Bacteriophage Therapy for Treating Infections: Hope or Hype?
Keywords:
Bacteriophage, Infection, Antibiotic, Antibitioc resistance, Pseudomonas aeruginosaAbstract
Bacteriophage therapy employs the use of viruses to kill bacteria and has been noted to confer reversal of antimicrobial resistance. It was proposed around the same time as antibiotic therapy for combatting infections but lost the race for becoming the mainstay therapy. However, antibiotic resistance is increasingly resulting in morbidity and mortality. Bacteriophage therapy as an alternative approach for combatting infections has garnered speculation and interest of many scientists with hopes that it may become a management strategy for multi-drug resistant infections. The aim of this review is to shed light on the developments in bacteriophage therapy, explain lytic cycles as the proposed functional mechanism and discuss the evidence base: preclinical, case-based and clinical trials. There is preliminary evidence that alludes to an element of safety and efficacy in treating multidrug resistant infections. However, there is a paucity of high-quality evidence, which could bring this therapy into routine practice. This is further burdened by limitations such as the need for an individualised approach and our lack of understanding of the immune reactions to it. This therapy is quite promising, but much work is needed before it can be considered for routine clinical practice.
References
2. Ribeiro da Cunha B, Fonseca LP, Calado CR. Antibiotic discovery: where have we come from, where do we go? Antibiotics. 2019;8(2):45.
3. Hamilton WL, Wenlock R. Antimicrobial resistance: a major threat to public health. Cambridge Med. 2016;10.
4. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-E86.
5. Department of Health. Contained and controlled: The UK’s 20-year vision for antimicrobial resistance. GOV UK. 2019:19.
6. Chan BK, Sistrom M, Wertz JE, Kortright KE, Narayan D, Turner PE. Phage selection restores antibiotic sensitivity in MDR Pseudomonas aeruginosa. Sci Rep. 2016;6:26717.
7. Wittebole X, De Roock S, Opal SM. A historical overview of bacteriophage therapy as an alternative to antibiotics for the treatment of bacterial pathogens. Virulence. 2014;5(1):226-35.
8. Howard-Varona C, Hargreaves KR, Abedon ST, Sullivan MB. Lysogeny in nature: mechanisms, impact and ecology of temperate phages. ISME J. 2017;11(7):1511-20.
9. Brüssow H, Hendrix RW. Phage genomics: small is beautiful. Cell. 2002;108(1):13-6.
10. Lederberg EM, Lederberg J. Genetic studies of lysogenicity in Escherichia coli. Genetics. 1953;38(1):51.
11. Pang Z, Raudonis R, Glick BR, Lin T-J, Cheng Z. Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies. Biotechnol Adv. 2019;37(1):177-92.
12. Melo LD, Oliveira H, Pires DP, Dabrowska K, Azeredo J. Phage therapy efficacy: a review of the last 10 years of preclinical studies. Crit Rev Microbiol. 2020:1-22.
13. Chan BK, Turner PE, Kim S, Mojibian HR, Elefteriades JA, Narayan D. Phage treatment of an aortic graft infected with Pseudomonas aeruginosa. Evol Med Public Health. 2018;2018(1):60-6.
14. Schooley RT, Biswas B, Gill JJ, Hernandez-Morales A, Lancaster J, Lessor L, et al. Development and use of personalized bacteriophage-based therapeutic cocktails to treat a patient with a disseminated resistant Acinetobacter baumannii infection. Antimicrob Agents Chemother. 2017;61(10):e00954-17.
15. Maddocks S, Fabijan AP, Ho J, Lin RC, Ben Zakour NL, Dugan C, et al. Bacteriophage therapy of ventilator-associated pneumonia and empyema caused by Pseudomonas aeruginosa. Am J Respir Crit Care Med. 2019;200(9):1179-81.
16. Law N, Logan C, Yung G, Furr C-LL, Lehman SM, Morales S, et al. Successful adjunctive use of bacteriophage therapy for treatment of multidrug-resistant Pseudomonas aeruginosa infection in a cystic fibrosis patient. Infection. 2019;47(4):665-8.
17. Rhoads D, Wolcott R, Kuskowski MA, Wolcott B, Ward L, Sulakvelidze A. Bacteriophage therapy of venous leg ulcers in humans: results of a phase I safety trial. J Wound Care. 2009;18(6):237-43.
18. Wright A, Hawkins CH, Anggard EE, Harper DR. A controlled clinical trial of a therapeutic bacteriophage preparation in chronic otitis due to antibiotic-resistant Pseudomonas aeruginosa; a preliminary report of efficacy. Clin Otolaryngol. 2009;34(4):349-57.
19. Principi N, Silvestri E, Esposito S. Advantages and limitations of bacteriophages for the treatment of bacterial infections. Front Pharmacol. 2019;10:513.
20. Krut O, Bekeredjian-Ding I. Contribution of the immune response to phage therapy. J Immunol Res. 2018;200(9):3037-44.
Downloads
Published
How to Cite
License
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
Provided they are the owners of the copyright to their work, authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository, in a journal or publish it in a book), with an acknowledgement of its initial publication in this journal.