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NF-kappaB activation mediates the response of a subpopulation of basal uroepithelial cells to a cell wall component of Enterococcus faecalis.

Earlier in vitro studies revealed that treatment of basal urothelial cells (UT) with lipoteichoic acid, a cell wall component of Enterococcus faecalis (LT-2), stimulated a subpopulation of quiescent cells with high proliferative potential to divide (Elgavish et al., 1996b, J Cell Physiol 169:42-51). Studies were consistent with the possibility that NO-mediated mechanisms were involved (Elgavish et al., 1996c, J Cell Physiol 169:66-77). We postulated that LT-2 may upregulate expression of iNOS. Promoters of the gene encoding iNOS, as well as genes encoding many cytokines, contain elements homologous to consensus sequences for the binding of the transcription factor NF-kappaB. Based on this, we postulated that: (1) NF-kappaB activation is an early event following exposure of basal UT to LT-2 and (2) NF-kappaB activation mediates basal UT proliferation triggered by LT-2. To test these hypotheses, UT maintained for 3 days under growth-restricting conditions, were treated with or without 25 microg/ml LT-2. Nuclear distribution of NF-kappaB, that is, activated NF-kappaB, was detected by immunofluorescence microscopy in a subpopulation of basal UT as early as 5-10 min after the beginning of the treatment. In contrast, LT-2 had no effect on cultures containing more differentiated UT. NF-kappaB activation preceded production of NO, since treatment with 25 microM hemoglobin, a potent inactivator of NO, did not prevent LT-2-triggered NF-kappaB activation. Treatment with 10 microM pyrrolidine dithiocarbamate (PDTC) inhibited LT-2-triggered activation of NF-kappaB and prevented the stimulatory effect of LT-2 on proliferation of basal UT. These findings support the possibility that NF-kappaB activation mediates basal UT proliferation triggered by LT-2.

Cell Wall↗

Factors influencing determination of high-level aminoglycoside resistance in Enterococcus faecalis.

The ability of seven methods to detect high-level gentamicin (58 strains) and streptomycin resistance (56 strains) among 107 Enterococcus faecalis isolates was investigated at the University of Chicago Medical Center and the University of Nebraska Medical Center. Methods included a standard agar screen plate, high-content disk diffusion, Remel (Lenexa, Kans.) EF Synergy Quad plates, standard microdilution panels prepared in house, Pasco MIC Gram-Positive panels (Difco Laboratories, Detroit, Mich.), MicroScan MIC Type 5 dry panels (Baxter Healthcare Corp., MicroScan Div., West Sacramento, Calif.), and Vitek GPS-TA cards (Vitek Systems Inc., Hazelwood, Mo.). Results indicating false resistance were not obtained by any method, and there was 100% agreement between the results of the disk diffusion and standard agar screen methods. Prolonging incubation from 24 to 48 h increased resistance detection for both agar and microdilution screens. EF Synergy Quad plates inoculated with micropipettes detected 100% of the streptomycin- and gentamicin-resistant isolates. Resistance detection for streptomycin and gentamicin, respectively, was 93 and 96% by standard microdilution, 93 and 98% by Pasco panels, 88 and 89% by MicroScan panels, and 88 and 91% by Vitek GPS-TA cards. False susceptibility occurred more frequently with streptomycin-resistant isolates than it did with gentamicin-resistant strains and appeared to be strain related in some instances. The use of an increased inoculum size enhanced resistance detection with these strains, but it complicated interpretation of results and led to the selection of streptomycin-resistant mutants. Until results of further studies delineate optimum test conditions, a delay in the final interpretation of agar and microdilution screen results until 48 h for isolates showing no or light growth at 24 h may help to minimize the occurrence of false susceptibility reporting.

Anti-Bacterial Agents↗

The influence of Enterococcus faecalis on the morphology and the antibody-binding capacity of the intestinal bacteria of ten healthy human volunteers.

The influence of Enterococcus faecalis on the morphology of the bacterial cells which make up the gut microflora and on the levels of circulating IgG bound to the gut microflora was assessed. After 29 days of pretreatment monitoring, ten healthy human volunteers ingested 10(7) viable cells of E. faecalis three times daily, for 21 days. After this treatment another 21 days of follow-up completed the study. Each volunteer delivered eleven faecal samples during the entire study period of 71 days with a 7 day interval. Before and after the faeces sampling period, blood samples were collected from all volunteers. The influence of the ingestion of E. faecalis on the morphology of the gut microflora was measured by image analysis. In addition, the binding of circulating IgG to intestinal bacteria in all intermediate faecal samples was measured by means of quantitative immunofluorescence. The oral administration of E. faecalis resulted in a significant change of the morphological composition of the gut microflora and in a significant decrease in IgG-binding capacity of the gut microflora.

