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Open AccessArticle

Eradication of Vancomycin-Resistant Enterococci by Combining Phage and Vancomycin

1
Department of Prosthodontics, Hadassah School of Dental Medicine, Hebrew University, Jerusalem 91120, Israel
2
Faculty of Dental Sciences, Hadassah School of Dental Medicine, Hebrew University, Jerusalem 91120, Israel
*
Author to whom correspondence should be addressed.
N.B. and R.H. contributed equally to this work.
Viruses 2019, 11(10), 954; https://doi.org/10.3390/v11100954
Received: 16 August 2019 / Revised: 8 October 2019 / Accepted: 11 October 2019 / Published: 16 October 2019
(This article belongs to the Special Issue Bacteriophages and Biofilms)
Currently, effective options are needed to fight vancomycin-resistant Enterococcus faecalis (VRE). The present study shows that combinations of phage and vancomycin are highly efficient against VRE, despite being resistant to the antibiotic. Vancomycin-phage EFLK1 (anti-E. faecalis phage) synergy was assessed against VRE planktonic and biofilm cultures. The effect of the combined treatment on VRE biofilms was determined by evaluating the viable counts and biomass and then visualized using scanning electron microscopy (SEM). The cell wall peptidoglycan was stained after phage treatment, visualized by confocal microscopy and quantified by fluorescence activated cell sorting (FACS) analysis. The combined treatment was synergistically effective compared to treatment with phage or antibiotic alone, both in planktonic and biofilm cultures. Confocal microscopy and FACS analysis showed that fluorescence intensity of phage-treated bacteria increased eight-fold, suggesting a change in the peptidoglycan of the cell wall. Our results indicate that with combined treatment, VRE strains are not more problematic than sensitive strains and thus give hope in the continuous struggle against the current emergence of multidrug resistant pathogens. View Full-Text
Keywords: phage therapy; Enterococcus faecalis (VRE); vancomycin; phage EFLK1; phage-antibiotic synergy (PAS) phage therapy; Enterococcus faecalis (VRE); vancomycin; phage EFLK1; phage-antibiotic synergy (PAS)
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Shlezinger, M.; Coppenhagen-Glazer, S.; Gelman, D.; Beyth, N.; Hazan, R. Eradication of Vancomycin-Resistant Enterococci by Combining Phage and Vancomycin. Viruses 2019, 11, 954.

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