ArticleArchives of microbiology2026
Harnessing phage-ciprofloxacin synergy to overcome multidrug-resistant infections and biofilm persistence.
Article in Archives of microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Enterococcus faecalis is a Gram-positive opportunistic pathogen commonly associated with hospital-acquired and chronic wound infections. Its capacity for biofilm formation and increasing resistance to standard antibiotics, particularly ciprofloxacin (CIP), complicates treatment. The emergence of CIP-resistant E. faecalis (EFR) strains limits existing antibiotic options and requires alternative treatment approaches. Our study evaluated the antibacterial efficacy of a lytic bacteriophage (φR12EFP) and its combination with CIP against E. faecalis. Phage φR12EFP was isolated from environmental samples and characterized. Transmission electron microscopy revealed an icosahedral tailed morphology. Whole-genome sequencing identified a 58.6 kb linear double-stranded DNA genome with high coding density and no lysogeny-associated genes, confirming its classification within the Saphexavirus genus. φR12EFP exhibited host specificity toward E. faecalis. Growth curve analysis showed the emergence of bacterial resistance after 10 h of phage exposure. Adsorption and one-step growth assays demonstrated rapid host attachment, with a burst size of approximately 356 PFU/cell, and optimal antibacterial activity at a multiplicity of infection (MOI) of 0.1. φR12EFP remained stable between 4 and 60 °C and pH 5-9. A CIP-resistant EFR strain was developed under selective pressure to establish a clinically relevant model. Combined treatment with φR12EFP (MOI 0.1) and low-dose CIP (5 µg/mL) exhibited EFR bacterial suppression and restored antibiotic efficacy. The combination reduced established EFR biofilm by 75% and improved embryo survival to 90-100% in an in ovo infection model compared with φR12EFP monotherapy alone. These findings indicate that φR12EFP restores CIP sensitivity in resistant E. faecalis and supports the use of phage-antibiotic regimens against multidrug-resistant enterococci.
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Registered trials
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