Adult↗

The Enterococcus faecalis pyr operon is regulated by autogenous transcriptional attenuation at a single site in the 5' leader.

The 5' end of the Enterococcus faecalis pyr operon specifies, in order, the promoter, a 5' untranslated leader, the pyrR gene encoding the regulatory protein for the operon, a 39-nucleotide (nt) intercistronic region, the pyrP gene encoding a uracil permease, a 13-nt intercistronic region, and the pyrB gene encoding aspartate transcarbamylase. The 5' leader RNA is capable of forming stem-loop structures involved in attenuation control of the operon. No attenuation regions, such as those found in the Bacillus subtilis pyr operon, are present in the pyrR-pyrP or pyrP-pyrB intercistronic regions. Several lines of evidence demonstrate that the E. faecalis pyr operon is repressed by uracil via transcriptional attenuation at the single 5' leader termination site and that attenuation is mediated by the PyrR protein.

5' Untranslated Regions↗

Antibacterial effect of two mineral trioxide aggregate (MTA) preparations against Enterococcus faecalis and Streptococcus sanguis in vitro.

The antibacterial effects of gray-colored MTA (GMTA) and white-colored MTA (WMTA) against Enterococcus faecalis and Streptococcus sanguis were assessed in vitro using the tube dilution test. Broth tubes were prepared and divided into experimental and control groups. Aliquots of each of the tested microorganisms were taken from a stock culture and added to each experimental and positive control group. All groups were incubated at 37 degrees C and evaluated for turbidity at 0, 1, 24, 48, and 72-hour time periods. A direct correlation was found between GMTA and WMTA concentrations and their antibacterial effect. Tubes containing GMTA in concentrations of 50, 25, and 12.5 mg/ml did not show E. faecalis growth at any of the time periods tested whereas tubes containing WMTA showed E. faecalis growth at all concentrations and time periods tested. Statistically significant differences were found between tubes containing GMTA in concentrations of 50, 25 and 12.5 mg/ml and tubes containing similar concentrations of WMTA (p < 0.001). Tubes containing GMTA in concentrations of 50, 25, 12.5, 6.25, and 3.12 mg/ml and tubes containing WMTA in concentrations of 50, 25, and 12.5 mg/ml did not show S. sanguis growth at any of the time periods tested. Statistically significant differences were found between tubes containing GMTA in concentrations 6.25 and 3.12 mg/ml and tubes containing similar concentrations of WMTA (p < 0.001). It appears that the susceptibility of E. faecalis and S. sanguis to MTA differed and that GMTA requires lower concentrations than WMTA to exert the same antibacterial effect against each of the microorganisms tested.

Aluminum Compounds↗

Survival of Enterococcus faecalis in seawater microcosms is limited in the presence of bacterivorous zooflagellates.

The survival and persistence of growing and starved cells of Enterococcus faecalis in untreated and differentially filtered (20 microm, 5 microm, 3 microm, 1.2 microm, and 0.1 microm) seawater was analyzed in samples taken at different times over a 1-year period by plate counts and scanning electron microscopy. Whereas seawater filtered through a 0.1-microm mesh was not at all or only slightly bactericidal during incubation at 16 degrees C in the dark, culturability of E. faecalis in the other systems decreased as a function of increasing pore size of the filters. Recovery of culturable, glucose pre-starved cells was always higher than that of cells harvested from the exponential growth phase. Electron microscopic analysis showed that the disappearance of enterococci appeared related to the presence and multiplication of various zooflagellates.

Animals↗

Linkage of vancomycin and high-level gentamicin resistance genes on the same plasmid in a clinical isolate of Enterococcus faecalis.

A transferable 55-MDa plasmid which encoded resistance to both vancomycin and high concentrations of gentamicin was identified in a clinical isolate of Enterococcus faecalis. The plasmid hybridized with probes for the vanB and aac6'aph2" resistance genes. This is the first report of linkage of glycopeptide and high-level aminoglycoside resistance genes in an Enterococcus sp.

Base Sequence↗

Local genetic patterns within a vancomycin-resistant Enterococcus faecalis clone isolated in three hospitals in Portugal.

Eight pulsed-field gel electrophoresis subtypes and six Tn1546 variants were identified among Enterococcus faecalis isolates of a single clone recovered in three geographically separate Portuguese hospitals. Some clonal subtypes were found in particular hospitals, and Tn1546 variants were either widespread or confined to some of them. We also report on the first Tn1546 transposon containing an ISEf1 insertion.

Anti-Bacterial Agents↗

Genetic stability of the antagonistic character of Enterococcus faecalis ssp. liquefaciens and the detection of a new inhibitory bacteriocin-like substance.

