Bacteriophages and Lysins as Possible Alternatives to Treat Antibiotic-Resistant Urinary Tract Infections

Urinary tract infections represent a major public health problem as the rapid emergence of antibiotic-resistant strains among uropathogens is causing the failure of many current treatments. The use of bacteriophages (phages) and their derivatives to combat infectious diseases is an old approach that has been forgotten by the West for a long time, mostly due to the discovery and great success of antibiotics. In the present so-called “post-antibiotic era”, many researchers are turning their attention to the re-discovered phage therapy, as an effective alternative to antibiotics. Phage therapy includes the use of natural or engineered phages, as well as their purified lytic enzymes to destroy pathogenic strains. Many in vitro and in vivo studies have been conducted, and these have proved the great potential for this therapy against uropathogenic bacteria. Nevertheless, to date, the lack of appropriate clinical trials has hindered its widespread clinic application.

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Targeting Biofilm of MDR Providencia stuartii by Phages Using a Catheter Model

Antibiotics ◽

10.3390/antibiotics10040375 ◽

2021 ◽

Vol 10 (4) ◽

pp. 375

Author(s):

Chani Rakov ◽

Shira Ben Porat ◽

Sivan Alkalay-Oren ◽

Ortal Yerushalmy ◽

Mohanad Abdalrhman ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Phage Therapy ◽

Multiple Drug ◽

Bacterial Strains ◽

Antibiotic Resistant ◽

Isolation And Characterization ◽

Wide Range ◽

Providencia Stuartii ◽

Tract Infections

Providencia spp. are emerging pathogens mainly in nosocomial infections. Providencia stuartii in particular is involved in urinary tract infections and contributes significantly to the high incidence of biofilm-formation in catheterized patients. Furthermore, recent reports suggested a role for multiple drug resistant (MDR) P. stuartii in hospital-associated outbreaks which leads to excessive complications resulting in challenging treatments. Phage therapy is currently one of the most promising solutions to combat antibiotic-resistant infections. However, the number of available phages targeting Providencia spp. is extremely limited, restricting the use of phage therapy in such cases. In the present study, we describe the isolation and characterization of 17 lytic and temperate bacteriophages targeting clinical isolates of Providencia spp. as part of the Israeli Phage Bank (IPB). These phages, isolated from sewage samples, were evaluated for host range activity and effectively eradicated 95% of the tested bacterial strains isolated from different geographic locations and displaying a wide range of antibiotic resistance. Their lytic activity is demonstrated on agar plates, planktonic cultures, and biofilm formed in a catheter model. The results suggest that these bacteriophages can potentially be used for treatment of antibiotic-resistant Providencia spp. infections in general and of urinary tract infections in particular.

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Targeting Biofilm of MDR Providencia stuartii by Phages Using a Catheter Model

10.1101/2021.03.02.433687 ◽

2021 ◽

Author(s):

Chani Rakov ◽

Shira Ben Porat ◽

Sivan Alkalay-Oren ◽

Ortal Yerushalmy ◽

Mohanad Abdalrhman ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Phage Therapy ◽

Multiple Drug ◽

Bacterial Strains ◽

Antibiotic Resistant ◽

Isolation And Characterization ◽

Wide Range ◽

Providencia Stuartii ◽

Tract Infections

AbstractProvidencia spp. are emerging pathogens mainly in nosocomial infections. Providencia stuartii in particular is involved in urinary tract infections and contributes significantly to the high incidence of biofilm-formation in catheterized patients. Furthermore, recent reports suggested a role for multiple drug resistant (MDR) P. stuartii in hospital-associated outbreaks which leads to excessive complications resulting in challenging treatments. Phage therapy is currently one of the most promising solutions to combat antibiotic-resistant infections. However, the number of available phages targeting Providencia spp. is extremely limited, restricting the use of phage therapy in such cases. In the present study, we describe the isolation and characterization of 17 lytic and lysogenic bacteriophages targeting clinical isolates of Providencia spp. as part of the Israeli Phage Bank (IPB). These phages, isolated from sewage samples, were evaluated for host range activity and effectively eradicated 95% of the tested bacterial strains isolated from different geographic locations and displaying a wide range of antibiotic resistance. Their lytic activity is demonstrated on agar plates, planktonic cultures, and biofilm formed in a catheter model. The results suggest that these bacteriophages can potentially be used for treatment of antibiotic-resistant Providencia spp. infections in general and of urinary tract infections in particular.

