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Ronit A, Porskrog A, Djebara S, Bergmann S, Pirnay JP, Merabishvili M, Barfod TS, Thomsen K, Brandt CT. Bacteriophages for the treatment of pseudomonas-infected vascular prosthesis. Ugeskr Laeger 2024; 186:V09230617. [PMID: 38305316 DOI: 10.61409/v09230617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
We present a case report detailing therapeutic application of two lytic antipseudomonal bacteriophages to treat a chronic relapsing Pseudomonas aeruginosa infection of a prosthetic aortic graft. As there are currently no Danish laboratories offering phages for clinical therapy, and this case, to our knowledge represents the first applied phage therapy in Denmark, the practical and regulatory aspects of offering this treatment option in Denmark is briefly reviewed along with the clinical case.
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Affiliation(s)
- Andreas Ronit
- Infektionsmedicin, Sjællands Universitetshospital, Roskilde
- Infektionsmedicinsk Afdeling, Københavns Universitetshospital - Amager og Hvidovre Hospital
| | | | - Sarah Djebara
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruxelles
| | | | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruxelles
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruxelles
| | - Toke S Barfod
- Infektionsmedicin, Sjællands Universitetshospital, Roskilde
- Institut for Klinisk Medicin, Københavns Universitet
| | - Kim Thomsen
- Klinisk Mikrobiologisk Afdeling, Sjællands Universitetshospital, Slagelse
| | - Christian T Brandt
- Infektionsmedicin, Sjællands Universitetshospital, Roskilde
- Institut for Klinisk Medicin, Københavns Universitet
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2
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Pirnay JP, Merabishvili M, De Vos D, Verbeken G. Bacteriophage Production in Compliance with Regulatory Requirements. Methods Mol Biol 2024; 2734:89-115. [PMID: 38066364 DOI: 10.1007/978-1-0716-3523-0_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
In this chapter, we discuss production requirements for therapeutic bacteriophage preparations. We review the current regulatory expectancies and focus on pragmatic production processes, implementing relevant controls to ensure the quality, safety, and efficacy of the final products. The information disclosed in this chapter can also serve as a basis for discussions with competent authorities regarding the implementation of expedited bacteriophage product development and licensing pathways, taking into account some peculiarities of bacteriophages (as compared to conventional medicines), such as their specificity for, and co-evolution with, their bacterial hosts. To maximize the potential of bacteriophages as natural controllers of bacterial populations, the implemented regulatory frameworks and manufacturing processes should not only cater to defined bacteriophage products. But, they should also facilitate personalized approaches in which bacteriophages are selected ad hoc and even trained to target the patient's infecting bacterial strain(s), whether or not in combination with other antimicrobials such as antibiotics.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium.
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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3
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Merabishvili M, Pirnay JP, De Vos D. Guidelines to Compose an Ideal Bacteriophage Cocktail. Methods Mol Biol 2024; 2734:49-66. [PMID: 38066362 DOI: 10.1007/978-1-0716-3523-0_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Properly designed bacteriophage therapeutics are the cornerstone for a successful outcome of bacteriophage therapy. Here we present an overview of the different strategies and steps that can be taken to develop a bacteriophage cocktail that complies with relevant quality and safety requirements. It is based on empirical bacteriophage therapy knowledge from over a century of experience, more recently performed studies, and emerging technologies. We emphasize the selection of adequate bacteriophages and describe a modified Appelmans' method to improve the overall performance of therapeutic bacteriophages individually and collectively in the cocktail. We present two versions of the method, which differ from each other by the employed techniques to evaluate phage activity and synergy: photometric assessment of bacterial growth versus measurement of bacterial respiration via the Omnilog® system.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium.
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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4
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Bakuradze N, Merabishvili M, Kusradze I, Ceyssens PJ, Onsea J, Metsemakers WJ, Grdzelishvili N, Natroshvili G, Tatrishvili T, Lazvliashvili D, Mitskevich N, Pirnay JP, Chanishvili N. Characterization of a Bacteriophage GEC_vB_Bfr_UZM3 Active against Bacteroides fragilis. Viruses 2023; 15:v15051042. [PMID: 37243129 DOI: 10.3390/v15051042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/15/2023] [Accepted: 04/15/2023] [Indexed: 05/28/2023] Open
Abstract
Bacteroides fragilis is a commensal gut bacterium that is associated with a number of blood and tissue infections. It has not yet been recognized as one of the drug-resistant human pathogens, but cases of the refractory infections, caused by strains that are not susceptible to the common antibiotic regimes established for B. fragilis, have been more frequently reported. Bacteriophages (phages) were found to be a successful antibacterial alternative to antibiotic therapy in many cases of multidrug-resistant (MDR) bacterial infections. We have characterized the bacteriophage GEC_vB_Bfr_UZM3 (UZM3), which was used for the treatment of a patient with a chronic osteomyelitis caused by a B. fragilis mixed infection. Studied biological and morphological properties of UZM3 showed that it seems to represent a strictly lytic phage belonging to a siphovirus morphotype. It is characterized by high stability at body temperature and in pH environments for about 6 h. Whole genome sequencing analysis of the phage UZM3 showed that it does not harbor any known virulence genes and can be considered as a potential therapeutic phage to be used against B. fragilis infections.
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Affiliation(s)
- Nata Bakuradze
- Laboratory of Microbial Biotechnology, Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi 0160, Georgia
- Department of Biology, Faculty of Exact and Natural Sciences, Javakhishvili Tbilisi State University, Tbilisi 0179, Georgia
- AIETI Medical School, Davit Tvildiani Medical University, Tbilisi 0159, Georgia
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium
| | - Ia Kusradze
- Laboratory of General Microbiology, Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi 0160, Georgia
- Faculty of Medicine, European University, Tbilisi 0141, Georgia
| | | | - Jolien Onsea
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Willem-Jan Metsemakers
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Nino Grdzelishvili
- Laboratory of Microbial Biotechnology, Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi 0160, Georgia
- Faculty of Natural Science and Medicine, Ilia State University, Tbilisi 0162, Georgia
| | - Guliko Natroshvili
- Laboratory of Microbial Biotechnology, Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi 0160, Georgia
| | - Tamar Tatrishvili
- Laboratory of Microbial Biotechnology, Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi 0160, Georgia
- Faculty of Natural Science and Medicine, Ilia State University, Tbilisi 0162, Georgia
| | - Davit Lazvliashvili
- Laboratory of Microbial Biotechnology, Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi 0160, Georgia
- Faculty of Natural Science and Medicine, Ilia State University, Tbilisi 0162, Georgia
| | - Nunu Mitskevich
- Department of Biology, Faculty of Exact and Natural Sciences, Javakhishvili Tbilisi State University, Tbilisi 0179, Georgia
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium
| | - Nina Chanishvili
- Laboratory of Microbial Biotechnology, Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi 0160, Georgia
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5
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Laumen JGE, Abdellati S, Manoharan-Basil SS, Van Dijck C, Van den Bossche D, De Baetselier I, de Block T, Malhotra-Kumar S, Soentjes P, Pirnay JP, Kenyon C, Merabishvili M. Screening of Anorectal and Oropharyngeal Samples Fails to Detect Bacteriophages Infecting Neisseria gonorrhoeae. Antibiotics (Basel) 2022; 11:antibiotics11020268. [PMID: 35203870 PMCID: PMC8868155 DOI: 10.3390/antibiotics11020268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 01/27/2023] Open
Abstract
There are real concerns that Neisseria gonorrhoeae may become untreatable in the near future due to the rapid emergence of antimicrobial resistance. Alternative therapies are thus urgently required. Bacteriophages active against N. gonorrhoeae could play an important role as an antibiotic-sparing therapy. To the best of our knowledge, no bacteriophages active against N. gonorrhoeae have ever been found. The aim of this study was to screen for bacteriophages able to lyse N. gonorrhoeae in oropharyngeal and anorectal swabs of 74 men who have sex with men attending a sexual health clinic in Antwerp, Belgium. We screened 210 swabs but were unable to identify an anti-gonococcal bacteriophage. This is the first report of a pilot screening that systematically searched for anti-gonococcal phages directly from clinical swabs. Further studies may consider screening for phages at other anatomical sites (e.g., stool samples, urine) or in environmental settings (e.g., toilet sewage water of sex clubs or sexually transmitted infection clinics) where N. gonorrhoeae can be found.
