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Abstract

Enterococcus faecalis (E. faecalis) is a multidrug-resistant bacteria causing endodontic failure. The current study aimed to isolate E. faecalis from endodontic failure cases and determine its antibiotic susceptibility profile. Moreover, it evaluated the anti- E. faecalis potential of F. arabica. Fifty samples were collected from patients with endodontic failure. Ten E. faecalis isolates were successfully confirmed by 16S rRNA. The disk-diffusion method was used to assess antibiotic susceptibility. Agar well diffusion assay was employed to determine the antibacterial activities of methanolic, ethanolic, and distilled water extracts of F. arabica. Sodium hypochlorite (2.5%) and distilled water served as positive and negative controls, respectively. GC–MS analysis was followed by quantum chemical analysis and molecular dynamics (MD) simulation of the selected compounds against the E. faecalis Ace protein. Two compounds (C1 and C2) were subjected to quantum chemical analyses, followed by MD simulations. Statistical analysis using linear mixed effects showed significant differences in antimicrobial susceptibility, extract efficacy, and MIC values (p<0.001). All isolates (100%, n = 10) exhibited complete resistance to vancomycin and tetracycline, whereas 80% (n=8) were susceptible to erythromycin. Conversely, 100% of isolates were sensitive to ampicillin and amoxicillin-clavulanate (p<0.001). In agar well diffusion testing, F. arabica extracts demonstrated comparable antimicrobial activity (padj = 0.624) to 2.5% sodium hypochlorite (padj <0.01) and distilled water (padj <0.001). The MIC assay demonstrated superior potency (26.42 ± µg/mL) compared to that of methanolic extract and sodium hypochlorite (padj <0.005). GC–MS analysis and MD simulations revealed that C1 is a more favorable inhibitor of Ace protein than C2 (phthalic acid) in F. arabica. However, further studies are necessary to assess the clinical efficacy before therapeutic applications.

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