-range, latent period, burst size, the ability to detach the pre-formed biofilm and destroy entrapped cells were investigated. The phage genome was purified, sequenced, and subjected to bioinformatics analysis for identifying and characterizing its features, as well as, the suitability for clinical application. Finally, the ability of the phage to rescue mice from deadly, experimentally induced E. faecalis bacteremia was evaluated. Results A virulent phage was isolated from sewage water against a clinical MDR E. faecalis isolate. Morphological and genomic studies indicated that the phage belongs to the Efquatrovirus genus, with a long tail, icosahedral head and a linear double-stranded DNA genome of approximately 42.9 kbp. The phage was named vB_Efa_ZAT1 (shortly ZAT1). It demonstrated a shorter latent period and larger burst size than regular-tailed phages, and a characteristic stability over a wide range of pH and temperatures, with the optimum activity at pH 7.4 and 37 °C, respectively. Phage ZAT1 showed a narrow spectrum of activity and a characteristic biofilm disruption ability. The phage managed successfully to control E. faecalis-induced bacteremia in mice models, which was lethal within 48 h in the control group. An intraperitoneal injection of 3 × 108 PFU of the phage solution given 1 h after the bacterial challenge was sufficient to save all the animals, completely reversing the trend of 100% mortality caused by this bacterium. Conclusions Phage therapy can be a promising alternative to traditional antibiotics in the post-antibiotic era with a significant antimicrobial and antibiofilm activities against MDR E. faecalis.https://doi.org/10.1186/s12866-025-03785-zVREVancomycin-resistant enterococcusEnterococcus faecalisBacteriophageIn vivo animal modelAnti-biofilm
spellingShingle Zienab Ali
Karim Abdelkader
Maha M. Abdel-Fattah
Ahmed Farag Azmy
Ahmed O. El-Gendy
Tarek Dishisha
Therapeutic potential of a newly isolated bacteriophage against multi-drug resistant Enterococcus faecalis infections: in vitro and in vivo characterization
BMC Microbiology
VRE
Vancomycin-resistant enterococcus
Enterococcus faecalis
Bacteriophage
In vivo animal model
Anti-biofilm
title Therapeutic potential of a newly isolated bacteriophage against multi-drug resistant Enterococcus faecalis infections: in vitro and in vivo characterization
title_full Therapeutic potential of a newly isolated bacteriophage against multi-drug resistant Enterococcus faecalis infections: in vitro and in vivo characterization
title_fullStr Therapeutic potential of a newly isolated bacteriophage against multi-drug resistant Enterococcus faecalis infections: in vitro and in vivo characterization
title_full_unstemmed Therapeutic potential of a newly isolated bacteriophage against multi-drug resistant Enterococcus faecalis infections: in vitro and in vivo characterization
title_short Therapeutic potential of a newly isolated bacteriophage against multi-drug resistant Enterococcus faecalis infections: in vitro and in vivo characterization
title_sort therapeutic potential of a newly isolated bacteriophage against multi drug resistant enterococcus faecalis infections in vitro and in vivo characterization
topic VRE
Vancomycin-resistant enterococcus
Enterococcus faecalis
Bacteriophage
In vivo animal model
Anti-biofilm
url https://doi.org/10.1186/s12866-025-03785-z
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