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Affiliation(s)
- Jolein Gyonne Elise Laumen
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, 2610 Wilrijk, Belgium;
- Correspondence: ; Tel.: +32-(0)3-345-5398
| | - Saïd Abdellati
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
| | - Sheeba Santhini Manoharan-Basil
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
| | - Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, 2610 Wilrijk, Belgium;
| | - Dorien Van den Bossche
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
| | - Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
| | - Tessa de Block
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, 2610 Wilrijk, Belgium;
| | - Patrick Soentjes
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
- Center for Infectious Diseases, Queen Astrid Military Hospital, Neder-over-Heembeek, 1120 Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Neder-over-Heembeek, 1120 Brussels, Belgium; (J.-P.P.); (M.M.)
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (S.A.); (S.S.M.-B.); (C.V.D.); (D.V.d.B.); (I.D.B.); (T.d.B.); (P.S.); (C.K.)
- Department of Medicine, University of Cape Town, Cape Town 7701, South Africa
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Neder-over-Heembeek, 1120 Brussels, Belgium; (J.-P.P.); (M.M.)
- Microbiology and Virology (EIBMV), Eliava Institute of Bacteriophage, Tbilisi 0162, Georgia
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6
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Onsea J, Uyttebroek S, Chen B, Wagemans J, Lood C, Van Gerven L, Spriet I, Devolder D, Debaveye Y, Depypere M, Dupont L, De Munter P, Peetermans WE, van Noort V, Merabishvili M, Pirnay JP, Lavigne R, Metsemakers WJ. Bacteriophage Therapy for Difficult-to-Treat Infections: The Implementation of a Multidisciplinary Phage Task Force ( The PHAGEFORCE Study Protocol). Viruses 2021; 13:1543. [PMID: 34452408 PMCID: PMC8402896 DOI: 10.3390/v13081543] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 12/22/2022] Open
Abstract
In times where only a few novel antibiotics are to be expected, antimicrobial resistance remains an expanding global health threat. In case of chronic infections caused by therapy-resistant pathogens, physicians have limited therapeutic options, which are often associated with detrimental consequences for the patient. This has resulted in a renewed interest in alternative strategies, such as bacteriophage (phage) therapy. However, there are still important hurdles that currently impede the more widespread implementation of phage therapy in clinical practice. First, the limited number of good-quality case series and clinical trials have failed to show the optimal application protocol in terms of route of administration, frequency of administration, treatment duration and phage titer. Second, there is limited information on the systemic effects of phage therapy. Finally, in the past, phage therapy has been applied intuitively in terms of the selection of phages and their combination as parts of phage cocktails. This has led to an enormous heterogeneity in previously published studies, resulting in a lack of reliable safety and efficacy data for phage therapy. We hereby present a study protocol that addresses these scientific hurdles using a multidisciplinary approach, bringing together the experience of clinical, pharmaceutical and molecular microbiology experts.
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Affiliation(s)
- Jolien Onsea
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (B.C.); (W.-J.M.)
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Saartje Uyttebroek
- Department of Otorhinolaryngology, University Hospitals Leuven, 3000 Leuven, Belgium; (S.U.); (L.V.G.)
- Department of Neurosciences, Experimental Otorhinolaryngology, Rhinology Research, KU Leuven, 3000 Leuven, Belgium
| | - Baixing Chen
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (B.C.); (W.-J.M.)
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Jeroen Wagemans
- Department of Biosystems, Laboratory of Gene Technology, KU Leuven, 3000 Leuven, Belgium; (J.W.); (C.L.); (R.L.)
| | - Cédric Lood
- Department of Biosystems, Laboratory of Gene Technology, KU Leuven, 3000 Leuven, Belgium; (J.W.); (C.L.); (R.L.)
- Center of Microbial and Plant Genetics, KU Leuven, 3000 Leuven, Belgium;
| | - Laura Van Gerven
- Department of Otorhinolaryngology, University Hospitals Leuven, 3000 Leuven, Belgium; (S.U.); (L.V.G.)
- Department of Neurosciences, Experimental Otorhinolaryngology, Rhinology Research, KU Leuven, 3000 Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, 3000 Leuven, Belgium
| | - Isabel Spriet
- Pharmacy Department, University Hospitals Leuven, 3000 Leuven, Belgium; (I.S.); (D.D.)
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, 3000 Leuven, Belgium
| | - David Devolder
- Pharmacy Department, University Hospitals Leuven, 3000 Leuven, Belgium; (I.S.); (D.D.)
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, 3000 Leuven, Belgium
| | - Yves Debaveye
- Department of Intensive Care Medicine, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Melissa Depypere
- Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium;
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Lieven Dupont
- Department of Pneumology, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Paul De Munter
- Department of Internal Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (P.D.M.); (W.E.P.)
- Laboratory for Clinical Infectious and Inflammatory Disorders, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Willy E. Peetermans
- Department of Internal Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (P.D.M.); (W.E.P.)
- Laboratory for Clinical Infectious and Inflammatory Disorders, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Vera van Noort
- Center of Microbial and Plant Genetics, KU Leuven, 3000 Leuven, Belgium;
- Institute of Biology, Leiden University, 2333 BE Leiden, The Netherlands
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (M.M.); (J.-P.P.)
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (M.M.); (J.-P.P.)
| | - Rob Lavigne
- Department of Biosystems, Laboratory of Gene Technology, KU Leuven, 3000 Leuven, Belgium; (J.W.); (C.L.); (R.L.)
| | - Willem-Jan Metsemakers
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (B.C.); (W.-J.M.)
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
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7
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Lebeaux D, Merabishvili M, Caudron E, Lannoy D, Van Simaey L, Duyvejonck H, Guillemain R, Thumerelle C, Podglajen I, Compain F, Kassis N, Mainardi JL, Wittmann J, Rohde C, Pirnay JP, Dufour N, Vermeulen S, Gansemans Y, Van Nieuwerburgh F, Vaneechoutte M. A Case of Phage Therapy against Pandrug-Resistant Achromobacter xylosoxidans in a 12-Year-Old Lung-Transplanted Cystic Fibrosis Patient. Viruses 2021; 13:v13010060. [PMID: 33466377 PMCID: PMC7824836 DOI: 10.3390/v13010060] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
Bacteriophages are a promising therapeutic strategy among cystic fibrosis and lung-transplanted patients, considering the high frequency of colonization/infection caused by pandrug-resistant bacteria. However, little clinical data are available regarding the use of phages for infections with Achromobacter xylosoxidans. A 12-year-old lung-transplanted cystic fibrosis patient received two rounds of phage therapy because of persistent lung infection with pandrug-resistant A. xylosoxidans. Clinical tolerance was perfect, but initial bronchoalveolar lavage (BAL) still grew A. xylosoxidans. The patient's respiratory condition slowly improved and oxygen therapy was stopped. Low-grade airway colonization by A. xylosoxidans persisted for months before samples turned negative. No re-colonisation occurred more than two years after phage therapy was performed and imipenem treatment was stopped. Whole genome sequencing indicated that the eight A. xylosoxidans isolates, collected during phage therapy, belonged to four delineated strains, whereby one had a stop mutation in a gene for a phage receptor. The dynamics of lung colonisation were documented by means of strain-specific qPCRs on different BALs. We report the first case of phage therapy for A. xylosoxidans lung infection in a lung-transplanted patient. The dynamics of airway colonization was more complex than deduced from bacterial culture, involving phage susceptible as well as phage resistant strains.
