Bacteriophages as Potential Treatment for Urinary Tract Infections

Abstract

Background: Urinary tract infections (UTIs) are among the most prevalent microbial diseases and their financial burden on society is substantial. The continuing increase of antibiotic resistance worldwide is alarming so that well-tolerated, highly effective therapeutic alternatives are urgently needed.Objective: To investigate the effect of bacteriophages on Escherichia coli and Klebsiella pneumoniae strains isolated from the urine of patients suffering from UTIs.Material and methods: Forty-one E. coli and 9 K. pneumoniae strains, isolated from the urine of patients suffering from UTIs, were tested in vitro for their susceptibility toward bacteriophages. The bacteriophages originated from either commercially available bacteriophage cocktails registered in Georgia or from the bacteriophage collection of the George Eliava Institute of Bacteriophage, Microbiology and Virology. In vitro screening of bacterial strains was performed by use of the spot-test method. The experiments were implemented three times by different groups of scientists.Results: The lytic activity of the commercial bacteriophage cocktails on the 41 E. coli strains varied between 66% (Pyo bacteriophage) and 93% (Enko bacteriophage). After bacteriophage adaptation of the Pyo bacteriophage cocktail, its lytic activity was increased from 66 to 93% and only one E. coli strain remained resistant. One bacteriophage of the Eliava collection could lyse all 9 K. pneumoniae strains.Conclusions: Based on the high lytic activity and the potential of resistance optimization by direct adaption of bacteriophages as reported in this study, and in view of the continuing increase of antibiotic resistance worldwide, bacteriophage therapy is a promising treatment option for UTIs highly warranting randomized controlled trials.

Predatory Bacteria Attenuate Klebsiella pneumoniae Burden in Rat Lungs

“…For these reasons, among others, it is crucial that we begin to develop new treatments to combat bacterial infection. Researchers have already begun investigating potential new antimicrobial strategies (22), such as the use of antimicrobial peptides (23, 24), phage therapy (25, 26), and gene-editing enzymes (27, 28). Here, we report another promising novel approach: the use of predatory bacteria to control Gram-negative human pathogens.…”

Phage therapy: present and future

“…There is evidence for successful use of phage therapy in urology [13]. Positive results were observed in treating different urinary tract diseases in children [14].…”

In vitro Effectiveness of Commercial Bacteriophage Cocktails on Diverse Extended-Spectrum Beta-Lactamase Producing Escherichia coli Strains

“…might find a room in these bacteriophage cocktails. However, in another study conducted by Sybesma et al (2016) in which they used 29 E. coli bacteriophages from the Eliava collection in addition to four commercial phage cocktails on E. coli set compromising ESBL negative and positive E. coli , the phage susceptibility rate was found to be 92.6%. In the current study, 7.7% ESBL-EC isolates were found to be resistant to all bacteriophage cocktails tested.…”

“…On the other hand, isolation of bacteriophages, which are able to be effective on these resistant strains from those pathogens’ own environment might be possible. With a specified preparation of phage cocktails and/or with the adaptation of bacteriophages (Sybesma et al, 2016), even more successful susceptibility results are potentially achievable. In our study, SES-bacteriophage was the least active (59.2%) cocktail whereas in Fitzgerald-Hughes et al’s (2014) study, SES-bacteriophage was the most active phage preparation.…”