scholarly journals Stemming the tide of antibiotic resistance by exploiting bacteriophages

2020 ◽  
Vol 42 (6) ◽  
pp. 6-11
Author(s):  
Michael J Love ◽  
Renwick C J Dobson ◽  
Craig Billington
Keyword(s):  
Clinical Trials ◽  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Ad Hoc ◽  
Phage Therapy ◽  
Antibiotic Use ◽  
Alternative Strategies ◽  
Life Saving ◽  
Regulatory Guidelines ◽  
Future Supply

The growing prevalence of antibiotic resistance is a global crisis. It is predicted that by 2050, antibiotic resistance-related deaths will exceed by 10 million per year. Thus, there is an urgent need for alternative strategies that can either replace or supplement antibiotic use. Bacteriophages and their encoded lytic proteins, called endolysins, have both shown promise as antibiotic alternatives. Bacteriophages were first investigated as therapeutics nearly a century ago, but the success of antibiotics led to phage therapy being largely abandoned in Western medicine until recently. While sporadic reports of life-saving successes in the ad hoc use of phage therapy have emerged, properly designed, robust clinical trials and clear regulatory guidelines are required before the true potential of phage therapy can be realized. In addition, despite endolysin research still being in its infancy, the early successes of endolysin-based therapeutics already entering clinical trials are an exciting glimpse into the future. No stone can be left unturned in the discovery and development of novel therapeutics if we are to ensure a future supply of effective treatments for bacterial infections.

scholarly journals Phage Therapy for a Multidrug-Resistant Acinetobacter baumannii Craniectomy Site Infection

2018 ◽  
Vol 5 (4) ◽  
Author(s):  
Stephanie LaVergne ◽  
Theron Hamilton ◽  
Biswajit Biswas ◽  
M Kumaraswamy ◽  
R T Schooley ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Alternative Treatment ◽  
Bacterial Infections ◽  
Phage Therapy ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Site Infection ◽  
Bacteriophage Therapy

Abstract In the era of antibiotic resistance, alternative treatment options for multidrug-resistant bacterial infections are being explored. We present a case of multidrug-resistant Acinetobacter baumannii infection treated with bacteriophages. Clinical trials are needed to further investigate bacteriophage therapy as an option to treat multidrug-resistant bacterial infections.

scholarly journals Bacteriophages as Alternatives to Antibiotics in Clinical Care

Antibiotics ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. 138 ◽  
Author(s):  
Danitza Romero-Calle ◽  
Raquel Guimarães Benevides ◽  
Aristóteles Góes-Neto ◽  
Craig Billington
Keyword(s):  
Clinical Trials ◽  
Bacterial Infections ◽  
Ad Hoc ◽  
Phage Therapy ◽  
Clinical Care ◽  
Bacterial Diseases ◽  
Immunological Responses ◽  
Regulatory Guidance ◽  
Review Reports ◽  
New Treatments

Antimicrobial resistance is increasing despite new treatments being employed. With a decrease in the discovery rate of novel antibiotics, this threatens to take humankind back to a “pre-antibiotic era” of clinical care. Bacteriophages (phages) are one of the most promising alternatives to antibiotics for clinical use. Although more than a century of mostly ad-hoc phage therapy has involved substantial clinical experimentation, a lack of both regulatory guidance standards and effective execution of clinical trials has meant that therapy for infectious bacterial diseases has yet to be widely adopted. However, several recent case studies and clinical trials show promise in addressing these concerns. With the antibiotic resistance crisis and urgent search for alternative clinical treatments for bacterial infections, phage therapy may soon fulfill its long-held promise. This review reports on the applications of phage therapy for various infectious diseases, phage pharmacology, immunological responses to phages, legal concerns, and the potential benefits and disadvantages of this novel treatment.