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Affiliation(s)
- David Lebeaux
- Université de Paris, F-75006 Paris, France; (I.P.); (F.C.); (J.-L.M.)
- Service de Microbiologie, Unité Mobile d’Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
- Correspondence: ; Tel.: +33-1-56-09-29-69; Fax: +33-1-56-09-24-46
| | - Maia Merabishvili
- Laboratory Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, B-1120 Brussels, Belgium; (M.M.); (J.-P.P.)
- Laboratory Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Gent, Belgium; (L.V.S.); (H.D.); (M.V.)
| | - Eric Caudron
- Service de Pharmacie, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris Centre Université-Paris, 20 rue Leblanc, 75015 Paris, France;
- Lipides, Systèmes Analytiques et Biologiques, Université Paris-Saclay, 92296 Châtenay-Malabry, France
| | - Damien Lannoy
- CHU Lille, Institut de Pharmacie, F-59000 Lille, France;
- ULR7365—GRITA—Groupe de Recherche Sur Les Formes Injectables et Les Technologies Associées, Universit Lille, F-59000 Lille, France
| | - Leen Van Simaey
- Laboratory Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Gent, Belgium; (L.V.S.); (H.D.); (M.V.)
| | - Hans Duyvejonck
- Laboratory Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Gent, Belgium; (L.V.S.); (H.D.); (M.V.)
- Research Center Health & Water Technology, University College Ghent, Keramiekstraat 80, B-9000 Gent, Belgium;
| | - Romain Guillemain
- Service d’Anesthésie-Réanimation, Hôpital Européen Georges Pompidou, 75015 Paris, France;
| | - Caroline Thumerelle
- Pediatric Pulmonology and Allergy Unit, Hôpital Jeanne de Flandre, University Lille, CHU Lille, F-59000 Lille, France;
| | - Isabelle Podglajen
- Université de Paris, F-75006 Paris, France; (I.P.); (F.C.); (J.-L.M.)
- Service de Microbiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Fabrice Compain
- Université de Paris, F-75006 Paris, France; (I.P.); (F.C.); (J.-L.M.)
- Service de Microbiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Najiby Kassis
- Unité d'Hygiène Hospitalière, Service de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France;
| | - Jean-Luc Mainardi
- Université de Paris, F-75006 Paris, France; (I.P.); (F.C.); (J.-L.M.)
- Service de Microbiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Johannes Wittmann
- Leibniz Institute DSMZ—German Collection of Microorganisms and Cell Cultures GmbH, Inhoffenstraße 7B, 38124 Braunschweig, Germany; (J.W.); (C.R.)
| | - Christine Rohde
- Leibniz Institute DSMZ—German Collection of Microorganisms and Cell Cultures GmbH, Inhoffenstraße 7B, 38124 Braunschweig, Germany; (J.W.); (C.R.)
| | - Jean-Paul Pirnay
- Laboratory Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, B-1120 Brussels, Belgium; (M.M.); (J.-P.P.)
| | - Nicolas Dufour
- Service de Réanimation Médico-Chirurgicale, Centre Hospitalier René Dubos, 95300 Pontoise, France;
| | - Stefan Vermeulen
- Research Center Health & Water Technology, University College Ghent, Keramiekstraat 80, B-9000 Gent, Belgium;
| | - Yannick Gansemans
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Gent, Belgium; (Y.G.); (F.V.N.)
| | - Filip Van Nieuwerburgh
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Gent, Belgium; (Y.G.); (F.V.N.)
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Gent, Belgium; (L.V.S.); (H.D.); (M.V.)
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Makalatia K, Kakabadze E, Wagemans J, Grdzelishvili N, Bakuradze N, Natroshvili G, Macharashvili N, Sedrakyan A, Arakelova K, Ktsoyan Z, Zakharyan M, Gevorgyan Z, Mnatsakanyan A, Tishkova F, Lood C, Vandenheuvel D, Lavigne R, Pirnay JP, De Vos D, Chanishvili N, Merabishvili M. Characterization of Salmonella Isolates from Various Geographical Regions of the Caucasus and Their Susceptibility to Bacteriophages. Viruses 2020; 12:v12121418. [PMID: 33321823 PMCID: PMC7764154 DOI: 10.3390/v12121418] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/27/2020] [Accepted: 12/02/2020] [Indexed: 02/05/2023] Open
Abstract
Non-typhoidal Salmonella present a major threat to animal and human health as food-borne infectious agents. We characterized 91 bacterial isolates from Armenia and Georgia in detail, using a suite of assays including conventional microbiological methods, determining antimicrobial susceptibility profiles, matrix assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry, serotyping (using the White-Kauffmann-Le Minor scheme) and genotyping (repetitive element sequence-based PCR (rep-PCR)). No less than 61.5% of the isolates were shown to be multidrug-resistant. A new antimicrobial treatment strategy is urgently needed. Phage therapy, the therapeutic use of (bacterio-) phages, the bacterial viruses, to treat bacterial infections, is increasingly put forward as an additional tool for combatting antibiotic resistant infections. Therefore, we used this representative set of well-characterized Salmonella isolates to analyze the therapeutic potential of eleven single phages and selected phage cocktails from the bacteriophage collection of the Eliava Institute (Georgia). All isolates were shown to be susceptible to at least one of the tested phage clones or their combinations. In addition, genome sequencing of these phages revealed them as members of existing phage genera (Felixounavirus, Seunavirus, Viunavirus and Tequintavirus) and did not show genome-based counter indications towards their applicability against non-typhoidal Salmonella in a phage therapy or in an agro-food setting.
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Affiliation(s)
- Khatuna Makalatia
- Research & Development Department, George Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi 0160, Georgia; (E.K.); (N.G.); (N.B.); (G.N.); (N.C.); (M.M.)
- Faculty of Exact and Natural Sciences, Ivane Javakhishvili Tbilisi State University, Tbilisi 0179, Georgia
- Correspondence:
| | - Elene Kakabadze
- Research & Development Department, George Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi 0160, Georgia; (E.K.); (N.G.); (N.B.); (G.N.); (N.C.); (M.M.)
- Faculty of Exact and Natural Sciences, Ivane Javakhishvili Tbilisi State University, Tbilisi 0179, Georgia
| | - Jeroen Wagemans
- Laboratory of Gene Technology, Department of Biosystems, KU Leuven, 3001 Heverlee, Belgium; (J.W.); (C.L.); (R.L.)
| | - Nino Grdzelishvili
- Research & Development Department, George Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi 0160, Georgia; (E.K.); (N.G.); (N.B.); (G.N.); (N.C.); (M.M.)
- Department of Natural Sciences and Medicine, Ilia State University, Tbilisi 0162, Georgia
| | - Nata Bakuradze
- Research & Development Department, George Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi 0160, Georgia; (E.K.); (N.G.); (N.B.); (G.N.); (N.C.); (M.M.)
