Therapeutic Effect of Bacteriophage alone and in combination with Meropenem on multidrug resistance enterococcus faecalis in vitro study

Abstract

Background:  Enterococcus faecalis is a Gram-positive bacterium which can be found in soil, water, and as a commensal organism in animals and humans GIT. E. faecalis phages are bacterial viruses which infect bacteria and can reproduce in 2 possible ways: lysogenic life cycle and lytic life cycle. Almost all E. faecalis isolates are multi-drug resistant (MDR) that lead to difficulty in their treatment. So antibiotics &phage combination are feasible choices to get rid of that problem.

Aims of the study: The aim of this study is to appraise the benefit of the  activity of bacteriophage as antibacterial agent alone and in combination(s) with antibiotic(s) against MDR E. faecalis and to get the proper antibacterial combination(s) for MDR treatment with synergistic effects.

Materials and Methods:Twenty six isolates were picked up from patients with urinary tract infections attended to the Medical City of Al-Imamain Al-Khadimain (peace being upon them) from April 2022 to June 2022.They were specified using morphological characteristics,VITEK2 compact system. 

Results: In this study, E.faecalis was obtained from patients with urinary tract infection. The  result include different types of bacteria causing UTI, E.coli  isolates were  higher percent (36.8%) followed by Enterococcus faecalis (24.5%). Distribution according to gender was show high percent in female than in male. The percentages of resistance of the isolates to the tested antibiotics were as follows: the higher is Tetracycline 84.62% and the lowest is Nitrofurantoin 3.85%. From 26 isolates, 12 isolates  were MDR, 4 Isolates were XDR and 0 isolate was PDR combination  of phage with ¼ or ½ MIC of each of meropenen for 11,20,22 isolates which were resulted in  synergist effects to the antibiotics against MDR E. faecalis strains obtained in this study.

Conclusions: During this study all E.faecalis isolates were resistant to different groups of antibiotic, and considered MDR.