Evaluation of Phage Therapy in the Context of <i>Enterococcus faecalis</i> and Its Associated Diseases

• Main Authors: Andrei S. Bolocan, Aditya Upadrasta, Pedro H. de Almeida Bettio, Adam G. Clooney, Lorraine A. Draper, R. Paul Ross, Colin Hill
• Format: Article
• Language: English
• Published: MDPI AG 2019-04-01
• Series: Viruses
• Subjects: phage therapy; <i>E. faecalis</i>; OrthoMCL
• Online Access: https://www.mdpi.com/1999-4915/11/4/366

Bacteriophages (phages) or bacterial viruses have been proposed as natural antimicrobial agents to fight against antibiotic-resistant bacteria associated with human infections. <i>Enterococcus faecalis</i> is a gut commensal, which is occasionally found in the mouth and vaginal tract, and does not usually cause clinical problems. However, it can spread to other areas of the body and cause life-threatening infections, such as septicemia, endocarditis, or meningitis, in immunocompromised hosts. Although <i>E. faecalis</i> phage cocktails are not commercially available within the EU or USA, there is an accumulated evidence from in vitro and in vivo studies that have shown phage efficacy, which supports the idea of applying phage therapy to overcome infections associated with <i>E. faecalis</i>. In this review, we discuss the potency of bacteriophages in controlling <i>E. faecalis</i>, in both in vitro and in vivo scenarios. <i>E. faecalis</i> associated bacteriophages were compared at the genome level and an attempt was made to categorize phages with respect to their suitability for therapeutic application, using orthocluster analysis. In addition, <i>E. faecalis</i> phages have been examined for the presence of antibiotic-resistant genes, to ensure their safe use in clinical conditions. Finally, the domain architecture of <i>E. faecalis</i> phage-encoded endolysins are discussed.