- Faculty of Exact and Natural Sciences, Ivane Javakhishvili Tbilisi State University, Tbilisi 0179, Georgia
| | - Gulnara Natroshvili
- Research & Development Department, George Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi 0160, Georgia; (E.K.); (N.G.); (N.B.); (G.N.); (N.C.); (M.M.)
| | - Nino Macharashvili
- Bacteriology Laboratory, Infectious Diseases and AIDS Center, Tbilisi 0160, Georgia;
| | - Anahit Sedrakyan
- Laboratory of Molecular Genetics, Institute of Molecular Biology, National Academy of Sciences of the Republic of Armenia, Yerevan 0014, Armenia; (A.S.); (K.A.); (Z.K.); (M.Z.)
| | - Karine Arakelova
- Laboratory of Molecular Genetics, Institute of Molecular Biology, National Academy of Sciences of the Republic of Armenia, Yerevan 0014, Armenia; (A.S.); (K.A.); (Z.K.); (M.Z.)
| | - Zhanna Ktsoyan
- Laboratory of Molecular Genetics, Institute of Molecular Biology, National Academy of Sciences of the Republic of Armenia, Yerevan 0014, Armenia; (A.S.); (K.A.); (Z.K.); (M.Z.)
| | - Magdalina Zakharyan
- Laboratory of Molecular Genetics, Institute of Molecular Biology, National Academy of Sciences of the Republic of Armenia, Yerevan 0014, Armenia; (A.S.); (K.A.); (Z.K.); (M.Z.)
| | - Zaruhi Gevorgyan
- Department of Clinical Laboratory Diagnostics, Yerevan State Medical University after Mkhitar Heratsi, Yerevan 0025, Armenia;
| | - Armine Mnatsakanyan
- Microbiological Laboratory, Nork Infectious Clinical Hospital, Ministry of Health of the Republic of Armenia, Yerevan 0047, Armenia;
| | - Farida Tishkova
- Virology Laboratory, Tajik Research Institute of Preventive Medicine, 734025 Dushanbe, Tajikistan;
| | - Cédric Lood
- Laboratory of Gene Technology, Department of Biosystems, KU Leuven, 3001 Heverlee, Belgium; (J.W.); (C.L.); (R.L.)
- Laboratory of Computational Systems Biology, Department of Microbial and Molecular Systems, KU Leuven, 3000 Leuven, Belgium
| | - Dieter Vandenheuvel
- Research Group Environmental Ecology and Applied Microbiology, Department of Bioscience Engineering, University of Antwerp, 2020 Antwerp, Belgium;
| | - Rob Lavigne
- Laboratory of Gene Technology, Department of Biosystems, KU Leuven, 3001 Heverlee, Belgium; (J.W.); (C.L.); (R.L.)
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (J.-P.P.); (D.D.V.)
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (J.-P.P.); (D.D.V.)
| | - Nina Chanishvili
- Research & Development Department, George Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi 0160, Georgia; (E.K.); (N.G.); (N.B.); (G.N.); (N.C.); (M.M.)
| | - Maia Merabishvili
- Research & Development Department, George Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi 0160, Georgia; (E.K.); (N.G.); (N.B.); (G.N.); (N.C.); (M.M.)
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (J.-P.P.); (D.D.V.)
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9
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Fauconnier A, Nagel TE, Fauconnier C, Verbeken G, De Vos D, Merabishvili M, Pirnay JP. The Unique Role That WHO Could Play in Implementing Phage Therapy to Combat the Global Antibiotic Resistance Crisis. Front Microbiol 2020; 11:1982. [PMID: 33013742 PMCID: PMC7500132 DOI: 10.3389/fmicb.2020.01982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/27/2020] [Indexed: 01/26/2023] Open
Affiliation(s)
| | - Tobi E Nagel
- Phages for Global Health, Oakland, CA, United States
| | | | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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10
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Onsea J, Soentjens P, Djebara S, Merabishvili M, Depypere M, Spriet I, De Munter P, Debaveye Y, Nijs S, Vanderschot P, Wagemans J, Pirnay JP, Lavigne R, Metsemakers WJ. Bacteriophage Application for Difficult-to-treat Musculoskeletal Infections: Development of a Standardized Multidisciplinary Treatment Protocol. Viruses 2019; 11:v11100891. [PMID: 31548497 PMCID: PMC6832313 DOI: 10.3390/v11100891] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022] Open
Abstract
Bacteriophage therapy has recently attracted increased interest, particularly in difficult-to-treat infections. Although it is not a novel concept, standardized treatment guidelines are currently lacking. We present the first steps towards the establishment of a "multidisciplinary phage task force" (MPTF) and a standardized treatment pathway, based on our experience of four patients with severe musculoskeletal infections. After review of their medical history and current clinical status, a multidisciplinary team found four patients with musculoskeletal infections eligible for bacteriophage therapy within the scope of Article 37 of the Declaration of Helsinki. Treatment protocols were set up in collaboration with phage scientists and specialists. Based on the isolated pathogens, phage cocktails were selected and applied intraoperatively. A draining system allowed postoperative administration for a maximum of 10 days, 3 times per day. All patients received concomitant antibiotics and their clinical status was followed daily during phage therapy. No severe side-effects related to the phage application protocol were noted. After a single course of phage therapy with concomitant antibiotics, no recurrence of infection with the causative strains occurred, with follow-up periods ranging from 8 to 16 months. This study presents the successful outcome of bacteriophage therapy using a standardized treatment pathway for patients with severe musculoskeletal infection. A multidisciplinary team approach in the form of an MPTF is paramount in this process.
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Affiliation(s)
- Jolien Onsea
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Patrick Soentjens
- Centre for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium.
| | - Sarah Djebara
- Centre for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
| | - Melissa Depypere
- Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Isabel Spriet
- Pharmacy Department, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Paul De Munter
- Department of General Internal Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium.
| | - Yves Debaveye
- Department of Intensive Care Medicine, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Stefaan Nijs
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Paul Vanderschot
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Jeroen Wagemans
- Laboratory of Gene Technology, KU Leuven, 3001 Leuven, Belgium.
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium.
| | - Rob Lavigne
- Laboratory of Gene Technology, KU Leuven, 3001 Leuven, Belgium.
| | - Willem-Jan Metsemakers
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium.
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
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11
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Bakuradze N, Makalatia K, Merabishvili M, Togoshvili L, Chanishvili N. SELECTION OF THE ACTIVE PHAGES AGAINST B.FRAGILIS FOR FURTHER STUDY OF THRAPEUTIC PERPECTIVES. Georgian Med News 2018:111-116. [PMID: 30702082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
B.fragilis is an obligate anaerobic commensal colonizing human intestines and carries number of physiological functions. At the same time B.fragilis is commonly isolated from the septic clinical samples and due to its capsule represents one of the provoking agents for abscess development. Enterotoxigenic B.fragilis (ETBF) strains also increase the likelihood of developing colon cancer. Increasing incidence of antibiotic-resistant pathogens led to the high demand to alternative antimicrobials. Bacteriophage (phage) therapy already practiced for a century in some of the Post-Soviet countries including Georgia has been suggested as a substitute of antibiotics. It should be noted that this study is the first attempt to isolate virulent B.fragilis phages for further therapeutic application as all phages known up until now were used for detection of fecal water contamination only. The aim of the study was to isolate B.fragilis specific phages for their further use against infections caused by this bacteria Eighteen B.fragilis strains were isolated from human feces using conventional microbiological methods and precise identification was done via MULDI-TOF mass spectrometry. Three ETBF strains were provided by the University of Ghent (Belgium). Three lytic phages (ФVA7, ФMTK and ФUZ-1) of Siphoviridae family were isolated from the waste water samples collected in Tbilisi and in Ghent using conventional phage isolation and enumeration techniques. Electron microscopy was used for the visualization of the phage particles. To determine lytic activity of the isolated phages and estimate their antimicrobial efficacy the spot test assay and efficiency of plating (EOP) were studied using 18 clinical strains of B.fragilis and 12 intestinal commensal strains related to Bacterioides spp. and Parabacterioides spp.. Although according to the spot test results two of the isolated phages expressed high specificity to B.fragilis demonstrating broad host range within this species, however EOP results showed that only ФVA7 can be selected as the best candidate for the model in vitro tissue culture experiments aiming demonstration of the therapeutic and prophylactic potential of phages against ETBF and/or NETBF.