scholarly journals Phage-Encoded Endolysins

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 124
Author(s):  
Fatma Abdelrahman ◽  
Maheswaran Easwaran ◽  
Oluwasegun I. Daramola ◽  
Samar Ragab ◽  
Stephanie Lynch ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cell Wall ◽  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Therapeutic Strategies ◽  
Therapeutic Application ◽  
Significant Evidence ◽  
Crucial Information

Due to the global emergence of antibiotic resistance, there has been an increase in research surrounding endolysins as an alternative therapeutic. Endolysins are phage-encoded enzymes, utilized by mature phage virions to hydrolyze the cell wall from within. There is significant evidence that proves the ability of endolysins to degrade the peptidoglycan externally without the assistance of phage. Thus, their incorporation in therapeutic strategies has opened new options for therapeutic application against bacterial infections in the human and veterinary sectors, as well as within the agricultural and biotechnology sectors. While endolysins show promising results within the laboratory, it is important to document their resistance, safety, and immunogenicity for in-vivo application. This review aims to provide new insights into the synergy between endolysins and antibiotics, as well as the formulation of endolysins. Thus, it provides crucial information for clinical trials involving endolysins.

scholarly journals Bacteriophages: A Revisited Strategy for the Treatment of Severe Bacterial Infections

2020 ◽  
Vol 2 (3) ◽  
pp. 78-79
Author(s):  
Roberto Badaro
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Phage Therapy ◽  
Bacterial Pathogen ◽  
Severe Infection ◽  
Current Increase ◽  
Therapeutic Alternative ◽  
The Ideal

Bacteriophages are viruses that infect and parasitize bacteria. The current increase in the incidence of antibiotic resistance in human bacteria has favoredthe study of phages as a therapeutic alternative (phage therapy). Phage therapy is defined as the administration of virulent phages directly to a patient to lyse the bacterial pathogen that is causing a clinically severe infection. The ideal route of administration and modification of bacteriopaghes genetically to deactivate bacterial resistance genes is the next future to antibiotic recovery sensitivity of MDR organisms.

A UK-based survey of cat owners’ perceptions and experiences of antibiotic usage

2019 ◽  
Vol 22 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Jennifer Stallwood ◽  
Alex Shirlow ◽  
Angie Hibbert
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Stewardship ◽  
Diagnostic Tests ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Diagnostic Testing ◽  
Antibiotic Use ◽  
Good Communication ◽  
Long Acting ◽  
Veterinary Antibiotic

Objectives The aim of this study was to explore owners’ knowledge of antibiotics, experience of antibiotic use in their cats and involvement in decision-making regarding antibiotic prescriptions. Methods Cat owners were recruited via social media and veterinary practices to complete a survey designed to evaluate general knowledge of antibiotics, attitudes to antibiotic stewardship and experiences of antibiotic use in their own cat between November 2017 and March 2018. Data were analysed descriptively. Results A total of 1436 surveys were completed; 247 respondents (17.2%) had a veterinary background. The majority of the remaining respondents correctly identified that antibiotics treat bacterial infections (84.0%; n = 999) but do not treat viral infections (72.8%; n = 865). A minority (n = 338; 28.4%) agreed that antibiotic resistance was a problem in cats in the UK; 92.3% (n = 1097) identified that resistance was a problem in human medicine. Seventy percent (n = 832) of the respondents’ cats had received antibiotics; 29.6% (n = 246) received a long-acting injectable antibiotic (14 days’ duration). Diagnostic tests were performed before antibiotic prescription in 38.7% (n = 322) of cats; 1.4% (n = 7) of respondents reported declining suggested tests and 65.8% (n = 778) indicated that they would be happy to pay for diagnostic tests to allow selection of the most appropriate antibiotic. Most respondents (95.8%; n = 792) indicated that they were happy to follow their veterinarian’s advice and recommendations; however, 49.2% (n = 405) had expected antibiotics to be prescribed. Conclusions and relevance Cat owners demonstrated good knowledge of antibiotic action; however, greater owner education regarding the potential for veterinary antibiotic resistance, requirement for diagnostic testing and training in the administration of oral medication with first-line antibiotics, as well as the use of veterinary antibiotic guidelines, will improve antibiotic stewardship. Good communication between veterinarians and owners is necessary for rational antibiotic use.

