feeding, or exchanging nutrients among bacteria, is a type of ecological interaction found 27 in many important microbial communities. Furthermore, cross-feeding interactions are found to 28 play a role in some infections, and research into treating infections with combinations of 29 bacteriophage in 'cocktails' is growing. Here, we used a combination of mathematical modelling 30 and wet-lab experiments to optimize suppression of a model pathogen with a bacteriophage 31 cocktail in a synthetic cross-feeding bacterial coculture. A key finding was that a physiological 32 parametergrowth rateof the bacteria was important to consider when choosing the most 33 effective cocktail formulation. This work is novel because it highlights an unexpected 34 multispecies-targeting strategy for designing phage cocktails for cross-feeding pathogens and 35 has relevance to many ecological systems ranging from human health to agriculture. We 36 demonstrate how leveraging knowledge of a pathogen's ecological interaction has the potential 37to improve precision medicine and management of microbial systems. 38
Summary 39Cocktail combinations of bacteria-infecting viruses (bacteriophage), can suppress pathogenic 40 bacterial growth. However, predicting how phage cocktails influence microbial communities with 41 complex ecological interactions, specifically cross-feeding interactions in which bacteria 42 exchange nutrients, remains challenging. Here, we used experiments and mathematical 43 simulations to determine how to best suppress a model pathogen, E. coli, when obligately 44 cross-feeding with S. enterica. We tested whether the duration of pathogen suppression caused 45 by a two-lytic phage cocktail was maximized when both phage targeted E. coli, or when one 46 phage targeted E. coli and the other its cross-feeding partner, S. enterica. Experimentally, we 47 observed that cocktails targeting both cross-feeders suppressed E. coli growth longer than 48 cocktails targeting only E. coli. Two non-mutually-exclusive mechanisms could explain these 49 results: 1) we found that treatment with two E. coli phage led to the evolution of a mucoid 50 phenotype that provided cross-resistance against both phage, and 2) S. enterica set the growth 51 rate of the co-culture, and therefore targeting S. enterica had a stronger effect on pathogen 52suppression. Simulations suggested that cross-resistance and the relative growth rates of cross-53 feeders modulated the duration of E. coli suppression. More broadly, we describe a novel 54 bacteriophage cocktail strategy for pathogens that cross-feed. 55