Association of virulence genes with biofilm formation in clinical <i>Enterococcus faecalis</i> isolates: a systematic review and meta-analysis
ARCHIVES OF MICROBIOLOGY, cilt.209, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 209 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00203-026-05261-2
- Dergi Adı: ARCHIVES OF MICROBIOLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, Environment Index, MEDLINE, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Lokman Hekim Üniversitesi Adresli: Evet
Özet
This systematic review and meta-analysis examined association between virulence gene carriage and phenotypic biofilm formation in human clinical Enterococcus faecalis isolates. PubMed, Scopus, and Web of Science databases were searched on April 9, 2026, and the protocol was registered in PROSPERO (CRD420261405485). Eligible studies used microplate-based biofilm assessment, detected virulence genes, and provided extractable 2 & times; 2 data. Random-effects meta-analyses were performed using odds ratios (OR). Twenty-six studies comprising 1848 isolates were included. For strong versus non-strong biofilm formation, esp (OR 2.34, 95% CI 1.32-4.13), efaA (OR 26.28, 95% CI 1.12-614.84), and sprE (OR 3.06, 95% CI 1.18-7.92) showed significant associations, although efaA and sprE estimates were based on few studies and were imprecise. For any biofilm versus no biofilm formation, asa1 (OR 2.55, 95% CI 1.39-4.67), esp (OR 2.71, 95% CI 1.82-4.04), agg (OR 1.87, 95% CI 1.25-2.78), and cylA (OR 2.17, 95% CI 1.20-3.91) were significant. Sensitivity analyses identified esp as the most consistent association, although heterogeneity remained for strong biofilm formation. Gene-biofilm associations were gene-specific and phenotype-dependent. esp positivity alone is insufficient to predict biofilm phenotype because biofilm formation is multifactorial and context dependent.