A review on re-emerging bacteriophage therapy in the era of XDR

In the present medicine world antibiotic resistance is one of the key threats to universal health coverage.Researchers continue to work hard to combat this global health concern.Phage therapy,an age-old practice during the early twentieth century,was outshined by the discovery of antibiotics.With the advent of widespread antibiotic resistance,phage therapy has again redeemed itself as a potential alternative owing to its adeptness to target bacteria precisely.Limited side effects,the ability to migrate to different body organs,a distinct mode of action,and proliferation at the infection site,make phages a profitable candidate to replace conventional antibiotics.The progressive outcome of numerous in vitro studies and case reports has validated the clinical efficacy of phage therapy.The bright perspective of using phages to treat bacterial infections has fueled enormous medical research to exploit their potential as therapeutics.The gaps in the information about phages and the lack of consent for clinical trials is major hurdle for consideration of phage therapy.Crafting phage therapy as a reality in medicine requires a coordinated effort from different fraternities.With this review,we aim to emphasize the importance of phage therapy in modern medicine.This review explains their historical journey,basic phage biology,cross-talk with the host immunity,obstacles with phage therapy,and their possible remedies.Comprehensive data on the various significant clinical trials of phage therapy has been presented.We evaluated the efficacy of antibiotics and phage therapy in part and in combination,along with recent progress and future perspectives of phage therapy.

Isolation and Biological Characteristics of Bacteriophage of an Antibiotic-resistant Escherchia coli Strain

In this study, bacteriophage of an antibiotic-resistant Escherchia coil strain isolated from feces of chicken was isolated. Its host range was determined by the method of spotting sample on monolayer agar, and its lysis titer, optimal multiplicity of infection （MOI）, temperature tolerance and pH tolerance were determined by the double-layer agar plate method. The results showed that the bacteriophage had a broad host range. The biological assay demonstrated that two strains of E. coil were fully lysed and one strain of E. coil was weakly lysed by the bacteriophage. The lysis titer and MOI of the bacteriophage were 1.20×10^8 PFU/ml and 1, respec- tively. Under the optimum temperature of 40℃, the Jysis titer of the bacteriophage reached 8.90×10^9 PFU/ml; however, the bacteriophage lost its infectivity at the tem- perature of 80℃. In the pH range of 5-11, the lysis titer of the bacteriophage ranged from10^6 to 10^9 PFU/mI. Under the condition of pH 4 and 12, the bacterio- phage was invalid.

Bacteriophages and their applications in the diagnosis and treatment of hepatitis B virus infection

Hepatitis B virus(HBV) infection is a major global health challenge leading to serious disorders such as cirrhosis and hepatocellular carcinoma. Currently, there exist various diagnostic and therapeutic approaches for HBV infection. However, prevalence and hazardous effects of chronic viral infection heighten the need to develop novel methodologies for the detection and treatment of this infection. Bacteriophages, viruses that specifically infect bacterial cells, with a long-established tradition in molecular biology and biotechnology have recently been introduced as novel tools for the prevention, diagnosis and treatment of HBV infection. Bacteriophages, due to tremendous genetic flexibility, represent potential to undergo a huge variety of surface modifications. This property has been the rationale behind introduction of phage display concept. This powerful approach, together with combinatorial chemistry, has shaped the concept of phage display libraries with diverse applications for the detection and therapy of HBV infection. This review aims to offer an insightful overview of the potential of bacteriophages in the development of helpful prophylactic(vaccine design), diagnostic and therapeutic strategies for HBV infection thereby providing new perspec-tives to the growing field of bacteriophage researches directing towards HBV infection.

Bacteriophages, revitalized after 100 years in the shadow of antibiotics

The year 2015 marks 100 years since Dr.Frederick Twort discovered the"filterable lytic factor",which was later independently discovered and named "bacteriophage" by Dr.Felix d’Herelle.On this memorable centennial,it is exciting to see a special issue published by Virologica Sinica on Phages and Therapy.In this issue,readers will not only fi nd that bacteriophage research is a

Bacteriophage therapy against Enterobacteriaceae

The Enterobacteriaceae are a class of gram-negative facultative anaerobic rods, which can cause a variety of diseases, such as bacteremia, septic arthritis, endocarditis, osteomyelitis, lower respiratory tract infections, skin and soft-tissue infections, urinary tract infections, intra-abdominal infections and ophthalmic infections, in humans, poultry, animals and fish. Disease caused by Enterobacteriaceae cause the deaths of millions of people every year, resulting in enormous economic loss. Drug treatment is a useful and efficient way to control Enterobacteriaceae infections. However, with the abuse of antibiotics, drug resistance has been found in growing number of Enterobacteriaceae infections and, as such, there is an urgent need to find new methods of control. Bacteriophage therapy is an efficient alternative to antibiotics as it employs a different antibacterial mechanism. This paper summarizes the history of bacteriophage therapy, its bacteriallytic mechanisms, and the studies that have focused on Enterobacteriaceae and bacteriophage therapy.

