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Raees F, Harun A, Ahmed A, Deris ZZ. Potential Usefulness of Bacteriophages for the Treatment of Multidrug-Resistant Acinetobacter Infection. Malays J Med Sci 2023; 30:7-22. [PMID: 37928784 PMCID: PMC10624448 DOI: 10.21315/mjms2023.30.5.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/11/2022] [Indexed: 11/07/2023] Open
Abstract
Bacteriophages were discovered in early 20th century. However, the interest in bacteriophage research was reduced with the discovery of antibiotics. With the increasing number of infections due to multidrug-resistant (MDR) organisms, the potential usefulness of bacteriophages as therapeutic agents has been re-evaluated. In this review, we found that more than 30 lytic bacteriophages that infect Acinetobacter species have been characterised. These are mainly members of Caudovirales, with genome sizes ranging from 31 kb to 234 kb and G+C contents ranging from 33.5% to 45.5%. The host range can be as low as < 10% of all tested Acinetobacter strains. Fourteen published murine trials indicated positive outcomes in bacteriophage-treated groups. Only two case reports were pertaining to the use of bacteriophages in the treatment of Acinetobacter infections in humans; in both cases, the infections were resolved with bacteriophage therapy. The use of bacteriophages has been associated with reduced Acinetobacter burden in the environment, as shown in two studies. The major limitation of bacteriophage therapy is its highly selective host strain. In conclusion, the potential usefulness of bacteriophage therapy for the treatment of MDR Acinetobacter species has been documented only in limited studies and more research is needed prior to its extensive use in clinical practice.
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Affiliation(s)
- Fahad Raees
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Department of Microbiology, College of Medicine, Umm al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Azian Harun
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | - Abdalla Ahmed
- Department of Microbiology, College of Medicine, Umm al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Zakuan Zainy Deris
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kelantan, Malaysia
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Kolsi A, Haukka K, Dougnon V, Agbankpè AJ, Fabiyi K, Virta M, Skurnik M, Kantele A, Kiljunen S. Isolation and characterization of three novel Acinetobacter baumannii phages from Beninese hospital wastewater. Arch Virol 2023; 168:228. [PMID: 37574509 PMCID: PMC10423700 DOI: 10.1007/s00705-023-05845-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/19/2023] [Indexed: 08/15/2023]
Abstract
Acinetobacter baumannii is an opportunistic pathogen that is mostly associated with hospital-acquired infections. The rapid emergence of multi- and pan-drug-resistant Acinetobacter strains poses an increasing challenge in hospitals. Phage therapy offers one treatment option for infections caused by A. baumannii. We isolated three phages from Beninese hospital wastewater - fBenAci001, fBenAci002, and fBenAci003 - that infected clinical A. baumannii strains from Finnish patients. Phylogenetic analysis showed that these phages resemble phages of the genus Friunavirus, family Autographiviridae. The isolated phages meet the requirements set for phages used for phage therapy. However, they were found to have a narrow host range, which may limit their therapeutic use.
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Affiliation(s)
- Anna Kolsi
- Human Microbiome Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Microbiology, University of Helsinki, Helsinki, Finland
| | - Kaisa Haukka
- Human Microbiome Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Microbiology, University of Helsinki, Helsinki, Finland
| | - Victorien Dougnon
- Research Unit in Applied Microbiology and Pharmacology of natural substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Abomey Calavi, Benin
| | - Alidehou Jerrold Agbankpè
- Research Unit in Applied Microbiology and Pharmacology of natural substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Abomey Calavi, Benin
| | - Kafayath Fabiyi
- Research Unit in Applied Microbiology and Pharmacology of natural substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Abomey Calavi, Benin
| | - Marko Virta
- Department of Microbiology, University of Helsinki, Helsinki, Finland
| | - Mikael Skurnik
- Human Microbiome Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Division of Clinical Microbiology, HUS Diagnostic Center, Hospital District of Helsinki and Uusimaa, Helsinki, Finland
| | - Anu Kantele
- Human Microbiome Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Meilahti Vaccine Research Center MeVac, Infectious Diseases, Helsinki University, Hospital District of Helsinki and Uusimaa, Helsinki, Finland
| | - Saija Kiljunen
- Human Microbiome Research Program, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
- Division of Clinical Microbiology, HUS Diagnostic Center, Hospital District of Helsinki and Uusimaa, Helsinki, Finland.
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Ioannou P, Baliou S, Samonis G. Bacteriophages in Infectious Diseases and Beyond-A Narrative Review. Antibiotics (Basel) 2023; 12:1012. [PMID: 37370331 DOI: 10.3390/antibiotics12061012] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/01/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
The discovery of antibiotics has revolutionized medicine and has changed medical practice, enabling successful fighting of infection. However, quickly after the start of the antibiotic era, therapeutics for infectious diseases started having limitations due to the development of antimicrobial resistance. Since the antibiotic pipeline has largely slowed down, with few new compounds being produced in the last decades and with most of them belonging to already-existing classes, the discovery of new ways to treat pathogens that are resistant to antibiotics is becoming an urgent need. To that end, bacteriophages (phages), which are already used in some countries in agriculture, aquaculture, food safety, and wastewater plant treatments, could be also used in clinical practice against bacterial pathogens. Their discovery one century ago was followed by some clinical studies that showed optimistic results that were limited, however, by some notable obstacles. However, the rise of antibiotics during the next decades left phage research in an inactive status. In the last decades, new studies on phages have shown encouraging results in animals. Hence, further studies in humans are needed to confirm their potential for effective and safe treatment in cases where there are few or no other viable therapeutic options. This study reviews the biology and applications of phages for medical and non-medical uses in a narrative manner.
