Bacteriophage as a Novel Therapeutic Weapon for Killing Colistin-Resistant Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Bacteria

Abstract

Colistin-resistant multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan-drug-resistant (PDR) bacteria are highly lethal and many researchers have tried hard to combat these microorganisms around the world. Infections caused by these bacteria are resistant to the last resort of antibiotic therapy and have posed a major challenge in clinical and public health. Since the production of new antibiotics is very expensive and also very slow compared to the increasing rate of antibiotic resistance, researchers are suggesting the use of natural substances with high antibacterial potential. Bacteriophages are one of the most effective therapeutic measures that are known to exist for use for incurable and highly resistant infections. Phages are highly taken into consideration due to the lack of side effects, potential spread to various body organs, distinct modes of action from antibiotics, and proliferation at the site of infection. Although the effects of phages on MDR and XDR bacteria have been demonstrated in various studies, only a few have investigated the effect of phage therapy on colistin-resistant isolates. Therefore, in this review, we discuss the problems caused by colistin-resistant MDR and XDR bacteria in the clinics, explain the different mechanisms associated with colistin resistance, introduce bacteriophage therapy as a powerful remedy, and finally present new studies that have used bacteriophages against colistin-resistant isolates.

Re-sensitising XDR biofilms using a combination of bacteriophage cocktails and colistin: a natural approach

“…Mortality due to MDR P. aeruginosa isolates estimated to be 18 to 61%, while for MDR and XDR A. baumannii is 21.2%. On the other hand, colistin resistant K. pneumoniae , and A. baumannii have been associated with high mortality range of 25 to 71%, and 28 to 70%, respectively (Mousavi et al, 2021). Moreover, biofilm formation, especially in nosocomial patients associated with medical devices, is difficult to manage to prevent recurrent infections.…”

Virulence Characteristics and Emerging Therapies for Biofilm-Forming Acinetobacter baumannii: A Review

“…The amalgamation of phage-vWUPSU, family Myoviridae and sacha inchi oil as antimicrobial agents suggestively repressed and detached biofilms, compared with the effects of either single treatment [ 106 ]. In recent years, the antibacterial and anti-biofilm activities of several phages targeting MDR A. baumannii have been characterized [ 107 ]. Some of the phages are listed as: FAB1- and phage Abp2-specific MDR A. baumannii [ 108 ], Phage ISTD [ 109 ], Phage IsfAB78 [ 110 ], and Phage B-R2096 [ 111 ].…”

Characterization of Novel Lytic Myoviridae Phage Infecting Multidrug-Resistant Acinetobacter baumannii and Synergistic Antimicrobial Efficacy between Phage and Sacha Inchi Oil

“…Due to increasing bacterial resistance to antibiotics and the specificity of phage and host interactions, there has been renewed interests in using phages as either alternatives or supplements to antibiotics to combat MDR bacteria [ 8 , 9 ]. In recent years, the antibacterial and antibiofilm activities of several phages targeting MDR A. baumannii have been characterized [ 10 , 11 ]. For example, phage ΦAB1- and phage φAbp2-specific MDR A. baumannii were characterized, and genomic analysis was performed [ 12 , 13 , 14 ].…”