Phage-antibiotic combinations against multidrug-resistant Pseudomonas aeruginosa in in vitro static and dynamic biofilm models

Biofilm-producing infections pose a severe threat to public health and are responsible for high morbidity and mortality. Phage-antibiotic combinations (PACs) are a promising strategy for combatting multidrug-resistant (MDR), extensively drug-resistant (XDR), and difficult-to-treat infections. Ten MD...

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Veröffentlicht in:Antimicrobial agents and chemotherapy Jg. 67; H. 11; S. e0057823
Hauptverfasser: Holger, Dana J, El Ghali, Amer, Bhutani, Natasha, Lev, Katherine L, Stamper, Kyle, Kebriaei, Razieh, Kunz Coyne, Ashlan J, Morrisette, Taylor, Shah, Rahi, Alexander, Jose, Lehman, Susan M, Rojas, Laura J, Marshall, Steven H, Bonomo, Robert A, Rybak, Michael J
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 15.11.2023
Schlagworte:
Anti-Bacterial Agents - pharmacology
Bacteriophages
Biofilms
Ciprofloxacin - pharmacology
Humans
Pseudomonas aeruginosa
Pseudomonas Infections - drug therapy
antimicrobial combinations
synergy
antimicrobial resistance
cocktail
Pseudomonas aeruginosa
MDR
phage
antibiotics
bacteriophage
biofilms
ISSN:1098-6596, 1098-6596
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Zusammenfassung:Biofilm-producing infections pose a severe threat to public health and are responsible for high morbidity and mortality. Phage-antibiotic combinations (PACs) are a promising strategy for combatting multidrug-resistant (MDR), extensively drug-resistant (XDR), and difficult-to-treat infections. Ten MDR/XDR strains and five . -specific phages were genetically characterized and evaluated based upon their antibiotic susceptibilities and phage sensitivities. Two selected strains, AR351 (XDR) and I0003-1 (MDR), were treated singly and in combination with either a broad-spectrum or narrow-spectrum phage, phage EM-T3762627-2_AH (EM), or 14207, respectively, and bactericidal antibiotics of five classes in biofilm time-kill analyses. Synergy and/or bactericidal activity was demonstrated with all PACs against one or both drug-resistant strains (average reduction: -Δ3.32 log CFU/cm ). Slightly improved ciprofloxacin susceptibility was observed in both strains after exposure to phages (EM and 14207) in combination with ciprofloxacin and colistin. Based on phage cocktail optimization with four phages (EM, 14207, E20050-C (EC), and 109), we identified several effective phage-antibiotic cocktails for further analysis in a 4-day pharmacokinetic/pharmacodynamic biofilm model. Three-phage cocktail, EM + EC + 109, in combination with ciprofloxacin demonstrated the greatest biofilm reduction against AR351 (-Δ4.70 log CFU/cm from baseline). Of remarkable interest, the addition of phage 109 prevented phage resistance development to EM and EC in the biofilm model. PACs can demonstrate synergy and offer enhanced eradication of biofilm against drug-resistant while preventing the emergence of resistance.
Bibliographie:ObjectType-Article-1
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content type line 23
ISSN:1098-6596
1098-6596
DOI:10.1128/aac.00578-23