Targeting Biofilm of MDR Providencia stuartii by Phages Using a Catheter Model

Abstract

Providencia spp. are emerging pathogens mainly in nosocomial infections. Providencia stuartii in particular is involved in urinary tract infections and contributes significantly to the high incidence of biofilm-formation in catheterized patients. Furthermore, recent reports suggested a role for multiple drug resistant (MDR) P. stuartii in hospital-associated outbreaks which leads to excessive complications resulting in challenging treatments. Phage therapy is currently one of the most promising solutions to combat antibiotic-resistant infections. However, the number of available phages targeting Providencia spp. is extremely limited, restricting the use of phage therapy in such cases. In the present study, we describe the isolation and characterization of 17 lytic and lysogenic bacteriophages targeting clinical isolates of Providencia spp. as part of the Israeli Phage Bank (IPB). These phages, isolated from sewage samples, were evaluated for host range activity and effectively eradicated 95% of the tested bacterial strains isolated from different geographic locations and displaying a wide range of antibiotic resistance. Their lytic activity is demonstrated on agar plates, planktonic cultures, and biofilm formed in a catheter model. The results suggest that these bacteriophages can potentially be used for treatment of antibiotic-resistant Providencia spp infections in general and of urinary tract infections in particular.

Clinical Phage Microbiology: a suggested framework and recommendations for the in-vitro matching steps of phage therapy

“…47 However, since invitro biofilm simulation can take a long time, we recommend doing these tests only in cases of biofilmassociated infections for which time to treatment can be delayed. We also recommend that the invitro biofilm simulation is grown on the infectionrelevant material (eg, pieces of joints, catheters, 62 and extracted teeth 36 ). Additional parameters should be simulated according to the clinical setting.…”

Providencia Species – Involvement in Pathology and Multidrug Resistance in a Romanian County Hospital

“…These germs are currently emerging (rate 4 per 100,000 hospital admissions) and are important in that they are biofilmforming pathogens and often multidrug resistant with very limited options of infection treatment and significant impact on patients' mortality (around 30% in hospitals) [6], [7], [8].…”

“…Phage therapy is one of the most promising solutions but the number of available phages targeting Providencia species is very limited. However, phages can be used mainly for the treatment of urinary tract infections [7].…”