Antimicrobial resistance and virulence traits of Enterococcus faecalis from primary endodontic infections

Abstract Objectives To determine the phenotypic and molecular characteristics of Enterococcus faecalis recovered from primary endodontic infections in Brazilian patients. Methods Twenty isolates of E. faecalis recovered from 43 Brazilian patients with primary endodontic infections were identified by...

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Bibliographic Details
Published in:Journal of dentistry 2013-09, Vol.41 (9), p.779-786
Main Authors: Lins, Renata Ximenes, de Oliveira Andrade, Aurimar, Hirata Junior, Raphael, Wilson, Melanie J, Lewis, Michael A.O, Williams, David W, Fidel, Rivail Antonio Sergio
Format: Article
Language:eng ; per
Subjects:
Agar
Anti-Bacterial Agents - pharmacology
Antibiotics
Antimicrobial agents
Antimicrobial susceptibility
Bacteria
Bacterial Proteins - analysis
Bacteriological Techniques
Dental Pulp Diseases - microbiology
Dentistry
Drug resistance
Drug Resistance, Bacterial
Endodontic infection
Enterococcus faecalis
Enterococcus faecalis - drug effects
Enterococcus faecalis - genetics
Enterococcus faecalis - pathogenicity
Enterococcus faecalis - physiology
Erythromycin - pharmacology
Gelatinases - analysis
Gene Expression Profiling
Genotype
Gram-Positive Bacterial Infections - microbiology
Membrane Proteins - analysis
Microbial Sensitivity Tests
Microbiology
Nosocomial infections
Patients
Penicillin G - pharmacology
Phenotype
Ribosomal DNA
RNA, Ribosomal, 16S - genetics
Sequence Analysis, DNA
Tetracycline Resistance
Vancomycin - pharmacology
Virulence
Virulence Factors - analysis
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Summary:Abstract Objectives To determine the phenotypic and molecular characteristics of Enterococcus faecalis recovered from primary endodontic infections in Brazilian patients. Methods Twenty isolates of E. faecalis recovered from 43 Brazilian patients with primary endodontic infections were identified by biochemical profiling (API20Strep) and 16S rDNA sequencing. Antimicrobial susceptibility was ascertained by agar dilution, using the recommended protocol of the Clinical and Laboratory Standards Institute (CLSI). PCR with validated primers was used to detect genes associated with antibiotic resistance and specific virulence factors. Results All isolates were deemed susceptible to penicillin G, erythromycin and vancomycin. However, nine isolates had a minimum inhibitory concentration of 4 μg/mL to vancomycin (the resistance breakpoint). Fourteen isolates (70% of isolates) were also resistant to tetracycline with MICs of >64 μg/mL. PCR products for tetracycline resistance genes were detected in test isolates, while erythromycin and vancomycin resistance genes were not evident. Gelatinase, aggregation substance and enteroccocal surface protein genes were detected in 20, 18 and 12 isolates, respectively. Conclusions Endodontic E. faecalis isolates exhibit high level of resistance to tetracycline, an antibiotic that has use in local treatment of dental infections. This opens up a much-needed debate on the role and efficacy of this antibiotic for oral infections. Furthermore, these isolates were shown to possess genes that could contribute to pathogenicity in the pulp cavity.
ISSN:0300-5712
1879-176X
DOI:10.1016/j.jdent.2013.07.004