Phage Therapy: Primer and Role in the Treatment of MDROs
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ANTIMICROBIAL DEVELOPMENT AND DRUG RESISTANCE (KC CLAEYS AND J SMITH, SECTION EDITORS)
Phage Therapy: Primer and Role in the Treatment of MDROs Nancy Law 1 & Saima Aslam 1,2 Accepted: 27 October 2020 / Published online: 13 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Given increasing prevalence of multi-drug resistant organisms (MDROs), there is a significant interest in exploring non-antibiotic therapeutic options. We discuss basics of bacteriophage therapy (BT) and its role in the treatment of infections due to MDRO. Recent Findings BT employs lytic viruses to infect and lyse bacterial pathogens and is an emerging treatment strategy for treatment of infections caused by MDROs. We summarize key characteristics that make BT an attractive option against MDROs, discuss recent cases in which BT was successfully used to treat antibiotic recalcitrant infections, and discuss challenges that need to be overcome to make BT a viable clinical strategy. Summary BT is a viable therapeutic option needing further research in order to bring it to clinical practice. Keywords Bacteriophage . Phage therapy . Multidrug-resistant organisms . MDRO
Introduction The increasing prevalence of multi-drug resistant organisms (MDRO) is a major public health threat. The Centers for Disease Control and Prevention (CDC) reported in 2019 that more than 2.8 million antibiotic-resistant infections occur in the USA each year leading to mortality in greater than 35,000 people [1]. The lack of development of new antibiotics coupled with their misuse and overuse has now created a situation termed as the “post-antibiotic” era [2, 3]. Due to this, multiple nonantibiotic research avenues are being pursued for both prevention and treatment of infections. These include the use of vaccines and immune stimulation, bacteriophages as well as bacteriophage lysins, antibodies that bind to and inactivate pathogen virulence factors or toxins, and probiotics [3–15].
This article is part of the Topical Collection on Antimicrobial Development and Drug Resistance * Saima Aslam [email protected] 1
Division of Infectious Diseases and Global Public Health, University of California, 4510 Executive Drive, MC 7745, La Jolla, San Diego, CA 92121, USA
2
Center for Innovative Phage Applications and Therapeutics, University of California, La Jolla, San Diego, CA, USA
Bacteriophage therapy (BT) is an emerging strategy for the treatment of MDRO infections and is considered to be among the top ten innovative therapies meriting further investigation in the antimicrobial arena [4]. BT consists of the administration of targeted lytic bacteriophages for the treatment of infections [16]. In this review, we discuss mechanisms of action and potential clinical utility of BT for treatment of MDRO infections as well as benefits, challenges, and future directions.
Primer on Bacteriophages Mechanism of Action Bacteriophages (phages) are viruses that bind to the surface of bacteria and transfer viral DNA or RNA into
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