Bacteriophages as antimicrobial agents against major pathogens in swine： a review

In recent years, the development of antibiotic resistant bacteria has become a global concern which has prompted research into the development of alternative disease control strategies for the swine industry. Bacteriophages （viruses that infect bacteria） offer the prospect of a sustainable alternative approach against bacterial pathogens with the flexibility of being applied therapeutically or for biological control purposes. This paper reviews the use of phages as an antimicrobial strategy for controlling critical pathogens including Salmonella and Eschefich[a coli with an emphasis on the application of phages for improving performance and nutrient digestibility in swine operations as well as in controlling zoonotic human diseases by reducing the bacterial load spread from pork products to humans through the meat,

Isolation and characterization of glacier VMY22, a novel lytic cold-active bacteriophage of Bacillus cereus

As a unique ecological system with low temperature and low nutrient levels, glaciers are considered a "living fossil" for the research of evolution. In this work, a lytic cold-active bacteriophage designated VMY22 against Bacillus cereus MYB41-22 was isolated from Mingyong Glacier in China, and its characteristics were studied. Electron microscopy revealed that VMY22 has an icosahedral head(59.2 nm in length, 31.9 nm in width) and a tail(43.2 nm in length). Bacteriophage VMY22 was classified as a Podoviridae with an approximate genome size of 18 to 20 kb. A one-step growth curve revealed that the latent and the burst periods were 70 and 70 min, respectively, with an average burst size of 78 bacteriophage particles per infected cell. The pH and thermal stability of bacteriophage VMY22 were also investigated. The maximum stability of the bacteriophage was observed to be at pH 8.0 and it was comparatively stable at p H 5.0–9.0. As VMY22 is a cold-active bacteriophage with low production temperature, its characterization and the relationship between MYB41-22 and Bacillus cereus bacteriophage deserve further study.

Bacteriophage secondary infection

Phages are credited with having been first described in what we now, officially, are commemorating as the 100 th anniversary of their discovery. Those one-hundred years of phage history have not been lacking in excitement, controversy, and occasional convolution. One such complication is the concept of secondary infection, which can take on multiple forms with myriad consequences. The terms secondary infection and secondary adsorption, for example, can be used almost synonymously to describe virion interaction with already phage-infected bacteria, and which can result in what are described as superinfection exclusion or superinfection immunity. The phrase secondary infection also may be used equivalently to superinfection or coinfection, with each of these terms borrowed from medical microbiology, and can result in genetic exchange between phages, phage-on-phage parasitism, and various partial reductions in phage productivity that have been termed mutual exclusion, partial exclusion, or the depressor effect. Alternatively, and drawing from epidemiology, secondary infection has been used to describe phage population growth as that can occur during active phage therapy as well as upon phage contamination of industrial ferments. Here primary infections represent initial bacterial population exposure to phages while consequent phage replication can lead to additional, that is, secondary infections of what otherwise are not yet phage-infected bacteria. Here I explore the varying meanings and resultant ambiguity that has been associated with the term secondary infection. I suggest in particular that secondary infection, as distinctly different phenomena, can in multiple ways influence the success of phage-mediated biocontrol of bacteria, also known as, phage therapy.

Complete genome sequence and proteomic analysis of a thermophilic bacteriophage BV1

Viruses of thermophiles are of great interest due to their roles in gene transfer, global geochemical cycle and evolution of life on earth. However, the thermophilic bacteriophages have not been studied extensively. In this investigation, a typical bacteriophage BV1 was obtained from a thermophilic bacterium Geobacillus sp. 6k512, which was isolated from an inshore hot spring in Xiamen of China. The BV1 contained a double-stranded linear DNA of 35 055 bp, which encodes 54 open reading frames （ORFs）. Interestingly, eight of the 54 BV1 ORFs shared sequence similarities to genes from human disease-relevant bacteria. Seven proteins of the purified BV1 virions were identified by proteomic analysis. Determination of BV1 functional genomics would facilitate the better understanding of the mechanism for virus-thermophile interaction.

Bacteriophage Biocontrol Rescues Mice Bacteremic of Clinically Isolated Mastitis from Dairy Cows Associated with Methicillin-Resistant <i>Staphyloccocus aureus</i>

Methicillin-resistant Staphylococcus aureus (MRSA) is among the most alarming pathogens affecting both humans and the global bovine industry. The current control measures in hospitals and on farms for MRSA have proven to be inadequate leaving a need for new rapid control methods to curb MRSA infections in situ. New control measures for bacterial infection are widely sought, with particular interest in the applications for bacteriophages (phages) as a biocontrol or therapeutic agent. The current study uses a wild highly lytic phage isolated from cow’s milk taken from three farms in Baghdad, Iraq. The resulting phage was able to rescue 100% of the mice from a median lethal dose (LD50) or (1 × 108 CFU mL-1 per mouse) for MRSA wild isolates achieved when the phage: bacteria ratio was 100:1. Even when treatment was delayed for 6 h post lethal infection, to the point where all mice were moribund, 80% of them were rescued by a single injection of this phage preparation. Based on the current results, a comprehensive study is needed to guide further research on the MRSA phage as a biocontrol for MRSA mastitis in dairy cows to replace or reduce the use of antibiotics in animal husbandry.