The inhibitory capacity of strain S-48 of Enterococcus faecalis ssp. liquefaciens was studied. The strain produces a broad-spectrum peptide antibiotic (AS-48) that has been characterized elsewhere. The isolation of mutants from S-48 after mutagenic treatment revealed another inhibitory substance which remained masked in the wild strain. The protein nature and restricted spectrum of this substance points to its being a bacteriocin.

Acridine Orange↗

Co-transfer of vancomycin and other resistance genes from Enterococcus faecalis NCTC 12201 to Staphylococcus aureus.

Conjugative transfer, in the apparent absence of plasmid DNA, of high-level vancomycin resistance from Enterococcus faecalis NCTC 12201 to Staphylococcus aureus B111 has been demonstrated in vivo and in vitro. Selection of transconjugants on media containing erythromycin or chloramphenicol may result in the transfer of resistance to erythromycin, chloramphenicol, gentamicin, streptomycin and vancomycin though these are capable of separate transfer. Vancomycin resistance has not been transmitted from staphylococcus to staphylococcus though transfer of erythromycin and of chloramphenicol resistance has been achieved.

Conjugation, Genetic↗

Molecular analysis of the Enterococcus faecalis serotype 2 polysaccharide determinant.

We previously described a 15-kb genetic cluster consisting of 11 open reading frames (cps2A to cps2K) of Enterococcus faecalis FA2-2 that is responsible for the production of the serotype 2 capsular polysaccharide. By using transcriptional fusions to a promoterless lacZ gene, we identified two independent promoters related to the expression of the polysaccharide. Both transcription initiation sites were mapped by primer extension. Reverse transcription-PCR (RT-PCR) demonstrated the transcriptional linkage of genes present in both transcripts. Real-time RT-PCR quantification of transcripts revealed maximum transcription during log phase growth, an observation confirmed by promoter fusion studies. The heterologous expression of this pathway in Escherichia coli caused reactivity with E. faecalis type 2 antiserum, thus demonstrating the essential role of this pathway in the synthesis of the type-specific polysaccharide.

Bacterial Capsules↗

Efficacy of the combination ampicillin plus ceftriaxone in the treatment of a case of enterococcal endocarditis due to Enterococcus faecalis highly resistant to gentamicin: efficacy of the "ex vivo" synergism method.

The case of a patient with highly gentamicin-resistant Enterococcus faecalis endocarditis treated with an ampicillin + ceftriaxone combination is described. We have designed a method to evaluate synergism between the antibacterial activity of patient's serum taken during a given antibiotic regimen (ampicillin) to which another antibiotic (ceftriaxone) is added in vitro. In this patient the two-drug combination was able to stop the bacteremia and prevent the infection of the prosthetic valve.

Aged↗

In vitro antimicrobial effect of chlorhexidine-impregnated gutta percha points on Enterococcus faecalis.

AIM: To evaluate the in vitro antimicrobial effect of chlorhexidine-impregnated gutta percha points, Roeko activ point (Roeko, Langenau, Germany) on Enterococcus faecalis. METHODOLOGY: Human maxillary premolar roots were prepared with.04 rotary ProFile instruments to a master apical file size 40, autoclave-sterilized and then infected with E. faecalis (ATCC 29212) for 3 weeks. Baseline controls were carried out verifying negligible effects of plain gutta percha cones on E. faecalis. Subsequent to intracanal placement of calcium hydroxide, 'activ points' or saline (positive control) and the 2-week incubation in 54 root specimens, dentine sampling at depths of 100 and 250 micro m was carried out using.04 rotary ProFile instruments at sizes 60 and 90 to assess the quantity of bacteria present. Inactivating agents were used prior to sampling and the colony-forming units (CFU) of E. faecalis were then plate-counted after culturing. Statistical analysis was completed using the paired t-test. RESULTS: In comparison to the positive control, treatment with calcium hydroxide (P = 0.000 and 0.000) or activ points (P = 0.000 and 0.002) produced significantly lower colony counts of E. faecalis at dentine depths of 100 and 250 micro m, respectively. Calcium hydroxide (2.10 x 102 CFU mL-1) was significantly more effective than activ points (1.58 x 103 CFU mL-1) at 100 micro m (P = 0.013), but not at 250 micro m (P = 0.353). Neither of these two medications was able to eliminate E. faecalis completely. CONCLUSIONS: Chlorhexidine-impregnated activ points did not possess an in vitro inhibitory activity strong enough to eliminate E. faecalis completely from infected dentinal tubules.

Anti-Infective Agents, Local↗

Morphological changes in heart and lungs of broilers experiencing pulmonary hypertension syndrome caused by Enterococcus faecalis.