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Affiliation(s)
- Petros Ioannou
- School of Medicine, University of Crete, 71003 Heraklion, Greece
- Internal Medicine Department, University Hospital of Heraklion, 71110 Heraklion, Greece
| | - Stella Baliou
- School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - George Samonis
- School of Medicine, University of Crete, 71003 Heraklion, Greece
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Rathor N, Bahadur T, Thakur CK, Bamola VD, Das BK, Chaudhry R. Bacteriophages as therapeutic & disinfectant agents to tackle multidrug-resistant Acinetobacter baumannii. Indian J Med Res 2023; 157:549-558. [PMID: 37530310 PMCID: PMC10466484 DOI: 10.4103/ijmr.ijmr_355_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Indexed: 08/03/2023] Open
Abstract
Background & objectives Multidrug-resistant (MDR) Acinetobacter baumannii is a serious threat for human health worldwide. The studies on agents targeting A. baumannii are imperative due to identified A. baumannii co-infections in COVID-19. Bacteriophages are promising antibacterial agents against drug-resistant bacteria. This study intended to isolate bacteriophages against MDR A. baumannii from the water of river Ganga, to be used potentially as therapeutic and disinfectant particles. Methods Acinetobacter phages were isolated from the Ganga water collected from Kanpur and further tested on 50 MDR A. baumannii isolates to determine host range. The phages were morphologically characterized by transmission electron microscopy. The disinfectant property of the isolated phages was tested by spraying of bacteriophage cocktail on MDR A. baumannii contaminated plastic surface, analyzed by colony-forming unit (CFU) and bioluminescence assay (adenosine triphosphate monitoring). Results A total of seven bacteriophages were isolated against MDR A. baumannii. The bacteriophages lysed three MDR A. baumannii isolates out of 50 tested, showing narrow host range. Electron microscopy revealed hexagonal heads and long tails of bacteriophages, belonging to order Caudovirales. The bacteriophage cocktail reduced the MDR A. baumannii load efficiently on plastic surface, evidenced by reduction in CFUs and bioluminescence. Interpretation & conclusions The findings of this study suggest that the isolated bacteriophages are potential lytic agents for MDR A. baumannii clinical isolates, and may be used as potential therapeutic agents as well as disinfectant to combat MDR A. baumannii with due consideration to phage host specificity, with further characterization.
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Affiliation(s)
- Nisha Rathor
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Tej Bahadur
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Chandan Kumar Thakur
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwa Deepak Bamola
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bimal Kumar Das
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rama Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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Challenges in the Hospital Water System and Innovations to Prevent Healthcare-Associated Infections. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2023. [DOI: 10.1007/s40506-023-00261-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Chavignon M, Kolenda C, Medina M, Bonhomme M, Blazere L, Legendre T, Tristan A, Laurent F, Butin M. Bacteriophage-based decontamination to control environmental colonization by Staphylococcus capitis in neonatal intensive care units: An in vitro proof-of-concept. Front Cell Infect Microbiol 2022; 12:1060825. [DOI: 10.3389/fcimb.2022.1060825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
IntroductionIn neonatal intensive care units (NICUs), the standard chemical-based disinfection procedures do not allow a complete eradication of pathogens from environmental surfaces. In particular, the clone Staphylococcus capitis NRCS-A, a significant pathogen in neonates, was shown to colonize neonatal incubators. The aim of this study was to evaluate the in vitro effect of a bacteriophage cocktail on NRCS-A eradication.MethodsThree bacteriophages were isolated, genetically characterized and assessed for their host range using a collection of representative clinical strains (n=31) belonging to the clone NRCS-A. The efficacy of a cocktail including these three bacteriophages to eradicate the reference strain S. capitis NRCS-A CR01 was determined in comparison or in combination with the chemical disinfectant Surfanios Premium on either dry inoculum or biofilm-embedded bacteria. The emergence of bacterial resistance against the bacteriophages alone or in cocktail was evaluated by growth kinetics.ResultsThe three bacteriophages belonged to two families and genera, namely Herelleviridae/Kayvirus for V1SC01 and V1SC04 and Rountreeviridae/Andhravirus for V1SC05. They were active against 17, 25 and 16 of the 31 tested strains respectively. Bacteriophage cocktails decreased the bacterial inoculum of both dry spots and biofilms, with a dose dependent effect. The sequential treatment with bacteriophages then Surfanios Premium did not show enhanced efficacy. No bacterial resistance was observed when using the bacteriophage cocktail.DiscussionThis study established a proof-of-concept for the use of bacteriophages to fight against S. capitis NRCS-A. Further investigations are needed using a larger bacterial collection and in real-life conditions before being able to use such technology in NICUs
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Jiang Y, Ding Y, Wei Y, Jian C, Liu J, Zeng Z. Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit. Front Microbiol 2022; 13:1045206. [PMID: 36439795 PMCID: PMC9684325 DOI: 10.3389/fmicb.2022.1045206] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/24/2022] [Indexed: 07/30/2023] Open
Abstract
Carbapenem-resistant Acinetobacter baumannii (CRAB) has become one of the leading causes of healthcare-associated infections globally, particularly in intensive care units (ICUs). Cross-transmission of microorganisms between patients and the hospital environment may play a crucial role in ICU-acquired CRAB colonization and infection. The control and treatment of CRAB infection in ICUs have been recognized as a global challenge because of its multiple-drug resistance. The main concern is that CRAB infections can be disastrous for ICU patients if currently existing limited therapeutic alternatives fail in the future. Therefore, the colonization, infection, transmission, and resistance mechanisms of CRAB in ICUs need to be systematically studied. To provide a basis for prevention and control countermeasures for CRAB infection in ICUs, we present an overview of research on CRAB in ICUs, summarize clinical infections and environmental reservoirs, discuss the drug resistance mechanism and homology of CRAB in ICUs, and evaluate contemporary treatment and control strategies.
