Khalifa Leron, Shlezinger Mor, Beyth Shaul, Houri-Haddad Yael, Coppenhagen-Glazer Shunit, Beyth Nurit, Hazan Ronen
Institute of Dental Science, The Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel.
Department of Prosthodontics, The Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel.
J Oral Microbiol. 2016 Sep 16;8:32157. doi: 10.3402/jom.v8.32157. eCollection 2016.
Antibiotic resistance is an ever-growing problem faced by all major sectors of health care, including dentistry. Recurrent infections related to multidrug-resistant bacteria such as methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, and vancomycin-resistant enterococci (VRE) in hospitals are untreatable and question the effectiveness of notable drugs. Two major reasons for these recurrent infections are acquired antibiotic resistance genes and biofilm formation. None of the traditionally known effective techniques have been able to efficiently resolve these issues. Hence, development of a highly effective antibacterial practice has become inevitable. One example of a hard-to-eradicate pathogen in dentistry is Enterococcus faecalis, which is one of the most common threats observed in recurrent root canal treatment failures, of which the most problematic to treat are its biofilm-forming VRE strains. An effective response against such infections could be the use of bacteriophages (phages). Phage therapy was found to be highly effective against biofilm and multidrug-resistant bacteria and has other advantages like ease of isolation and possibilities for genetic manipulations. The potential of phage therapy in dentistry, in particular against E. faecalis biofilms in root canals, is almost unexplored. Here we review the efforts to develop phage therapy against biofilms. We also focus on the phages isolated against E. faecalis and discuss the possibility of using phages against E. faecalis biofilm in root canals.
抗生素耐药性是包括牙科在内的所有主要医疗领域都面临的一个日益严重的问题。医院中与耐多药细菌相关的复发性感染，如耐甲氧西林金黄色葡萄球菌、耐碳青霉烯肠杆菌科细菌和耐万古霉素肠球菌（VRE），难以治疗，这对一些知名药物的有效性提出了质疑。这些复发性感染的两个主要原因是获得性抗生素耐药基因和生物膜形成。传统上已知的有效技术都无法有效解决这些问题。因此，开发一种高效的抗菌方法已成为必然。牙科中一种难以根除的病原体是粪肠球菌，它是根管再治疗失败中最常见的威胁之一，其中最难治疗的是其形成生物膜的VRE菌株。针对此类感染的一种有效应对方法可能是使用噬菌体。人们发现噬菌体疗法对生物膜和耐多药细菌非常有效，并且具有其他优点，如易于分离和进行基因操作的可能性。噬菌体疗法在牙科中的潜力，特别是针对根管中粪肠球菌生物膜的潜力，几乎尚未得到探索。在这里，我们回顾了开发针对生物膜的噬菌体疗法的努力。我们还重点介绍了针对粪肠球菌分离出的噬菌体，并讨论了在根管中使用噬菌体对抗粪肠球菌生物膜的可能性。
