Distribution of Ebp pili among clinical and fecal isolates of Enterococcus faecalis and evaluation for human platelet activation.

Although Enterococcus faecalis is known as normal flora in colon, it is also amongst the most common causative agents of infective endocarditis (IE). Platelet activation resulting from adherence to platelets is an essential step in the pathogenesis of IE. One of the factors proposed in adhesion is endocarditis- and biofilm- associated pili encoded by ebp operon. The aim of this study was to investigate ebp in isolates from different origins and analyze the potential of isolates to activate human platelets of different donors. The ebp distribution was investigated in E. faecalis from different origin infections (n = 103) and fecal flora (n = 20). Then, selected isolates from blood (n = 5), urine (n = 2), and fecal flora (n = 3) were analyzed by flow cytometry assay for the ability to activate platelets of four different donors. No statistically significant difference was found for the ebp presence between infective and fecal isolates. Also, it was found that the ability for platelet activation is independent of the bacterial origin. However, significant difference was found in platelet activation between different donors. The results suggest that the presence or absence of ebp is not a critical factor for platelet activation by E. faecalis isolates. However, host factors seem to contribute in this activity.