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Rahimzadeh G, Zazouli MA, Rezai MS. Potential of lytic bacteriophages as disinfectant to control of Pseudomonas aeruginosa on fomites. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2022; 20:219-225. [PMID: 35669812 PMCID: PMC9163256 DOI: 10.1007/s40201-021-00770-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/18/2021] [Indexed: 06/15/2023]
Abstract
PURPOSE Nosocomial infections can be transmitted by contaminated hospital surfaces with resistant pathogens. Pseudomonas aeruginosa (P. aeruginosa) is an opportunistic pathogen that causes public healthcare issues. Conventional sanitation is not efficiently contributing to removing resistant pathogens. Bacteriophages suggest safe and specific decontamination. Bacteriophages are a promising alternative strategy to chemical biocides. This research aimed to evaluate the potential of phage in controlling P. aeruginosa in infected hard surfaces. METHODS Bacteriophage was isolated from hospital wastewater. The efficiency lytic activity of phage against P. aeruginosa was assessed on various infected hard surfaces as plastic and ceramic. 50 µl of the phage lysate (2 × 1012 PFU/mL) and 50 µl of 70% Ethanol solution separately were spread on the different infected surfaces. After 15 min, 1, 3, 6, and 24 h, surfaces were directly sampled by contact plates. The bacterial load was evaluated by enumerating plate CFU. RESULTS Cystoviridae phages with titer (2 × 1012 PFU/mL) efficiently can reduce P. aeruginosa on contaminated surfaces. The treated surfaces with 70% Ethanol solution and phage showed an evident drop in bacterial cell number. CONCLUSIONS Bacteriophages can be used as a new option for the development of biological products aimed at the control and deletion of pathogens on contaminated hard surfaces.
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Affiliation(s)
- Golnar Rahimzadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Ali Zazouli
- Department of Environmental Health Engineering, Faculty of Health, Mazandaran University of Medical Science, Sari, Iran
| | - Mohammad Sadegh Rezai
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Chen LK, Chang JC, Chu HT, Chen YT, Jiang HL, Wang LS, Teh SH, Yang HH, Chen DS, Li YZ, Chang CC, Sankhla D, Tseng CC. Preoptimized phage cocktail for use in aerosols against nosocomial transmission of carbapenem-resistant Acinetobacter baumannii: A 3-year prospective intervention study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 236:113476. [PMID: 35367880 DOI: 10.1016/j.ecoenv.2022.113476] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
Using bacteriophages (phages) as environmental sanitizers has been recognized as a potential alternative method to remove bacterial contamination in vitro; however, very few studies are available on the application of phages for infection control in hospitals. Here, we performed a 3-year prospective intervention study using aerosolized phage cocktails as biocontrol agents against carbapenem-resistant Acinetobacter baumannii (CRAB) infection in the hospital. When a CRAB-infected patient was identified in an intensive care unit (ICU), their surrounding environment was chosen for phage aerosol decontamination. Before decontamination, 501 clinical specimens from the patients were subjected to antibiotic resistance analysis and phage typing. The optimal phage cocktails were a combination of different phage families or were constructed by next-evolutionary phage typing with the highest score for the host lysis zone to prevent the development of environmental CRAB phage resistance. The phage infection percentage of the antibiotic-resistant A. baumannii strains was 97.1%, whereas the infection percentage in the antibiotic-susceptible strains was 79.3%. During the phage decontamination periods from 2017 to 2019, the percentage of carbapenem-resistant A. baumannii in test ICUs decreased significantly from 65.3% to 55%. The rate of new acquisitions of CRAB infection over the three years was 4.4 per 1000 patient-days, which was significantly lower than that in the control wards (8.9 per 1000 patient-days) where phage decontamination had never been performed. In conclusion, our results support the potential of phage cocktails to decrease CRAB infection rates, and the aerosol generation process may make this approach more comprehensive and time-saving.
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Affiliation(s)
- Li-Kuang Chen
- Institute of Medical Sciences, Department of Laboratory Diagnostic, College of Medicine, Tzu Chi University, Hualien, Taiwan; Branch of Clinical Pathology, Department of Laboratory Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| | - Jui-Chih Chang
- Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Zhongyang Rd., Hualien, Taiwan; Department of Surgery, School of Medicine, Tzu Chi University, No. 701, Section 3, Zhongyang Rd., Hualien, Taiwan.
| | - Hsiu-Tzu Chu
- Department of Laboratory Medicine, Clinical Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Department and Graduate Institute of Public Health, Tzu Chi University, Hualien, Taiwan.
| | - Yi-Ting Chen
- Department and Graduate Institute of Public Health, Tzu Chi University, Hualien, Taiwan.
| | - Hui-Li Jiang
- Unit of Infection Control and Management, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| | - Lih-Shinn Wang
- Division of Infectious Diseases, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| | - Soon-Hian Teh
- Division of Infectious Diseases, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| | - Hui-Hua Yang
- Bioinnovation Center, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
| | - Dar-Sen Chen
- School of Pharmacy, China Medical University, Taiwan.
| | - Yu-Zhong Li
- Department of Laboratory Medicine, Clinical Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| | - Chin-Cheng Chang
- Department of Laboratory Medicine, Clinical Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| | - Debangana Sankhla
- Department of Laboratory Medicine, Clinical Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
| | - Chun-Chieh Tseng
- Department and Graduate Institute of Public Health, Tzu Chi University, Hualien, Taiwan.