scholarly journals Antibiotics in Food Chain: The Consequences for Antibiotic Resistance

Antibiotics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 688
Author(s):  
Shashi B. Kumar ◽  
Shanvanth R. Arnipalli ◽  
Ouliana Ziouzenkova
Keyword(s):  
Public Health ◽  
Antibiotic Resistance ◽  
Food Chain ◽  
Bacterial Infections ◽  
Antibiotic Resistance Genes ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Alternative Strategies ◽  
Antibiotic Resistant ◽  
Continuous Use

Antibiotics have been used as essential therapeutics for nearly 100 years and, increasingly, as a preventive agent in the agricultural and animal industry. Continuous use and misuse of antibiotics have provoked the development of antibiotic resistant bacteria that progressively increased mortality from multidrug-resistant bacterial infections, thereby posing a tremendous threat to public health. The goal of our review is to advance the understanding of mechanisms of dissemination and the development of antibiotic resistance genes in the context of nutrition and related clinical, agricultural, veterinary, and environmental settings. We conclude with an overview of alternative strategies, including probiotics, essential oils, vaccines, and antibodies, as primary or adjunct preventive antimicrobial measures or therapies against multidrug-resistant bacterial infections. The solution for antibiotic resistance will require comprehensive and incessant efforts of policymakers in agriculture along with the development of alternative therapeutics by experts in diverse fields of microbiology, biochemistry, clinical research, genetic, and computational engineering.

scholarly journals The Ecology of Phage Resistance: The Key to Successful Phage Therapy?

2020 ◽  
Author(s):  
Marissa Gittrich ◽  
Yunxiao Liu ◽  
Funing Tian ◽  
Audra Crouch ◽  
Ho Bin Jang ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Natural Variation ◽  
Phage Therapy ◽  
Phage Resistance ◽  
Clinical Settings ◽  
Viral Sequence ◽  
Bacterial Gene ◽  
Microbial Host ◽  
Host Genes

: As antibiotic resistance undermines efforts to treat bacterial infections, phage therapy is being increasingly considered as an alternative in clinical settings and agriculture. However, a major concern in using phages is that pathogens will develop resistance to the phage. Due to the constant evolutionary pressure by phages, bacteria have evolved numerous mechanisms to block infection. If we determine the most common among them, we could use this knowledge to guide phage therapeutics. Here we compile data from 88 peer-reviewed studies where phage resistance was experimentally observed and linked to a bacterial gene, then assessed these data for patterns. In total, 141 host genes were identified to block infection against one or more of 80 phages (representing five families of the Caudovirales) across 16 microbial host genera. These data suggest that bacterial phage resistance is diverse, but even well-studied systems are understudied, and there are gaping holes in our knowledge of phage resistance across lesser-studied regions of microbial and viral sequence space. Fortunately, scalable approaches are newly available that, if broadly adopted, can provide data to power ecosystem-aware models that will guide harvesting natural variation towards designing effective, broadly applicable phage therapy cocktails as an alternative to antibiotics.

scholarly journals The Mortality Burden of Multidrug-resistant Pathogens in India: A Retrospective, Observational Study

2018 ◽  
Vol 69 (4) ◽  
pp. 563-570 ◽  
Author(s):  
Sumanth Gandra ◽  
Katie K Tseng ◽  
Anita Arora ◽  
Bhaskar Bhowmik ◽  
Matthew L Robinson ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Future Research ◽  
Middle Income ◽  
Health Crisis ◽  
Transmission Mechanisms ◽  
Hospital Study