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1069: Bad bugs: antibiotic-resistant lower urinary tract infections and risk of pyelonephritis in pregnancy

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.11.1082 ◽

2020 ◽

Vol 222 (1) ◽

pp. S660

Author(s):

Anna DeNoble ◽

Madison Krischak ◽

Heather Rosett ◽

Sarika Sachdeva ◽

Kristin Weaver ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Lower Urinary Tract ◽

Antibiotic Resistant ◽

Tract Infections ◽

In Pregnancy ◽

Lower Urinary

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A clinical and microbiological profile of urinary tract infection in patients with chronic kidney diseases

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20192263 ◽

2019 ◽

Vol 6 (3) ◽

pp. 911

Author(s):

Siddharth Pugalendhi ◽

Tarun Kumar Dutta ◽

Hemachandar R. ◽

Lokesh S.

Keyword(s):

Urinary Tract ◽

Urine Analysis ◽

Kidney Diseases ◽

Tertiary Care ◽

Public Health Problem ◽

Blood Analysis ◽

Resistance Pattern ◽

Major Public Health Problem ◽

Care Hospital ◽

Tract Infections

Background: Urinary tract infections (UTIs) are a major public health problem in terms of morbidity and financial cost in CKD patients in India. The resistance pattern of community acquired uropathogens in CKD patients has not been extensively studied. Thus, knowledge of local antimicrobial susceptibility patterns of common uropathogens is essential for prudent empiric therapy of community acquired UTIs.Methods: It is a cross sectional study conducted in a tertiary care hospital involving 65 chronic kidney disease patients with UTI who attended general medicine OPD and those admitted in wards after fulfilling the inclusion and exclusion criteria, after obtaining written informed consent. Blood sample and urine samples were collected from these patients and sent for blood analysis, urine analysis and urine culture and sensitivity.Results: Among 65 CKD participants with UTI who were studied, E. coli (47.7%) and K. pneumoniae (15.4%) were the most common isolates which were sensitive in order of colistin, polymyxin B, meropenem (carbapenem) and less sensitive to other commonly used antibiotics.Conclusions: The main purpose of this study was to find the various common local uropathogens in CKD patients and their antibiotic profile which will help in formulating antibiotic therapies. As previously stated, there are very few studies regarding profile and management of UTI in CKD patients. Hence this study can throw some light into this area.

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Spread of Enterococcal Surface Protein in Antibiotic Resistant Entero-coccus faecium and Enterococcus faecalis isolates from Urinary Tract Infections

The Open Microbiology Journal ◽

10.2174/1874285801509010014 ◽

2015 ◽

Vol 9 (1) ◽

pp. 14-17 ◽

Cited By ~ 21

Author(s):

Hossein Samadi Kafil ◽

Ashraf Mohabati Mobarez

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Biofilm Formation ◽

Urinary Infection ◽

Surface Protein ◽

Antibiotic Resistant ◽

Specific Pcr ◽

Tract Infections

Enterococci rank among leading cause of nosocomial bacteremia and urinary tract infection in hospital and community acquired infections. Several traits that may contribute to enhanced virulence have been identified in Enterococci. Extracellular surface protein (Esp) is a virulence factor that contributes in biofilm formation and resistance to environmental stresses. In this study we aimed to determine occurrence ofespinE. faeciumandE. faecalisisolates isolated from urinary tract infections and to investigate whether there is any correlation between presence ofespand antibiotic resistance. One hundred and sixty six isolates were collected from patients with UTI and after identification by biochemical and PCR, antibiotic resistances were examined. The presence ofespwas investigated by primer-specific PCR. 43.3% of isolates identified asE. faeciumand 56.7% asE. faecalis. Theespgene was found in 76.1% ofE. faeciumisolates and 77.9% ofE. faecalisisolate. There were significant correlation betweenesppositiveE. faeciumand resistance to Vancomycin (p<0.01), also inE.faecaliswe found correlation betweenesppositive and resistance to Ampicillin, Chloramphenicol and Tetracycline (p<0.01, p<0.01, p<0.01 respectively). Occurrence ofespin our isolates from urinary tract infection was high that indicates importance of this gene in urinary tract infections and shows importance of ability to forming biofilm and hydrophobicity of surface of Enterococci for causing urinary infection by Enterococci. Also, our finding showed significant correlation between resistance to antibiotics and presence ofespin Enterococci.