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Thomas RE, Thomas BC. Reducing Biofilm Infections in Burn Patients' Wounds and Biofilms on Surfaces in Hospitals, Medical Facilities and Medical Equipment to Improve Burn Care: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13195. [PMID: 34948803 PMCID: PMC8702030 DOI: 10.3390/ijerph182413195] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 11/21/2022]
Abstract
Biofilms in burns are major problems: bacterial communities rapidly develop antibiotic resistance, and 60% of burn mortality is attributed to biofilms. Key pathogens are Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and multidrug-resistant Acinetobacter baumanii. Purpose: identify current and novel interventions to reduce biofilms on patients' burns and hospital surfaces and equipment. Medline and Embase were searched without date or language limits, and 31 possible interventions were prioritised: phages, nano-silver, AgSD-NLs@Cur, Acticoat and Mepilex silver, acetic acid, graphene-metal combinations, CuCo2SO4 nanoparticles, Chlorhexidene acetate nanoemulsion, a hydrogel with moxifloxacin, carbomer, Chitosan and Boswellia, LED light therapy with nano-emodin or antimicrobial blue light + Carvacrol to release reactive oxygen species, mannosidase + trypsin, NCK-10 (a napthalene compound with a decyl chain), antimicrobial peptide PV3 (includes two snake venoms), and polypeptides P03 and PL2. Most interventions aimed to penetrate cell membranes and reported significant reductions in biofilms in cfu/mL or biofilm mass or antibiotic minimal inhibitory concentrations or bacterial expression of virulence or quorum sensing genes. Scanning electron microscopy identified important changes in bacterial surfaces. Patients with biofilms need isolating and treating before full admission to hospital. Cleaning and disinfecting needs to include identifying biofilms on keyboards, tablets, cell phones, medical equipment (especially endoscopes), sinks, drains, and kitchens.
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Affiliation(s)
- Roger E. Thomas
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
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Alomari MMM, Dec M, Urban-Chmiel R. Bacteriophages as an Alternative Method for Control of Zoonotic and Foodborne Pathogens. Viruses 2021; 13:2348. [PMID: 34960617 PMCID: PMC8709489 DOI: 10.3390/v13122348] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022] Open
Abstract
The global increase in multidrug-resistant infections caused by various pathogens has raised concerns in human and veterinary medicine. This has renewed interest in the development of alternative methods to antibiotics, including the use of bacteriophages for controlling bacterial infections. The aim of this review is to present potential uses of bacteriophages as an alternative to antibiotics in the control of bacterial infections caused by multidrug-resistant bacteria posing a risk to humans, with particular emphasis on foodborne and zoonotic pathogens. A varied therapeutic and immunomodulatory (activation or suppression) effect of bacteriophages on humoral and cellular immune response mechanisms has been demonstrated. The antibiotic resistance crisis caused by global antimicrobial resistance among bacteria creates a compelling need for alternative safe and selectively effective antibacterial agents. Bacteriophages have many properties indicating their potential suitability as therapeutic and/or prophylactic agents. In many cases, bacteriophages can also be used in food quality control against microorganisms such as Salmonella, Escherichia coli, Listeria, Campylobacter and others. Future research will provide potential alternative solutions using bacteriophages to treat infections caused by multidrug-resistant bacteria.
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Affiliation(s)
| | - Marta Dec
- Department of Veterinary Prevention and Avian Diseases, Faculty of Veterinary Medicine University of Life Sciences in Lublin, 20-033 Lublin, Poland;
| | - Renata Urban-Chmiel
- Department of Veterinary Prevention and Avian Diseases, Faculty of Veterinary Medicine University of Life Sciences in Lublin, 20-033 Lublin, Poland;
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Deka D, Annapure US, Shirkole SS, Thorat BN. Bacteriophages: An organic approach to food decontamination. J FOOD PROCESS PRES 2021. [DOI: 10.1111/jfpp.16101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Darshana Deka
- Department of Food Engineering and Technology Institute of Chemical Technology Mumbai, ICT – IOC Campus Bhubaneswar India
| | - U. S. Annapure
- Department of Food Engineering and Technology Institute of Chemical Technology Mumbai India
| | - S. S. Shirkole
- Department of Food Engineering and Technology Institute of Chemical Technology Mumbai, ICT – IOC Campus Bhubaneswar India
| | - B. N. Thorat
- Department of Food Engineering and Technology Institute of Chemical Technology Mumbai, ICT – IOC Campus Bhubaneswar India
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13
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Chakraborty S, Dutta H. Use of nature‐derived antimicrobial substances as safe disinfectants and preservatives in food processing industries: A review. J FOOD PROCESS PRES 2021. [DOI: 10.1111/jfpp.15999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Himjyoti Dutta
- Department of Food Technology Mizoram University Aizawl India
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Gkartziou F, Giormezis N, Spiliopoulou I, Antimisiaris SG. Nanobiosystems for Antimicrobial Drug-Resistant Infections. NANOMATERIALS 2021; 11:nano11051075. [PMID: 33922004 PMCID: PMC8143556 DOI: 10.3390/nano11051075] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 02/07/2023]
Abstract
The worldwide increased bacterial resistance toward antimicrobial therapeutics has led investigators to search for new therapeutic options. Some of the options currently exploited to treat drug-resistant infections include drug-associated nanosystems. Additionally, the use of bacteriophages alone or in combination with drugs has been recently revisited; some studies utilizing nanosystems for bacteriophage delivery have been already reported. In this review article, we focus on nine pathogens that are the leading antimicrobial drug-resistant organisms, causing difficult-to-treat infections. For each organism, the bacteriophages and nanosystems developed or used in the last 20 years as potential treatments of pathogen-related infections are discussed. Summarizing conclusions and future perspectives related with the potential of such nano-antimicrobials for the treatment of persistent infections are finally highlighted.
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Affiliation(s)
- Foteini Gkartziou
- Institute of Chemical Engineering, FORTH/ICES, Platani, 26504 Patras, Greece;
| | - Nikolaos Giormezis
- National Reference Centre for Staphylococci, School of Medicine, University of Patras, 26504 Patras, Greece;
| | - Iris Spiliopoulou
- National Reference Centre for Staphylococci, School of Medicine, University of Patras, 26504 Patras, Greece;
- Department of Microbiology, School of Medicine, University of Patras, 26504 Patras, Greece
- Correspondence: (I.S.); (S.G.A.)
| | - Sophia G. Antimisiaris
- Institute of Chemical Engineering, FORTH/ICES, Platani, 26504 Patras, Greece;
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, University of Patras, 26504 Patras, Greece
- Correspondence: (I.S.); (S.G.A.)