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Affiliation(s)
- N Bakuradze
- G. Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi; I. Javakhishvili Tbilisi State University; Ghent University, Laboratory of Bacteriology Research, University Hospital, Gent, Belgium; Eliava Diagnostic Center, Tbilisi, Georgia
| | - Kh Makalatia
- G. Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi; I. Javakhishvili Tbilisi State University; Ghent University, Laboratory of Bacteriology Research, University Hospital, Gent, Belgium; Eliava Diagnostic Center, Tbilisi, Georgia
| | - M Merabishvili
- G. Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi; I. Javakhishvili Tbilisi State University; Ghent University, Laboratory of Bacteriology Research, University Hospital, Gent, Belgium; Eliava Diagnostic Center, Tbilisi, Georgia
| | - L Togoshvili
- G. Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi; I. Javakhishvili Tbilisi State University; Ghent University, Laboratory of Bacteriology Research, University Hospital, Gent, Belgium; Eliava Diagnostic Center, Tbilisi, Georgia
| | - N Chanishvili
- G. Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi; I. Javakhishvili Tbilisi State University; Ghent University, Laboratory of Bacteriology Research, University Hospital, Gent, Belgium; Eliava Diagnostic Center, Tbilisi, Georgia
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12
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Bachert C, Holtappels G, Merabishvili M, Meyer T, Murr A, Zhang N, Van Crombruggen K, Gevaert E, Völker U, Bröker B, Vaneechoutte M, Schmidt F. Staphylococcus aureus controls interleukin-5 release in upper airway inflammation. J Proteomics 2018; 180:53-60. [DOI: 10.1016/j.jprot.2017.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/17/2017] [Accepted: 12/05/2017] [Indexed: 01/18/2023]
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13
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Abstract
Correctly designed bacteriophage therapeutics are the cornerstone for a successful outcome of bacteriophage therapy. Here we overview strategies on how to choose bacteriophages and their bacterial hosts at different steps of a bacteriophage cocktail development in order to comply with all quality and safety requirements based on the already existing essentially empirical experience in bacteriophage therapy and current accomplishments in modern biomedical sciences. A modification of the classic Appelmans' method (1922) to assess stability of bacteriophage activity in liquid media is presented in order to improve the overall performance of therapeutic bacteriophages individually and collectively in the cocktail.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, Brussels, 1120, Belgium.
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, Brussels, 1120, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, Brussels, 1120, Belgium
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14
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Abstract
In this chapter we review bacteriophage production requirements to help institutions, which wish to manufacture bacteriophage products for human use in compliance with the applicable regulatory expectancies, defining production processes and implementing relevant controls ensuring quality, safety, and efficacy of the final products. The information disclosed in this chapter can also serve as a basis for discussions with competent authorities regarding the development of expedited bacteriophage product development and licensing pathways, including relevant and pragmatic requirements, and allowing for the full exploitation of bacteriophages as natural controllers of bacterial populations.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium.
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Hilde Van Raemdonck
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussels, Belgium
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15
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Merabishvili M, Monserez R, van Belleghem J, Rose T, Jennes S, De Vos D, Verbeken G, Vaneechoutte M, Pirnay JP. Stability of bacteriophages in burn wound care products. PLoS One 2017; 12:e0182121. [PMID: 28750102 PMCID: PMC5531522 DOI: 10.1371/journal.pone.0182121] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 07/12/2017] [Indexed: 12/05/2022] Open
Abstract
Bacteriophages could be used along with burn wound care products to enhance antimicrobial pressure during treatment. However, some of the components of the topical antimicrobials that are traditionally used for the prevention and treatment of burn wound infection might affect the activity of phages. Therefore, it is imperative to determine the counteraction of therapeutic phage preparations by burn wound care products before application in patients. Five phages, representatives of two morphological families (Myoviridae and Podoviridae) and active against 3 common bacterial burn wound pathogens (Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus) were tested against 13 different products commonly used in the treatment of burn wounds. The inactivation of the phages was quite variable for different phages and different products. Majority of the anti-infective products affected phage activity negatively either immediately or in the course of time, although impact was not always significant. Products with high acidity had the most adverse effect on phages. Our findings demonstrate that during combined treatment the choice of phages and wound care products must be carefully defined in advance.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- Laboratory for Bacteriology Research, Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
- George Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi, Georgia
- * E-mail:
| | - Riet Monserez
- Hospital Pharmacy, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jonas van Belleghem
- Laboratory for Bacteriology Research, Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Thomas Rose
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Serge Jennes
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Mario Vaneechoutte
- Laboratory for Bacteriology Research, Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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16
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Jennes S, Merabishvili M, Soentjens P, Pang KW, Rose T, Keersebilck E, Soete O, François PM, Teodorescu S, Verween G, Verbeken G, De Vos D, Pirnay JP. Use of bacteriophages in the treatment of colistin-only-sensitive Pseudomonas aeruginosa septicaemia in a patient with acute kidney injury-a case report. Crit Care 2017; 21:129. [PMID: 28583189 PMCID: PMC5460490 DOI: 10.1186/s13054-017-1709-y] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Serge Jennes
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | - Maia Merabishvili
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Patrick Soentjens
- Phage therapy center, Queen Astrid military hospital, Brussels, Belgium
| | - Kim Win Pang
- Phage therapy center, Queen Astrid military hospital, Brussels, Belgium
| | - Thomas Rose
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | | | - Olivier Soete
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | | | - Simona Teodorescu
- Burn wound center, Queen Astrid military hospital, Brussels, Belgium
| | - Gunther Verween
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for molecular and cellular technology, Queen Astrid military hospital, Brussels, Belgium.
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17
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De Vos D, Pirnay JP, Bilocq F, Jennes S, Verbeken G, Rose T, Keersebilck E, Bosmans P, Pieters T, Hing M, Heuninckx W, De Pauw F, Soentjens P, Merabishvili M, Deschaght P, Vaneechoutte M, Bogaerts P, Glupczynski Y, Pot B, van der Reijden TJ, Dijkshoorn L. Molecular Epidemiology and Clinical Impact of Acinetobacter calcoaceticus-baumannii Complex in a Belgian Burn Wound Center. PLoS One 2016; 11:e0156237. [PMID: 27223476 PMCID: PMC4880317 DOI: 10.1371/journal.pone.0156237] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 05/11/2016] [Indexed: 12/21/2022] Open
Abstract
Multidrug resistant Acinetobacter baumannii and its closely related species A. pittii and A. nosocomialis, all members of the Acinetobacter calcoaceticus-baumannii (Acb) complex, are a major cause of hospital acquired infection. In the burn wound center of the Queen Astrid military hospital in Brussels, 48 patients were colonized or infected with Acb complex over a 52-month period. We report the molecular epidemiology of these organisms, their clinical impact and infection control measures taken. A representative set of 157 Acb complex isolates was analyzed using repetitive sequence-based PCR (rep-PCR) (DiversiLab) and a multiplex PCR targeting OXA-51-like and OXA-23-like genes. We identified 31 rep-PCR genotypes (strains). Representatives of each rep-type were identified to species by rpoB sequence analysis: 13 types to A. baumannii, 10 to A. pittii, and 3 to A. nosocomialis. It was assumed that isolates that belonged to the same rep-type also belonged to the same species. Thus, 83.4% of all isolates were identified to A. baumannii, 9.6% to A. pittii and 4.5% to A. nosocomialis. We observed 12 extensively drug resistant Acb strains (10 A. baumannii and 2 A. nosocomialis), all carbapenem-non-susceptible/colistin-susceptible and imported into the burn wound center through patients injured in North Africa. The two most prevalent rep-types 12 and 13 harbored an OXA-23-like gene. Multilocus sequence typing allocated them to clonal complex 1 corresponding to EU (international) clone I. Both strains caused consecutive outbreaks, interspersed with periods of apparent eradication. Patients infected with carbapenem resistant A. baumannii were successfully treated with colistin/rifampicin. Extensive infection control measures were required to eradicate the organisms. Acinetobacter infection and colonization was not associated with increased attributable mortality.
