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Profiling antibiotic susceptibility among distinct Enterococcus faecalis isolates from dental root canals
Division of Cariology and Endodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, Campus Huddinge, Stockholm, Sweden.
Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, Campus Huddinge, Stockholm, Sweden.
Department of Laboratory Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Campus Huddinge, Stockholm, Sweden.
Biomaterials Laboratory, Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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2024 (English)In: Antibiotics, E-ISSN 2079-6382, Vol. 13, no 1, article id 18Article in journal (Refereed) Published
Abstract [en]

Enterococcus faecalis, a leading multi-resistant nosocomial pathogen, is also the most frequently retrieved species from persistently infected dental root canals, suggesting that the oral cavity is a possible reservoir for resistant strains. However, antimicrobial susceptibility testing (AST) for oral enterococci remains scarce. Here, we examined the AST profiles of 37 E. faecalis strains, including thirty-four endodontic isolates, two vanA-type vancomycin-resistant isolates, and the reference strain ATCC-29212. Using Etest gradient strips and established EUCAST standards, we determined minimum inhibitory concentrations (MICs) for amoxicillin, vancomycin, clindamycin, tigecycline, linezolid, and daptomycin. Results revealed that most endodontic isolates were susceptible to amoxicillin and vancomycin, with varying levels of intrinsic resistance to clindamycin. Isolates exceeding the clindamycin MIC of the ATCC-29212 strain were further tested against last-resort antibiotics, with 7/27 exhibiting MICs matching the susceptibility breakpoint for tigecycline, and 1/27 reaching that of linezolid. Both vanA isolates confirmed vancomycin resistance and demonstrated resistance to tigecycline. In conclusion, while most endodontic isolates remained susceptible to first-line antibiotics, several displayed marked intrinsic clindamycin resistance, and MICs matched tigecycline’s breakpoint. The discovery of tigecycline resistance in vanA isolates highlights the propensity of clinical clone clusters to acquire multidrug resistance. Our results emphasize the importance of implementing AST strategies in dental practices for continued resistance surveillance.

Place, publisher, year, edition, pages
MDPI, 2024. Vol. 13, no 1, article id 18
Keywords [en]
antibiotic resistance, antimicrobial susceptibility testing, endodontic infections, Enterococcus faecalis, tigecycline-resistant VRE, vancomycin-resistant enterococci
National Category
Dentistry Infectious Medicine
Identifiers
URN: urn:nbn:se:umu:diva-220483DOI: 10.3390/antibiotics13010018ISI: 001151768200001PubMedID: 38247577Scopus ID: 2-s2.0-85183595900OAI: oai:DiVA.org:umu-220483DiVA, id: diva2:1834787
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Karolinska InstituteAvailable from: 2024-02-05 Created: 2024-02-05 Last updated: 2025-04-24Bibliographically approved

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Brundin, Malin

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