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Affiliation(s)
- Sophia Häfner
- University of Copenhagen, BRIC Biotech Research & Innovation Centre, Lund Group, 2200 Copenhagen, Denmark.
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16
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Wu N, Zhu T. Potential of Therapeutic Bacteriophages in Nosocomial Infection Management. Front Microbiol 2021; 12:638094. [PMID: 33633717 PMCID: PMC7901949 DOI: 10.3389/fmicb.2021.638094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/11/2021] [Indexed: 01/05/2023] Open
Abstract
Nosocomial infections (NIs) are hospital-acquired infections which pose a high healthcare burden worldwide. The impact of NIs is further aggravated by the global spread of antimicrobial resistance (AMR). Conventional treatment and disinfection agents are often insufficient to catch up with the increasing AMR and tolerance of the pathogenic bacteria. This has resulted in a need for alternative approaches and raised new interest in therapeutic bacteriophages (phages). In contrast to the limited clinical options available against AMR bacteria, the extreme abundance and biodiversity of phages in nature provides an opportunity to establish an ever-expanding phage library that collectively provides sustained broad-spectrum and poly microbial coverage. Given the specificity of phage-host interactions, phage susceptibility testing can serve as a rapid and cost-effective method for bacterial subtyping. The library can also provide a database for routine monitoring of nosocomial infections as a prelude to preparing ready-to-use phages for patient treatment and environmental sterilization. Despite the remaining obstacles for clinical application of phages, the establishment of phage libraries, pre-stocked phage vials prepared to good manufacturing practice (GMP) standards, and pre-optimized phage screening technology will facilitate efforts to make phages available as modern medicine. This may provide the breakthrough needed to demonstrate the great potential in nosocomial infection management.
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Affiliation(s)
- Nannan Wu
- Shanghai Institute of Phage, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Tongyu Zhu
- Shanghai Institute of Phage, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Organ Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China
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17
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Ssekatawa K, Byarugaba DK, Kato CD, Wampande EM, Ejobi F, Tweyongyere R, Nakavuma JL. A review of phage mediated antibacterial applications. ALEXANDRIA JOURNAL OF MEDICINE 2020. [DOI: 10.1080/20905068.2020.1851441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Kenneth Ssekatawa
- College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
- Department of Biochemistry, Faculty of Biomedical Sciences, Kampala International University-Western Campus, Bushenyi
- African Center of Excellence in Materials Product Development and Nanotechnology (MAPRONANO ACE), College of Engineering Design Art and Technology, Makerere University, Kampala, Uganda
| | - Denis K. Byarugaba
- College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Charles D. Kato
- College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Eddie M. Wampande
- College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Francis Ejobi
- College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Robert Tweyongyere
- College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Jesca L. Nakavuma
- College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
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18
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Martins WM, Toleman MA, Gales AC. Clinical utilization of bacteriophages: a new perspective to combat the antimicrobial resistance in Brazil. Braz J Infect Dis 2020; 24:239-246. [PMID: 32422119 PMCID: PMC9392036 DOI: 10.1016/j.bjid.2020.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/08/2020] [Accepted: 04/11/2020] [Indexed: 01/13/2023] Open
Abstract
Due to the emergence of multi-drug resistant bacteria, and the evident limitation in therapeutic options, alternatives to combat bacterial infections have been sought. One of these is phage therapy, which is the use of bacterial viruses to kill pathogenic bacteria responsible for the infection. These viruses called bacteriophages are very abundant organisms in the world and are harmless to humans. There are several advantages in using phage therapy, especially against multi-drug resistant pathogens, which tend to be dominated by individual strains. The advantages include fewer collateral effects such as lower disturbance of gut microbiota and less antimicrobials consumption, which itself leads to reducing antibiotic resistance rates. Unfortunately, few clinical studies have been initiated in Brazil and this area is little explored in our country. This manuscript describes clinical evidence of successful phage utilization on pathogens considered a threat in Brazil, highlighting the benefits of a possible phage utilization as an important tool to combat antimicrobial resistance in our country.
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19
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Butler DA, Biagi M, Tan X, Qasmieh S, Bulman ZP, Wenzler E. Multidrug Resistant Acinetobacter baumannii: Resistance by Any Other Name Would Still be Hard to Treat. Curr Infect Dis Rep 2019; 21:46. [PMID: 31734740 DOI: 10.1007/s11908-019-0706-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Acinetobacter baumannii (AB) is an infamous nosocomial pathogen with a seemingly limitless capacity for antimicrobial resistance, leading to few treatment options and poor clinical outcomes. The debatably low pathogenicity and virulence of AB are juxtaposed by its exceptionally high rate of infection-related mortality, likely due to delays in time to effective antimicrobial therapy secondary to its predilection for resistance to first-line agents. Recent studies of AB and its infections have led to a burgeoning understanding of this critical microbial threat and provided clinicians with new ammunition for which to target this elusive pathogen. This review will provide an update on the virulence, resistance, diagnosis, and treatment of multidrug resistant (MDR) AB. RECENT FINDINGS Advances in bacterial genomics have led to a deeper understanding of the unique mechanisms of resistance often present in MDR AB and how they may be exploited by new antimicrobials or optimized combinations of existing agents. Further, improvements in rapid diagnostic tests (RDTs) and their more pervasive use in combination with antimicrobial stewardship interventions have allowed for more rapid diagnosis of AB and decreases in time to effective therapy. Unfortunately, there remains a paucity of high-quality clinical data for which to inform the optimal treatment of MDR AB infections. In fact, recently completed studies have failed to identify a combination regimen that is consistently superior to monotherapy, despite the benefits demonstrated in vitro. Encouragingly, new and updated guidelines offer strategies for the treatment of MDR AB and may help to harmonize the use of high toxicity agents such as the polymyxins. Finally, new antimicrobial agents such as eravacycline and cefiderocol have promising in vitro activity against MDR AB but their place in therapy for these infections remains to be determined. Notwithstanding available clinical trial data, polymyxin-based combination therapies with either a carbapenem, minocycline, or eravacycline remain the treatment of choice for MDR, particularly carbapenem-resistant, AB. Incorporating antimicrobial stewardship intervention with RDTs relevant to MDR AB can help avoid potentially toxic combination therapies and catalyze the most important modifiable risk factor for mortality-time to effective therapy. Further research efforts into pharmacokinetic/pharmacodynamic-based dose optimization and clinical outcomes data for MDR AB continue to be desperately needed.