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Affiliation(s)
- Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- * E-mail:
| | - Florence Bilocq
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Serge Jennes
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Thomas Rose
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | | | - Petra Bosmans
- Hospital Hygiene and Infection Control Team, Queen Astrid Military Hospital, Brussels, Belgium
| | - Thierry Pieters
- Hospital Hygiene and Infection Control Team, Queen Astrid Military Hospital, Brussels, Belgium
| | - Mony Hing
- Clinical Laboratory, Queen Astrid Military Hospital, Brussels, Belgium
| | - Walter Heuninckx
- Clinical Laboratory, Queen Astrid Military Hospital, Brussels, Belgium
| | - Frank De Pauw
- Medical Communication and Information Systems, ACOS WB/Health Division, Queen Astrid Military Hospital, Brussels, Belgium
| | - Patrick Soentjens
- Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- Laboratory Bacteriology Research, University of Ghent, Ghent, Belgium
| | - Pieter Deschaght
- Laboratory Bacteriology Research, University of Ghent, Ghent, Belgium
| | | | - Pierre Bogaerts
- Laboratoire de Bactériologie, CHU Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Youri Glupczynski
- Laboratoire de Bactériologie, CHU Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Bruno Pot
- Applied Maths, Sint-Martens-Latem, Belgium
| | - Tanny J. van der Reijden
- Department of Infectious Diseases C5-P, Leiden University Medical Center, Leiden, The Netherlands
| | - Lenie Dijkshoorn
- Department of Infectious Diseases C5-P, Leiden University Medical Center, Leiden, The Netherlands
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18
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Debarbieux L, Pirnay JP, Verbeken G, De Vos D, Merabishvili M, Huys I, Patey O, Schoonjans D, Vaneechoutte M, Zizi M, Rohde C. A bacteriophage journey at the European Medicines Agency. FEMS Microbiol Lett 2015; 363:fnv225. [PMID: 26656541 PMCID: PMC5812529 DOI: 10.1093/femsle/fnv225] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2015] [Indexed: 11/27/2022] Open
Abstract
The seriously and globally increasing bacterial multi-drug resistance calls out on concerted counteractive measures: international health authorities give consideration to the therapeutical use of bacteriophage therapy.
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Affiliation(s)
- Laurent Debarbieux
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Jean-Paul Pirnay
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Gilbert Verbeken
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Daniel De Vos
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Maia Merabishvili
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Isabelle Huys
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Olivier Patey
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Dirk Schoonjans
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Mario Vaneechoutte
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Martin Zizi
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
| | - Christine Rohde
- P.H.A.G.E., Queen Astrid Military Hospital, Lab. for Molecular and Cellular Technology (LabMCT) Bruynstraat 1, 1120 Brussels, Belgium
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19
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Friman VP, Soanes-Brown D, Sierocinski P, Molin S, Johansen HK, Merabishvili M, Pirnay JP, De Vos D, Buckling A. Pre-adapting parasitic phages to a pathogen leads to increased pathogen clearance and lowered resistance evolution with Pseudomonas aeruginosa cystic fibrosis bacterial isolates. J Evol Biol 2015; 29:188-98. [PMID: 26476097 DOI: 10.1111/jeb.12774] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/12/2015] [Indexed: 12/17/2022]
Abstract
Recent years have seen renewed interest in phage therapy--the use of viruses to specifically kill disease-causing bacteria--because of the alarming rise in antibiotic resistance. However, a major limitation of phage therapy is the ease at with bacteria can evolve resistance to phages. Here, we determined whether in vitro experimental coevolution can increase the efficiency of phage therapy by limiting the resistance evolution of intermittent and chronic cystic fibrosis Pseudomonas aeruginosa lung isolates to four different phages. We first pre-adapted all phage strains against all bacterial strains and then compared the efficacy of pre-adapted and nonadapted phages against ancestral bacterial strains. We found that evolved phages were more efficient in reducing bacterial densities than ancestral phages. This was primarily because only 50% of bacterial strains were able to evolve resistance to evolved phages, whereas all bacteria were able to evolve some level of resistance to ancestral phages. Although the rate of resistance evolution did not differ between intermittent and chronic isolates, it incurred a relatively higher growth cost for chronic isolates when measured in the absence of phages. This is likely to explain why evolved phages were more effective in reducing the densities of chronic isolates. Our data show that pathogen genotypes respond differently to phage pre-adaptation, and as a result, phage therapies might need to be individually adjusted for different patients.