In a previous report, a method of identification of birds experiencing early symptoms of pulmonary hypertension syndrome (PHS) caused by challenge with Enterococcus faecalis was delineated. This method involved subjective heart scores based on visual observation of a cavity on the external surface of the right ventricular wall (RVW), as well as tonicity and thickness of this wall. Accuracy in identifying birds 48 h postchallenge with E. faecalis was acceptable. However, this method did not attempt to offer other morphological or physiological characteristics for further understanding the etiology of PHS. In the present study, three trials were conducted to establish morphological characteristics of the heart from birds challenged with E. faecalis. In Trials 1 and 2, discrepancies were found in heart length (HL) and thickness of the RVW. In Trial 3, the dry weight of the right ventricle (RV) increased after challenge with E. faecalis, as was the ratio of the mass of the RV to the mass of the total ventricle (TV). Histopathological evidence of hearts and especially lungs of birds challenged with E. faecalis were suggestive of PHS. Results indicated that RV, RV:TV ratio, and histopatholgical evaluation of heart and lungs are complementary to diagnosis of PHS.

Animals↗

Isolation of a derivative of Escherichia coli-Enterococcus faecalis shuttle vector pAM401 temperature sensitive for maintenance in E. faecalis and its use in evaluating the mechanism of pAD1 par-dependent plasmid stabilization.

A derivative of the Escherichia coli-Enterococcus faecalis shuttle vector pAM401 was isolated by mutagenesis in an E. coli mutator strain. This plasmid, designated pAM401ts, was more than an order of magnitude less stable at 38 degreesC than at 30 degreesC in the E. faecalis host strain JH2-2. The E. faecalis plasmid pAD1-encoded par stability locus was cloned onto pAM401ts, and its effects on plasmid stability and host cell viability were assessed. It was found that par stabilized pAM401ts at 38 degreesC but also caused a substantial drop in cell viability three to four generations after a temperature shift from 30 to 38 degreesC. After a maximum viability drop of 94%, culture growth recovered as plasmid-free cells began to accumulate. Provision of excess RNAII, the putative par antidote, in trans attenuated cell killing. These characteristics support a postsegregational killing mechanism for par-mediated plasmid stabilization.

DNA Replication↗

Displacement of Enterococcus faecalis from hydrophobic and hydrophilic substrata by Lactobacillus and Streptococcus spp. as studied in a parallel plate flow chamber.

The displacement of Enterococcus faecalis 1131 from hydrophobic and hydrophilic substrata by isolates of Lactobacillus casei 36 and Streptococcus hyointestinalis KM1 was studied in a parallel plate flow chamber. The experiments were conducted with either 10 mM potassium phosphate buffer or human urine as the suspending fluid, and adhesion and displacement were measured by real-time in situ image analysis. The results showed that E. faecalis 1131 was displaced by lactobacilli (31%) and streptococci (74%) from fluorinated ethylene propylene in buffer and that displacement by lactobacilli was even more effective on a glass substratum in urine (54%). The passage of an air-liquid interface significantly impacted on adhesion, especially when the surface had been challenged with lactobacilli (up to 100% displacement) or streptococci (up to 94% displacement). These results showed that the parallel plate flow system with real-time in situ image analysis was effective for studying bacterial adhesion and that uropathogenic enterococci can be displaced by indigenous bacteria.

Adult↗

Enterococcus faecalis cytolysin without effect on the intestinal growth of susceptible enterococci in mice.

A murine model was developed to determine whether the Enterococcus faecalis cytolysin, through its bacteriolytic action on gram-positive bacteria, could promote intestinal overgrowth of cytolytic strains. Sets of E. faecalis strains with varying cytolytic production and susceptibility to cytolytic activity were mixed 1:1 and allowed to compete in vitro in broth or in vivo after orogastric administration in mice pretreated with antibiotics. In general, cytolytic strains outgrew, by as much as 2000-fold, competing cytolysin-susceptible or -hypersusceptible strains in vitro. In contrast, no growth advantage was observed in vivo, despite similar transient colonization of the murine intestinal tract by both cytolytic and cytolysin-susceptible strains. These data suggest that cytolysin plays little role in promoting intestinal overgrowth of enterococci through bacteriolytic activity.

Animals↗

Evolution of the Enterococcus faecalis sex pheromone system.

In this article we present data that form the basis of a model of the evolution of the unique Enterococcus faecalis sex pheromone system. The data indicate tht sex pheromone plasmid-encoded genes/functions, which are essential for this highly efficient plasmid collection system, are common among all sex pheromone plasmids; pAM373 seems to be only distantly related to all other pheromone plasmids. These genes appear to be restricted to sex pheromone plasmids (but see below for possible exceptions). However, the ability to produce sex pheromone-like peptides is not restricted to E. faecalis. We argue that the sex pheromone system of E. faecalis developed only once--but into at least 19 different variants--to form a system which is highly specific for this bacterium and is related to virulence.

Adhesins, Bacterial↗