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Affiliation(s)
- David A Butler
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL, 60612, USA
| | - Mark Biagi
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL, 60612, USA
| | - Xing Tan
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL, 60612, USA
| | - Samah Qasmieh
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL, 60612, USA
| | - Zackery P Bulman
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL, 60612, USA
| | - Eric Wenzler
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL, 60612, USA.
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20
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Pacífico C, Hilbert M, Sofka D, Dinhopl N, Pap IJ, Aspöck C, Hilbert F. Characterization of Bacteria and Inducible Phages in an Intensive Care Unit. J Clin Med 2019; 8:E1433. [PMID: 31510095 PMCID: PMC6780966 DOI: 10.3390/jcm8091433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 09/08/2019] [Indexed: 12/29/2022] Open
Abstract
Intensive care units (ICUs) are critical locations for the transmission of pathogenic and opportunistic microorganisms. Bacteria may develop a synergistic relationship with bacteriophages and more effectively resist various stresses, enabling them to persist despite disinfection and antimicrobial treatment. We collected 77 environmental samples from the surroundings of 12 patients with infection/colonizations by Escherichia coli, Staphylococcus aureus or Klebsiella spp in an ICU in Austria. Surface swabs were tested for lytic phages and bacterial isolates for mitomycin C-inducible prophages. No lytic bacteriophages were detected, but S. aureus was isolated from the surroundings of all patients. About 85% of the colonies isolated from surface samples were resistant to antimicrobials, with 94% of them multidrug resistant. Two inducible temperate bacteriophages-myovirus vB_EcoM_P5 and siphovirus vB_SauS_P9-were recovered from two clinical isolates. Staphylococci phage vB_SauS_P9 lysed S. aureus isolates from the surface swabs collected from the surroundings of three patients. No transductants were obtained on propagation in phage-sensitive antimicrobial-resistant isolates. The two phages were sensitive to 0.25% (v/v) of the disinfectant TPH Protect, which eliminated viable phages after 15 min. Coliphage vB_EcoM_P5 was inactivated at 70 °C and staphylococci phage vB_SauS_P9 at 60 °C after 60 min.
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Affiliation(s)
- Cátia Pacífico
- Department of Farm Animals and Veterinary Public Health, University of Veterinary Medicine, 1210 Vienna, Austria
- Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
| | - Miriam Hilbert
- Department of Farm Animals and Veterinary Public Health, University of Veterinary Medicine, 1210 Vienna, Austria
- Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
| | - Dmitrij Sofka
- Department of Farm Animals and Veterinary Public Health, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Nora Dinhopl
- Department of Pathobiology, University of Veterinary Medicine, 1210 Vienna, Austria
| | - Ildiko-Julia Pap
- Institute of Hygiene and Microbiology, University Clinic St. Pölten, 3100 St. Pölten, Austria
| | - Christoph Aspöck
- Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria
- Institute of Hygiene and Microbiology, University Clinic St. Pölten, 3100 St. Pölten, Austria
| | - Friederike Hilbert
- Department of Farm Animals and Veterinary Public Health, University of Veterinary Medicine, 1210 Vienna, Austria.
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21
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Tseng CC, Chang DC, Chang KC. Development of a Biocontrol Method Applying Bacteriophage-Containing Aerosol against Mycobacterium tuberculosis Using the Bacteriophage BTCU-1 and M. smegmatis as Models. Microorganisms 2019; 7:microorganisms7080237. [PMID: 31382591 PMCID: PMC6722745 DOI: 10.3390/microorganisms7080237] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/29/2019] [Accepted: 08/02/2019] [Indexed: 12/20/2022] Open
Abstract
The application of bacteriophages for biocontrol has attracted increasing attention. Here, we applied ϕBTCU-1 as a model phage to develop a method for controlling Mycobacterium tuberculosis (MTB) by using a bacteriophage-containing aerosol in a chamber study. The soil-isolated ϕBTCU-1 can infect both MTB and Mycobacterium smegmatis. Our study used M. smegmatis as an MTB surrogate for safety reasons. Among all the evaluated air samplers, the Andersen impactor was chosen to evaluate the bactericidal efficiency of ϕBTCU-1 against M. smegmatis since the recovery rates of the Andersen impactor were 1.5 to 10.6 times higher than those of sampling filters. When airborne ϕBTCU-1 with the highest concentration of 109 PFU/m3 challenged M. smegmatis (105 CFU/m3) for 10 s, no M. smegmatis colony was recovered from the culture medium. For surface decontamination, no colony of M. smegmatis, which started at 1000 CFU/plate (63.6 cm2), was recovered when exposed to higher ϕBTCU-1 concentrations (>109 PFU/m3) for 60 min. Bacteriophages may be useful for reducing MTB contamination in the air or on hard surfaces. The method we have established suggests that the biocontrol method may be an alternative approach or may be combined with other disinfection methods to prevent MTB infection.