Survival and proliferation of the lysogenic bacteriophage CTXΦ in Vibrio cholerae

The lysogenic phage CTXΦ of Vibrio cholerae can transfer the cholera toxin gene both horizontally(inter-strain) and vertically(cell proliferation). Due to its diversity in form and species, the complexity of regulatory mechanisms, and the important role of the infection mechanism in the production of new virulent strains of V.cholerae, the study of the lysogenic phage CTXΦ has attracted much attention. Based on the progress of current research, the genomic features and their arrangement, the host-dependent regulatory mechanisms of CTXΦ phage survival, proliferation and propagation were reviewed to further understand the phage's role in the evolutionary and epidemiological mechanisms of V. cholerae.

Bacteriophage cocktail supplementation improves growth performance,gut microbiome and production traits in broiler chickens

Background:Effective antibiotic alternatives are urgently needed in the poultry industry to control disease outbreaks.Phage therapy mainly utilizes lytic phages to kill their respective bacterial hosts and can be an attractive solution to combating the emergence of antibiotic resistance in livestock.Methods:Five hundred and four,one-day-old broilers(Ross 308)were allotted to 1 of 4 treatment groups in a completely randomized design.Treatments consisted of CON(basal diet),PC(CON+0.025%Avilamax®),BP 0.05(CON+0.05%bacteriophage),and BP 0.10(CON+0.10%bacteriophage).Results:A significant linear effect on body weight gain(BWG)was observed during days 1–7,days 22–35,and cumulatively in bacteriophage(BP)supplemented groups.The BWG tended to be higher(P=0.08)and the feed intake(FI)was increased(P=0.017)in the PC group over CON group.A greater(P=0.016)BWG and trends in increased FI(P=0.06)were observed in the experiment in birds fed PC than CON diet.At the genus level,the relative abundance of Lactobacillus was decreased in PC(65.28%),while it was similar in BP 0.05 and BP 0.10(90.65%,86.72%)compared to CON(90.19%).At the species level,the relative abundance of Lactobacillus salivarus was higher in BP 0.05(40.15%)and BP 0.10(38.58%)compared to the CON(20.04%)and PC(18.05%).A linear reduction in the weight of bursa of Fabricius(P=0.022)and spleen(P=0.052)was observed in birds fed graded level of BP and an increase(P=0.059)in the weight of gizzard was observed in birds fed PC over BP diets.Linear and quadratic responses were observed in redness of breast muscle color in birds fed graded level of BP.Conclusions:The inclusion of the 0.05%and 0.1%BP cocktail linearly improved broiler weight during the first 7 days,22–35 days and cumulatively,whereas 0.05%BP addition was sufficient for supporting immune organs,bursa and spleen as well as enhancing gut microbiome,indicating the efficacy of 0.05%BP as a substitute antibiotic growth promoter in broiler diets.

Compressed wormlike chain moving out of confined space: A model of DNA ejection from bacteriophage

The molecular biomechanics of DNA ejection from bacteriophage is of interest to not only fundamental biological understandings but also practical applications such as the design of advanced site-specific and controllable drug delivery systems. In this paper, we analyze the viscous motion of a semiflexible polymer chain coming out of a strongly confined space as a model to investigate the effects of various structure confinements and frictional resistances encountered during the DNA ejection process. The theoretically predicted relations between the ejection speed, ejection time, ejection length, and other physical parameters, such as the phage type, total genome length and ionic state of external buffer solutions, show excellent agreement with in vitro experimental observations in the literature.