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Risk Factors for Antibiotic-Resistant Escherichia coli Isolated from Hospitalized Patients with Urinary Tract Infections: a Prospective Study

Journal of Clinical Microbiology ◽

10.1128/jcm.39.2.438-444.2001 ◽

2001 ◽

Vol 39 (2) ◽

pp. 438-444 ◽

Cited By ~ 67

Author(s):

A. Sotto ◽

C. M. De Boever ◽

P. Fabbro-Peray ◽

A. Gouby ◽

D. Sirot ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Urinary Tract ◽

Prospective Study ◽

Urinary Tract Infections ◽

Hospitalized Patients ◽

Antibiotic Resistant ◽

Tract Infections ◽

A Prospective Study

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Phage Therapy as a Novel Strategy in the Treatment of Urinary Tract Infections Caused by E. Coli

Antibiotics ◽

10.3390/antibiotics9060304 ◽

2020 ◽

Vol 9 (6) ◽

pp. 304 ◽

Cited By ~ 4

Author(s):

Beata Zalewska-Piątek ◽

Rafał Piątek

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Biofilm Formation ◽

Bacterial Infections ◽

Phage Therapy ◽

Age Groups ◽

E Coli ◽

The World ◽

Novel Strategy ◽

Tract Infections

Urinary tract infections (UTIs) are regarded as one of the most common bacterial infections affecting millions of people, in all age groups, annually in the world. The major causative agent of complicated and uncomplicated UTIs are uropathogenic E. coli strains (UPECs). Huge problems with infections of this type are their chronicity and periodic recurrences. Other disadvantages that are associated with UTIs are accompanying complications and high costs of health care, systematically increasing resistance of uropathogens to routinely used antibiotics, as well as biofilm formation by them. This creates the need to develop new approaches for the prevention and treatment of UTIs, among which phage therapy has a dominant potential to eliminate uropathogens within urinary tract. Due to the growing interest in such therapy in the last decade, the bacteriophages (natural, genetically modified, engineered, or combined with antibiotics or disinfectants) represent an innovative antimicrobial alternative and a strategy for managing the resistance of uropathogenic microorganisms and controlling UTIs.

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Urinary Tract Infections with Antibiotic Resistant Organisms in Catheterized Nursing Home Patients

Infection Control ◽

10.1017/s0195941700059178 ◽

1984 ◽

Vol 5 (4) ◽

pp. 173-176 ◽

Cited By ~ 62

Author(s):

David T. Bjork ◽

Lawrence L. Pelletier ◽

Robert R. Tight

Keyword(s):

Nursing Home ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Resistant Bacteria ◽

Urinary Catheters ◽

Antibiotic Resistant ◽

Inappropriate Use ◽

Nursing Home Patients ◽

Tract Infections ◽

Antibiotic Courses

AbstractLong-term use of indwelling urinary catheters in nursing home (NH) patients is a potential cause of significant morbidity. We retrospectively studied 10 NH patients with chronic indwelling urinary catheters. Sixty-four percent of all 84 antibiotic courses prescribed were for bacteriuria alone without clinical infection. Seventy percent of 63 antibiotic courses were followed by bacteriuria with organisms resistant to the antibiotic administered. Bacteria isolated from NH patients often displayed greater resistance to specific antibiotics than those isolated from hospitalized patients. Four of the 20 urinary tract infections were associated with bacteremia. Three episodes of bacteremia were with highly-resistant organisms and one was fatal. Use of urinary catheters and inappropriate use of antibiotics in NH patients results in urinary tract colonization and infection with resistant bacteria and is an important cause of morbidity and mortality.

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