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Affiliation(s)
- Chun-Chieh Tseng
- Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97071, Taiwan.
| | - Dan Chi Chang
- Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97071, Taiwan
| | - Kai-Chih Chang
- Department of Laboratory Medicine and Biotechnology, Tzu Chi University, Hualien 97071, Taiwan
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22
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Specific and Selective Bacteriophages in the Fight against Multidrug-resistant Acinetobacter baumannii. Virol Sin 2019; 34:347-357. [PMID: 31093881 DOI: 10.1007/s12250-019-00125-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/29/2019] [Indexed: 01/21/2023] Open
Abstract
Acinetobacter baumannii causes serious infections especially in immunocompromised and/or hospitalized patients. Several A. baumannii strains are multidrug resistant and infect wounds, bones, and the respiratory tract. Current studies are focused on finding new effective agents against A. baumannii. Phage therapy is a promising means to fight this bacterium and many studies on procuring and applying new phages against A. baumannii are currently being conducted. As shown in animal models, phages against multidrug-resistant A. baumannii may control bacterial infections caused by this pathogen and may be a real hope to solve this dangerous health problem.
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23
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D'Accolti M, Soffritti I, Lanzoni L, Bisi M, Volta A, Mazzacane S, Caselli E. Effective elimination of Staphylococcal contamination from hospital surfaces by a bacteriophage-probiotic sanitation strategy: a monocentric study. Microb Biotechnol 2019; 12:742-751. [PMID: 31025530 PMCID: PMC6559196 DOI: 10.1111/1751-7915.13415] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/29/2019] [Accepted: 04/06/2019] [Indexed: 01/09/2023] Open
Abstract
Persistent contamination of hospital surfaces and antimicrobial resistance (AMR) is recognized as major causes of healthcare‐associated infections (HAI). We recently showed that probiotic‐based sanitation (PCHS) can stably decrease surface pathogens and reduce AMR and HAIs. However, PCHS action is slow and non‐specific. By contrast, bacteriophages have been proposed as a decontamination method as they can rapidly attack specific targets, but their routine application has never been tested. Here, we analysed the feasibility and effectiveness of phage addition to PCHS sanitation, aiming to obtain a rapid and stable abatement of specific pathogens in the hospital environment. Staphylococcal contamination in the bathrooms of General Medicine wards was analysed, being those areas the most contaminated and Staphylococci the most prevalent bacteria in such settings. Results showed that a daily phage application by nebulization induced a rapid and significant decrease in Staphylococcus spp. load on treated surfaces, up to 97% more than PCHS alone (P < 0.001), suggesting that such a system might be considered as a part of prevention and control strategies, to counteract outbreaks of specific pathogens and prevent associated infections.
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Affiliation(s)
- Maria D'Accolti
- Section of Microbiology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Department of Architecture and Department of Medical Sciences, CIAS, University of Ferrara, Ferrara, Italy
| | - Irene Soffritti
- Section of Microbiology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Department of Architecture and Department of Medical Sciences, CIAS, University of Ferrara, Ferrara, Italy
| | - Luca Lanzoni
- Department of Architecture and Department of Medical Sciences, CIAS, University of Ferrara, Ferrara, Italy
| | - Matteo Bisi
- Department of Architecture and Department of Medical Sciences, CIAS, University of Ferrara, Ferrara, Italy
| | - Antonella Volta
- Department of Architecture and Department of Medical Sciences, CIAS, University of Ferrara, Ferrara, Italy
| | - Sante Mazzacane
- Department of Architecture and Department of Medical Sciences, CIAS, University of Ferrara, Ferrara, Italy
| | - Elisabetta Caselli
- Section of Microbiology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Department of Architecture and Department of Medical Sciences, CIAS, University of Ferrara, Ferrara, Italy
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24
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Isler B, Doi Y, Bonomo RA, Paterson DL. New Treatment Options against Carbapenem-Resistant Acinetobacter baumannii Infections. Antimicrob Agents Chemother 2019; 63:e01110-18. [PMID: 30323035 PMCID: PMC6325237 DOI: 10.1128/aac.01110-18] [Citation(s) in RCA: 166] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 10/08/2018] [Indexed: 01/08/2023] Open
Abstract
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a perilous nosocomial pathogen causing substantial morbidity and mortality. Current treatment options for CRAB are limited and suffer from pharmacokinetic limitations, such as high toxicity and low plasma levels. As a result, CRAB is declared as the top priority pathogen by the World Health Organization for the investment in new drugs. This urgent need for new therapies, in combination with faster FDA approval process, accelerated new drug development and placed several drug candidates in the pipeline. This article reviews available information about the new drugs and other therapeutic options focusing on agents in clinical or late-stage preclinical studies for the treatment of CRAB, and it evaluates their expected benefits and potential shortcomings.
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Affiliation(s)
- Burcu Isler
- Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Yohei Doi
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Robert A Bonomo
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA
- Case Western Reserve University Veterans Affairs Center of Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA
| | - David L Paterson
- The University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Campus, Brisbane, Queensland, Australia
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25
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D'Accolti M, Soffritti I, Piffanelli M, Bisi M, Mazzacane S, Caselli E. Efficient removal of hospital pathogens from hard surfaces by a combined use of bacteriophages and probiotics: potential as sanitizing agents. Infect Drug Resist 2018; 11:1015-1026. [PMID: 30104889 PMCID: PMC6071622 DOI: 10.2147/idr.s170071] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Purpose Many hospital-acquired infections (HAIs) can be transmitted by pathogens contaminating hospital surfaces, not efficiently controlled by conventional sanitation, which can indeed contribute to the selection of MDR strains. Bacteriophages have been suggested as decontaminating agents, based on their selective ability to kill specific bacteria. However, there are no data on their stability in detergents and their potential use in routine sanitation. On the other hand, a probiotic-based sanitation system (Probiotic Cleaning Hygiene System, PCHS) was recently shown to stably reduce pathogens on treated surfaces. However, its action is not specific and slow, being based on competitive antagonism. This work aimed to assess the effectiveness of a combined use of phages and PCHS in removing HAI-associated pathogens from different hard surfaces. Materials and methods The decontamination ability of phages in PCHS was tested in vitro and in situ, against drug-susceptible or resistant Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa strains, and using bacterial densities similar to those detected on hospital surfaces. Results Phages targeted efficiently all tested bacteria, maintaining their full activity when added to the PCHS detergent. Notably, the combined use of phages and PCHS not only resulted in a rapid reduction (up to >90%) of the targeted pathogens, but also, due to the stabilizing effect of probiotics, the pathogens were maintained at low levels (>99%) at later times too, when instead the effect of phages tends to diminish. Conclusion These results suggest that a combined biological system might be successfully used in hospital sanitation protocols, potentially leading to effective and safe elimination of MDR pathogens from the hospital environment.