Abstract Background The threat posed by antibiotic resistance is of increasing concern in low- and middle-income countries (LMICs) as their rates of antibiotic use increase. However, an understanding of the burden of resistance is lacking in LMICs, particularly for multidrug-resistant (MDR) pathogens. Methods We conducted a retrospective, 10-hospital study of the relationship between MDR pathogens and mortality in India. Patient-level antimicrobial susceptibility test (AST) results for Enterococcus spp., Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. were analyzed for their association with patient mortality outcomes. Results We analyzed data on 5103 AST results from 10 hospitals. The overall mortality rate of patients was 13.1% (n = 581), and there was a significant relationship between MDR and mortality. Infections with MDR and extensively drug resistant (XDR) E. coli, XDR K. pneumoniae, and MDR A. baumannii were associated with 2–3 times higher mortality. Mortality due to methicillin-resistant S. aureus (MRSA) was significantly higher than susceptible strains when the MRSA isolate was resistant to aminoglycosides. Conclusions This is one of the largest studies undertaken in an LMIC to measure the burden of antibiotic resistance. We found that MDR bacterial infections pose a significant risk to patients. While consistent with prior studies, the variations in drug resistance and associated mortality outcomes by pathogen are different from those observed in high-income countries and provide a baseline for studies in other LMICs. Future research should aim to elucidate the burden of resistance and the differential transmission mechanisms that drive this public health crisis.

Phage Therapy: A Potential Solution for Antibiotic Resistance

2021 ◽  
Author(s):  
Chirag Choudhary ◽  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Phage Therapy ◽  
Biological Agents ◽  
Resistant Bacteria ◽  
Potential Solution ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant ◽  
The Future

The idea of using a virus to kill bacteria may seem counterintuitive, but it may be the future of treating bacterial infections. Before the COVID-19 pandemic, one of the most frightening biological agents were so-called “superbugs” – antibiotic resistant bacteria – which could not be treated with conventional therapeutics. When antibiotics were first developed, they were hailed as a panacea. A panacea they were not.

scholarly journals Public knowledge, attitudes and practices surrounding antibiotic use and resistance in Cambodia

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Jane Mingjie Lim ◽  
Pheak Chhoun ◽  
Sovannary Tuot ◽  
Chhorvoin Om ◽  
Sidonn Krang ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Action Plan ◽  
Household Survey ◽  
Population Level ◽  
Antibiotic Use ◽  
Local Context ◽  
Public Knowledge ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

Abstract Background WHO’s Global Action Plan on Antimicrobial Resistance includes as a priority to increase public education surrounding antibiotic use and resistance. Monitoring population-level antibiotic behaviours is crucial for informing intervention strategies, but data from a broad range of settings, particularly lower-resourced countries, are lacking. Objectives We measured public knowledge, attitudes and practices regarding antibiotics and antibiotic resistance in Cambodia, providing baseline information against which to monitor the progress of future interventions. Methods Between September and October 2018, we conducted a household survey of knowledge, attitudes and practices related to antibiotic use in urban and rural populations of three Cambodian provinces: Phnom Penh, Siem Reap and Prey Veng. Response rates were respectively 79%, 86% and 86%. Results Among the 2005 participants, we found high levels of awareness of terms relating to antibiotics (86.5%) and antibiotic resistance; most participants also recognized that antibiotic resistance is a problem (58.4%). However, few understood that antibiotics are effective only against bacterial infections (1.2%). We also found province-specific differences in participants’ sources of antibiotics and their sources of AMR-related information. In regression analyses, more favourable antibiotic practice scores were associated with higher knowledge (β = 0.18; 95% CI: 0.14–0.22) and attitude (β = 0.16; 95% CI: 0.11–0.22) scores, as well as trust in healthcare sources to obtain antibiotics and antibiotic information. Conclusions This study highlights the importance of interventions and public communication on antibiotic use and resistance that is effectively targeted to the local context through trusted healthcare providers.

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