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Affiliation(s)
- V-P Friman
- Biosciences, University of Exeter, Penryn, UK.,Department of Biology, University of York, York, UK
| | | | - P Sierocinski
- Biosciences, University of Exeter, Penryn, UK.,European Centre for Environment and Human Health in Cornwall, University of Exeter, Penryn, UK
| | - S Molin
- Department of Systems Biology, Technical University of Denmark, Lyngby, Denmark
| | - H K Johansen
- Department of Systems Biology, Technical University of Denmark, Lyngby, Denmark.,Department of Clinical Microbiology 9301, Rigshospitalet, København Ø, Denmark
| | - M Merabishvili
- Burn Wound Center, Queen Astrid Military Hospital, Brussel, Belgium.,Research and Development Department, George Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi, Georgia.,Laboratory for Bacteriology Research, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - J-P Pirnay
- Burn Wound Center, Queen Astrid Military Hospital, Brussel, Belgium
| | - D De Vos
- Burn Wound Center, Queen Astrid Military Hospital, Brussel, Belgium
| | - A Buckling
- Biosciences, University of Exeter, Penryn, UK
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20
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Oliveira H, Sillankorva S, Merabishvili M, Kluskens LD, Azeredo J. Unexploited opportunities for phage therapy. Front Pharmacol 2015; 6:180. [PMID: 26441644 PMCID: PMC4561355 DOI: 10.3389/fphar.2015.00180] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/11/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hugo Oliveira
- Laboratório de Investigação em Biofilmes Rosário Oliveira, Centre of Biological Engineering, University of MinhoBraga, Portugal
| | - Sanna Sillankorva
- Laboratório de Investigação em Biofilmes Rosário Oliveira, Centre of Biological Engineering, University of MinhoBraga, Portugal
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military HospitalBrussels, Belgium
| | - Leon D. Kluskens
- Laboratório de Investigação em Biofilmes Rosário Oliveira, Centre of Biological Engineering, University of MinhoBraga, Portugal
| | - Joana Azeredo
- Laboratório de Investigação em Biofilmes Rosário Oliveira, Centre of Biological Engineering, University of MinhoBraga, Portugal
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21
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Pirnay JP, Blasdel BG, Bretaudeau L, Buckling A, Chanishvili N, Clark JR, Corte-Real S, Debarbieux L, Dublanchet A, De Vos D, Gabard J, Garcia M, Goderdzishvili M, Górski A, Hardcastle J, Huys I, Kutter E, Lavigne R, Merabishvili M, Olchawa E, Parikka KJ, Patey O, Pouilot F, Resch G, Rohde C, Scheres J, Skurnik M, Vaneechoutte M, Van Parys L, Verbeken G, Zizi M, Van den Eede G. Quality and safety requirements for sustainable phage therapy products. Pharm Res 2015; 32:2173-9. [PMID: 25585954 PMCID: PMC4452253 DOI: 10.1007/s11095-014-1617-7] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/30/2014] [Indexed: 12/11/2022]
Abstract
The worldwide antibiotic crisis has led to a renewed interest in phage therapy. Since time immemorial phages control bacterial populations on Earth. Potent lytic phages against bacterial pathogens can be isolated from the environment or selected from a collection in a matter of days. In addition, phages have the capacity to rapidly overcome bacterial resistances, which will inevitably emerge. To maximally exploit these advantage phages have over conventional drugs such as antibiotics, it is important that sustainable phage products are not submitted to the conventional long medicinal product development and licensing pathway. There is a need for an adapted framework, including realistic production and quality and safety requirements, that allowsa timely supplying of phage therapy products for ‘personalized therapy’ or for public health or medical emergencies. This paper enumerates all phage therapy product related quality and safety risks known to the authors, as well as the tests that can be performed to minimize these risks, only to the extent needed to protect the patients and to allow and advance responsible phage therapy and research.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, 1120, Brussel, Belgium,
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22
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Merabishvili M, Vandenheuvel D, Kropinski AM, Mast J, De Vos D, Verbeken G, Noben JP, Lavigne R, Vaneechoutte M, Pirnay JP. Characterization of newly isolated lytic bacteriophages active against Acinetobacter baumannii. PLoS One 2014; 9:e104853. [PMID: 25111143 PMCID: PMC4128745 DOI: 10.1371/journal.pone.0104853] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/18/2014] [Indexed: 12/24/2022] Open
Abstract
Based on genotyping and host range, two newly isolated lytic bacteriophages, myovirus vB_AbaM_Acibel004 and podovirus vB_AbaP_Acibel007, active against Acinetobacter baumannii clinical strains, were selected from a new phage library for further characterization. The complete genomes of the two phages were analyzed. Both phages are characterized by broad host range and essential features of potential therapeutic phages, such as short latent period (27 and 21 min, respectively), high burst size (125 and 145, respectively), stability of activity in liquid culture and low frequency of occurrence of phage-resistant mutant bacterial cells. Genomic analysis showed that while Acibel004 represents a novel bacteriophage with resemblance to some unclassified Pseudomonas aeruginosa phages, Acibel007 belongs to the well-characterized genus of the Phikmvlikevirus. The newly isolated phages can serve as potential candidates for phage cocktails to control A. baumannii infections.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
- Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
- Laboratory for Bacteriology Research (LBR), Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | - Dieter Vandenheuvel
- Laboratory of Gene Technology, Faculty of Bioscience Engineering, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Andrew M. Kropinski
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Guelph, Ontario, Canada
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada
| | - Jan Mast
- Electron Microscopy Unit, Veterinary and Agrochemical Research Centre, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Noben
- Department of Pathology, Bacteriology and Poultry Diseases, Ghent University, Merelbeke, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology, Faculty of Bioscience Engineering, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Mario Vaneechoutte
- Laboratory for Bacteriology Research (LBR), Faculty Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, Brussels, Belgium
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23
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Merabishvili M, Vervaet C, Pirnay JP, De Vos D, Verbeken G, Mast J, Chanishvili N, Vaneechoutte M. Stability of Staphylococcus aureus phage ISP after freeze-drying (lyophilization). PLoS One 2013; 8:e68797. [PMID: 23844241 PMCID: PMC3699554 DOI: 10.1371/journal.pone.0068797] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 06/03/2013] [Indexed: 11/24/2022] Open
Abstract
Staphylococcus aureus phage ISP was lyophilized, using an Amsco-Finn Aqua GT4 freeze dryer, in the presence of six different stabilizers at different concentrations. Stability of the lyophilized phage at 4°C was monitored up to 37 months and compared to stability in Luria Bertani broth and physiological saline at 4°C. Sucrose and trehalose were shown to be the best stabilizing additives, causing a decrease of only 1 log immediately after the lyophilization procedure and showing high stability during a 27 month storage period.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium.
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24
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Merabishvili M, De Vos D, Verbeken G, Kropinski AM, Vandenheuvel D, Lavigne R, Wattiau P, Mast J, Ragimbeau C, Mossong J, Scheres J, Chanishvili N, Vaneechoutte M, Pirnay JP. Selection and characterization of a candidate therapeutic bacteriophage that lyses the Escherichia coli O104:H4 strain from the 2011 outbreak in Germany. PLoS One 2012; 7:e52709. [PMID: 23285164 PMCID: PMC3528706 DOI: 10.1371/journal.pone.0052709] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 11/20/2012] [Indexed: 11/18/2022] Open
Abstract
In 2011, a novel strain of O104:H4 Escherichia coli caused a serious outbreak of foodborne hemolytic uremic syndrome and bloody diarrhea in Germany. Antibiotics were of questionable use and 54 deaths occurred. Candidate therapeutic bacteriophages that efficiently lyse the E. coli O104:H4 outbreak strain could be selected rather easily from a phage bank or isolated from the environment. It is argued that phage therapy should be more considered as a potential armament against the growing threat of (resistant) bacterial infections.
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Affiliation(s)
- Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
- Laboratory of Bacteriology Research, Ghent University, Ghent, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
| | - Andrew M. Kropinski
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Ontario, Canada
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada
| | | | - Rob Lavigne
- Laboratory of Gene Technology, KU Leuven, Heverlee, Belgium
| | - Pierre Wattiau
- Unit of Highly Pathogenic & Foodborne Zoonoses, Veterinary and Agrochemical Research Centre, Brussels, Belgium
| | - Jan Mast
- Electron Microscopy Unit, Veterinary and Agrochemical 8 Research Centre, Brussels, Belgium
| | - Catherine Ragimbeau
- Surveillance and Epidemiology of Infectious Diseases, Laboratoire National de Santé, Luxembourg, Luxembourg
| | - Joel Mossong
- Surveillance and Epidemiology of Infectious Diseases, Laboratoire National de Santé, Luxembourg, Luxembourg
| | - Jacques Scheres
- Maastricht University Medical Centre, Maastricht, The Netherlands
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Nina Chanishvili
- Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
| | | | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
- * E-mail:
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25
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Pirnay JP, Verbeken G, Rose T, Jennes S, Zizi M, Huys I, Lavigne R, Merabishvili M, Vaneechoutte M, Buckling A, De Vos D. Introducing yesterday’s phage therapy in today’s medicine. Future Virol 2012. [DOI: 10.2217/fvl.12.24] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The worldwide emergence of ‘superbugs’ and a dry antibiotic pipeline threaten modern society with a return to the preantibiotic era. Phages – the viruses of bacteria – could help fight antibiotic-resistant bacteria. Phage therapy was first attempted in 1919 by Felix d’Herelle and was commercially developed in the 1930s before being replaced by antibiotics in most of the western world. The current antibiotic crisis fueled a worldwide renaissance of phage therapy. The inherent potential of phages as natural biological bacterium controllers can only be put to use if the potential of the coevolutionary aspect of the couplet phage–bacterium is fully acknowledged and understood, including potential negative consequences. We must learn from past mistakes and set up credible studies to gather the urgently required data with regard to the efficacy of phage therapy and the evolutionary consequences of its (unlimited) use. Unfortunately, our current pharmaceutical economic model, implying costly and time-consuming medicinal product development and marketing, and requiring strong intellectual property protection, is not compatible with traditional sustainable phage therapy. A specific framework with realistic production and documentation requirements, which allows a timely (rapid) supply of safe, tailor-made, natural bacteriophages to patients, should be developed. Ultimately, economic models should be radically reshaped to cater for more sustainable approaches such as phage therapy. This is one of the biggest challenges faced by modern medicine and society as a whole.