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Affiliation(s)
- Maria D'Accolti
- CIAS Interdepartmental Centre, Department of Medical Sciences, University of Ferrara, Ferrara, Italy,
| | - Irene Soffritti
- CIAS Interdepartmental Centre, Department of Medical Sciences, University of Ferrara, Ferrara, Italy,
| | - Micol Piffanelli
- CIAS Interdepartmental Centre, Department of Medical Sciences, University of Ferrara, Ferrara, Italy,
| | - Matteo Bisi
- CIAS Interdepartmental Centre, Department of Medical Sciences, University of Ferrara, Ferrara, Italy,
| | - Sante Mazzacane
- CIAS Interdepartmental Centre, Department of Medical Sciences, University of Ferrara, Ferrara, Italy,
| | - Elisabetta Caselli
- CIAS Interdepartmental Centre, Department of Medical Sciences, University of Ferrara, Ferrara, Italy, .,Section of Microbiology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy,
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26
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Schilling T, Dietrich S, Hoppert M, Hertel R. A CRISPR-Cas9-Based Toolkit for Fast and Precise In Vivo Genetic Engineering of Bacillus subtilis Phages. Viruses 2018; 10:v10050241. [PMID: 29734705 PMCID: PMC5977234 DOI: 10.3390/v10050241] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/29/2018] [Accepted: 05/01/2018] [Indexed: 12/13/2022] Open
Abstract
Phages are currently under discussion as a solution for the antibiotic crisis, as they may cure diseases caused by multi-drug-resistant pathogens. However, knowledge of phage biology and genetics is limited, which impedes risk assessment of therapeutic applications. In order to enable advances in phage genetic research, the aim of this work was to create a toolkit for simple and fast genetic engineering of phages recruiting Bacillus subtilis as host system. The model organism B. subtilis represents a non-pathogenic surrogate of its harmful relatives, such as Bacillus anthracis or Bacillus cereus. This toolkit comprises the application CutSPR, a bioinformatic tool for rapid primer design, and facilitates the cloning of specific CRISPR-Cas9-based mutagenesis plasmids. The employment of the prophage-free and super-competent B. subtilis TS01 strain enables an easy and fast introduction of specific constructs for in vivo phage mutagenesis. Clean gene deletions and a functional clean gene insertion into the genome of the model phage vB_BsuP-Goe1 served as proof of concept and demonstrate reliability and high efficiency. The here presented toolkit allows comprehensive investigation of the diverse phage genetic pool, a better understanding of phage biology, and safe phage applications.
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Affiliation(s)
- Tobias Schilling
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, 37077 Göttingen, Germany.
| | - Sascha Dietrich
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, 37077 Göttingen, Germany.
| | - Michael Hoppert
- Department of General Microbiology, Institute of Microbiology and Genetics, Georg-August-University Göttingen, 37077 Göttingen, Germany.
| | - Robert Hertel
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University Göttingen, 37077 Göttingen, Germany.
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27
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Chen LK, Kuo SC, Chang KC, Cheng CC, Yu PY, Chang CH, Chen TY, Tseng CC. Clinical Antibiotic-resistant Acinetobacter baumannii Strains with Higher Susceptibility to Environmental Phages than Antibiotic-sensitive Strains. Sci Rep 2017; 7:6319. [PMID: 28740225 PMCID: PMC5524697 DOI: 10.1038/s41598-017-06688-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/12/2017] [Indexed: 12/26/2022] Open
Abstract
Antibiotic-resistant Acinetobacter baumannii is associated with nosocomial infections worldwide. Here, we used clinically isolated A. baumannii strains as models to demonstrate whether antibiotic resistance is correlated with an increased susceptibility to bacteriophages. In this study, 24 active phages capable of infecting A. baumannii were isolated from various environments, and the susceptibilities of both antibiotic-sensitive and antibiotic-resistant strains of A. baumannii to different phages were compared. In our study, a total of 403 clinically isolated A. baumannii strains were identified. On average, the phage infection percentage of the antibiotic-resistant A. baumannii strains was 84% (from 81–86%), whereas the infection percentage in the antibiotic-sensitive A. baumannii strains was only 56.5% (from 49–64%). In addition, the risk of phage infection for A. baumannii was significantly increased in the strains that were resistant to at least four antibiotics and exhibited a dose-dependent response (p-trend < 0.0001). Among all of the A. baumannii isolates, 75.6% were phage typeable. The results of phage typing might also reveal the antibiotic-resistant profiles of clinical A. baumannii strains. In conclusion, phage susceptibility represents an evolutionary trade-off in A. baumannii strains that show adaptations for antibiotic resistance, particularly in medical environments that have high antibiotic use.
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Affiliation(s)
- Li-Kuang Chen
- Institute of Medical Sciences, Department of Laboratory Diagnostic, College of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Laboratory Medicine, Clinical Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Shu-Chen Kuo
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan
| | - Kai-Chih Chang
- Department of Laboratory Medicine and Biotechnology, Tzu Chi University, Hualien, Taiwan
| | - Chieh-Chen Cheng
- Department and Graduate Institute of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Pei-Ying Yu
- Department and Graduate Institute of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Chih-Hui Chang
- Department and Graduate Institute of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Tren-Yi Chen
- Emergency Department, Changhua Christian Hospital, Changhua, Taiwan
| | - Chun-Chieh Tseng
- Department and Graduate Institute of Public Health, Tzu Chi University, Hualien, Taiwan.
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