Isolation and characterization of a lytic bacteriophage φKp-lyy15 of Klebsiella pneumoniae

Dear Editor,Bacteriophages(phages)are viruses that specifically infect and kill bacteria.They are ubiquitous throughout all environments that bacteria inhabit.Following their discovery by F.W.Twort in 1915 and F.d’Herele in 1917,bacteriophages were recognized as potential agents to treat bacterial diseases and phage therapy has been used

Experience of the Eliava Institute in bacteriophage therapy

The rapid propagation of multidrug resistant bacterial strains is leading to renewed interest in bacteriophage therapy.With challenges in the treatment of bacterial infections,it is essential for people worldwide to understand how alternative approaches,such as bacteriophages,could be used to combat antibiotic resistant bacteria.The Eliava Institute

Isolation and Characterization of Bacteriophages from Laban Jameed

Laban jameed is a dried salty dairy product obtained by fermentation of milk using a complex population of lactic acid bacteria. Jameed is considered a traditional food product in most eastern Mediterranean countries and is usually made from sheep or cow milk. The aim of this study was to assess phage contamination of jameed dairy product. Two phages were isolated: one from sheep milk jameed (PPUDV) and the other from cow milk jameed (PPURV). Each of the two bacteriophages was partially characterized. The PPUDV phage was identified as a single stranded DNA virus with an approximately 20 kb genome that was resistant to RNase, whereas PPURV phage possessed a double stranded RNA genome of approximately 20 kb and was resistant to DNase. The phage bacterial strain hosts were identified as Lactobacillus helveticus and Bacillus amyloliquefaciens for PPUDV and PPURV, respectively. One step growth curve using a double layer plaque assay test was carried out to monitor the phage life cycle after host infection. PPUDV showed a latent period of about 36 h, burst period of 70 h and a burst size of about 600 Plaque Forming Units (PFU) per infected cell. PPURV phage showed a latent period of about 24 h, burst period of 47 h and a burst size of about 700 PFU per infected cell. SDS-PAGE analysis of total viral proteins showed at least three major bands (27, 40, and 45 kDa) for PPUDV. This is the first study to report the isolation of both DNA and RNA bacteriophages from laban jameed. This study adds new insights into the complexity of dairy contamination and fermentation microbiology of the jameed revealing the existence of two viral genomes in this highly dried and salty dairy product.

Isolation and rapid genetic characterization of a novel T4-like bacteriophage

Ubiquitous on earth,bacteriophages are the most abundant entities in every ecosystem,but human knowledge about them is still limited compared with that about other forms of organisms.To enrich human knowledge and promote the utilization of bacteriophages,it is necessary to isolate and characterize as many as possible different bacteriophages.Here we describe the isolation of a T4-like bacteriophage IME08 and a rapid method for its genetic characterization.With this method we easily cloned a few random fragments of the bacteriophage genome.Sequence analysis of these random clones showed that bacteriophage IME08 shared the highest sequence similarity with T4-like Enterobacteria phage T4（94%identity）,JS98（95% identity）,JS10（95%identity） and RB14（94%identity） respectively,which suggested that IME08 belonged to T4-like bacteriophage genus.

Effect of Post-Treatment Conditions on the Inactivation of MS2 Bacteriophage as Indicator for Pathogenic Viruses after the Composting Process

A rural model composting toilet system still had some pathogens in the compost after months of operation and hence requires a post-treatment. The aim of the study was to sanitize compost withdrawn from the composting toilet by setting post-treatment conditions. The kinetics inactivation of MS2 bacteriophage, selected as indicator for pathogenic viruses were determined during post-treatment at different temperatures (30°C, 40°C and 50°C) with varying moisture contents (50%, 60% and 70%). As a result, the inactivation rates during the post-treatment were 0.093 - 0.020 h-1, 0.025 - 0.088 h1, 0.447 - 0.100 h-1 at 30°C, 40°C and 50°C respectively. The inactivation rate coefficient (k) values of MS2 bacteriophage depended on higher temperature but not on moisture content.

Isolation and complete genome sequence of a novel virulent mycobacteriophage, CASbig

Dear Editor,Bacteriophages are powerful tools for investigating and manipulating their hosts(Fernandes et al.,2014).This holds particularly true for mycobacteriophages,which have facilitated the development of mycobacterial genetic systems and have generated tools for the clinical

Preparation and properties of bacteriophage-borne enzyme degrading bacterial exopolysaccharide

Bacteriophages infected different serotypes of Klebsiella were isolated from sewage. Among them, a heatstable polysaccharide depolymerase enzyme which could degrade bacterial exopolysaccharide effectively was prepared from the phage infecting Klebsiella K13. Treatment at 60℃ for 30 min could inactivate most of the K13 phage, with the titration decreasing from 6.4×10^8 PFU/mL to 1.6×10^6 PFU/mL. However, no obvious loss of phage enzyme activity was found after this treatment. The optimum hydrolytic temperature of phage enzyme was 60℃, with an activity 57 % higher than that at 30℃. The addition of phage enzyme could result in a rapid decrease of viscosity of exopolysaccharide （EPS） solution within minutes, indicating that K13 phage polysaccharide depolymerase acts as a kind of endo-glycanohydrolase. HPLC and reducing sugar analysis showed that the hydrolysis of EPS approached approximately the maxi-mum at 4h when the final concentration of phage was 6.0 x los PFU/mL. The results showed that K/eb-siella K13 phage depolymerase enzyme could be used as a good tool for the preparation of EPS oligosac- charide.