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Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Gilbert Verbeken
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Thomas Rose
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Serge Jennes
- Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Martin Zizi
- Well Being Department, Queen Astrid Military Hospital, Brussels, Belgium
- Department of Physiology, Free University Brussels, Brussels, Belgium
| | - Isabelle Huys
- Department of Pharmaceutical & Pharmacological Sciences, Centre for Pharmaceutical Care & Pharmacoeconomics, KU Leuven, Leuven, Belgium
- Center for Intellectual Property Rights, KU Leuven, Leuven, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology, KU Leuven, Leuven, Belgium
| | - Maia Merabishvili
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
- Laboratory of Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
- Eliava Institute of Bacteriophage, Microbiology, & Virology, Tbilisi, Georgia
| | - Mario Vaneechoutte
- Laboratory of Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Angus Buckling
- Biosciences, University of Exeter, Cornwall Campus, Penryn, UK
| | - Daniel De Vos
- Laboratory for Molecular & Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, Brussels, Belgium
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26
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Vandersteegen K, Mattheus W, Ceyssens PJ, Bilocq F, De Vos D, Pirnay JP, Noben JP, Merabishvili M, Lipinska U, Hermans K, Lavigne R. Microbiological and molecular assessment of bacteriophage ISP for the control of Staphylococcus aureus. PLoS One 2011; 6:e24418. [PMID: 21931710 PMCID: PMC3170307 DOI: 10.1371/journal.pone.0024418] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 08/09/2011] [Indexed: 01/03/2023] Open
Abstract
The increasing antibiotic resistance in bacterial populations requires alternatives for classical treatment of infectious diseases and therefore drives the renewed interest in phage therapy. Methicillin resistant Staphylococcus aureus (MRSA) is a major problem in health care settings and live-stock breeding across the world. This research aims at a thorough microbiological, genomic, and proteomic characterization of S. aureus phage ISP, required for therapeutic applications. Host range screening of a large batch of S. aureus isolates and subsequent fingerprint and DNA microarray analysis of the isolates revealed a substantial activity of ISP against 86% of the isolates, including relevant MRSA strains. From a phage therapy perspective, the infection parameters and the frequency of bacterial mutations conferring ISP resistance were determined. Further, ISP was proven to be stable in relevant in vivo conditions and subcutaneous as well as nasal and oral ISP administration to rabbits appeared to cause no adverse effects. ISP encodes 215 gene products on its 138,339 bp genome, 22 of which were confirmed as structural proteins using tandem electrospray ionization-mass spectrometry (ESI-MS/MS), and shares strong sequence homology with the ‘Twort-like viruses’. No toxic or virulence-associated proteins were observed. The microbiological and molecular characterization of ISP supports its application in a phage cocktail for therapeutic purposes.
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Affiliation(s)
| | - Wesley Mattheus
- Division of Gene Technology, Katholieke Universiteit Leuven, Heverlee, Belgium
| | - Pieter-Jan Ceyssens
- Division of Gene Technology, Katholieke Universiteit Leuven, Heverlee, Belgium
| | - Florence Bilocq
- Laboratory for Molecular and Cellular Technology, Burn Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Burn Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Burn Centre, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Noben
- Hasselt University, Biomedical Research Institute and Transnational University Limburg, School of Life Sciences, Diepenbeek, Belgium
| | - Maia Merabishvili
- Laboratory for Molecular and Cellular Technology, Burn Centre, Queen Astrid Military Hospital, Brussels, Belgium
- Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia
| | - Urszula Lipinska
- Department of Pathology, Bacteriology and Poultry Diseases, Ghent University, Merelbeke, Belgium
| | - Katleen Hermans
- Department of Pathology, Bacteriology and Poultry Diseases, Ghent University, Merelbeke, Belgium
| | - Rob Lavigne
- Division of Gene Technology, Katholieke Universiteit Leuven, Heverlee, Belgium
- * E-mail:
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27
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Pirnay JP, De Vos D, Verbeken G, Merabishvili M, Chanishvili N, Vaneechoutte M, Zizi M, Laire G, Lavigne R, Huys I, Van den Mooter G, Buckling A, Debarbieux L, Pouillot F, Azeredo J, Kutter E, Dublanchet A, Górski A, Adamia R. The phage therapy paradigm: prêt-à-porter or sur-mesure? Pharm Res 2010; 28:934-7. [PMID: 21063753 DOI: 10.1007/s11095-010-0313-5] [Citation(s) in RCA: 173] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 10/27/2010] [Indexed: 11/30/2022]
Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Burn Wound Centre, Queen Astrid Military Hospital, 1120, Brussels, Belgium
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28
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Ceyssens PJ, Noben JP, Ackermann HW, Verhaegen J, De Vos D, Pirnay JP, Merabishvili M, Vaneechoutte M, Chibeu A, Volckaert G, Lavigne R. Survey ofPseudomonas aeruginosaand its phages:de novopeptide sequencing as a novel tool to assess the diversity of worldwide collected viruses. Environ Microbiol 2009; 11:1303-13. [DOI: 10.1111/j.1462-2920.2008.01862.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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29
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Merabishvili M, Verhelst R, Glonti T, Chanishvili N, Krylov V, Cuvelier C, Tediashvili M, Vaneechoutte M. Digitized fluorescent RFLP analysis (fRFLP) as a universal method for comparing genomes of culturable dsDNA viruses: application to bacteriophages. Res Microbiol 2007; 158:572-81. [PMID: 17719750 DOI: 10.1016/j.resmic.2007.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 06/19/2007] [Accepted: 06/19/2007] [Indexed: 11/30/2022]
Abstract
Identification and classification of bacteriophages remains a cumbersome process even with the use of genotypic approaches, due to the lack of genes present in all phages. Restriction fragment length polymorphism analysis (RFLP) of the viral genome is a universal approach, but RFLP fingerprints obtained on agarose gels remain difficult to compare between laboratories. Here we describe the digitization of RFLP of viral genomes by amplification of all restriction fragments - after ligation of adapters - using primers complementary to the adapters only. Since one of the primers is fluorescently labelled, the restriction fragments become visible to a fluorescent capillary electrophoresis system (ABI310) and their lengths can be digitized immediately. The digitized fluorescent RFLP (fRFLP) fingerprint can be stored as an entry in a library. Dendrogram construction of the fRFLP fingerprints obtained for a total of 69 Caudovirales (tailed bacteriophages) showed that genomically and/or serologically closely related phages clustered, whereas host range was not completely in correspondence with genotype. fRFLP might be a tool for quickly establishing the relationship of newly isolated phages to previously isolated ones and for constructing an fRFLP library electronically accessible on the internet, to which fRFLP patterns of new phages can be compared.
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Affiliation(s)
- Maia Merabishvili
- George Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia.
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