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      Isolation and Phenotypic Characterization of Virulent Bacteriophages Against Multidrug-Resistant Escherichia coli and Its Phage-Resistant Variant from Sewage Sources

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          Abstract

          Purpose

          The use of lytic bacteriophages for the control or elimination of pathogenic multidrug-resistant (MDR) bacteria is the promising alternative. However, the emergence of resistant bacterial variants after phage application may challenge its therapeutic benefit. In this study, we aimed to isolate candidate phages from sewage samples against two MDR Escherichia coli as well as their phage-resistant variant.

          Methods

          MDR E. coli isolates (n = 10) obtained from Jimma Medical Center that had been properly identified and stored were used to isolate bacteriophages. Two lytic coliphages were isolated from hospital sewage samples following standard protocols. Upon single phage infection, phage-resistant variant quickly evolved serving as a new host for the isolation of a third lytic phage. This virulent phage’s lytic activity against both its host and the wild host was investigated. The host infectivity of the various cocktails was assessed, and each phage’s biological properties were studied.

          Results

          Out of the first round of phage isolation process, two lytic phages were identified as VBO- E. coli 4307 and VBW- E. coli 4194. When exposed to VBO- E. coli 4307, the wild-type E. coli 4307 developed resistant variants. A third phage (VBA- E. coli 4307R) was isolated specific to this resistant variant ( E. coli 4307R) under optimum condition. For VBO- E. coli 4307, VBW- E. coli 4194, and VBA- E. coli 4307R, the plaque assays generated under comparable conditions were 2.13 × 10 10 PFU mL −1, 9.17 × 10 12 PFU mL −1, and 3.3 × 10 10 PFU mL −1, respectively. These phages have nearly identical stability and lytic ability but differ greatly in their host ranges for VBA- E. coli 4307R.

          Conclusion

          While the wild-type MDR pathogen could easily evolve resistance when exposed to a single phage infection by VBO- E. coli 4307, it is still possible to isolate a novel bacteriophage from environmental samples that is effective against the phage-resistant variants. This indicates that it is possible to manage the effects of phage resistance pathogens even if they are MDR.

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          Most cited references31

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          Pathogenic Escherichia coli.

          Few microorganisms are as versatile as Escherichia coli. An important member of the normal intestinal microflora of humans and other mammals, E. coli has also been widely exploited as a cloning host in recombinant DNA technology. But E. coli is more than just a laboratory workhorse or harmless intestinal inhabitant; it can also be a highly versatile, and frequently deadly, pathogen. Several different E. coli strains cause diverse intestinal and extraintestinal diseases by means of virulence factors that affect a wide range of cellular processes.
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            Resistance Development to Bacteriophages Occurring during Bacteriophage Therapy

            Bacteriophage (phage) therapy, i.e., the use of viruses that infect bacteria as antimicrobial agents, is a promising alternative to conventional antibiotics. Indeed, resistance to antibiotics has become a major public health problem after decades of extensive usage. However, one of the main questions regarding phage therapy is the possible rapid emergence of phage-resistant bacterial variants, which could impede favourable treatment outcomes. Experimental data has shown that phage-resistant variants occurred in up to 80% of studies targeting the intestinal milieu and 50% of studies using sepsis models. Phage-resistant variants have also been observed in human studies, as described in three out of four clinical trials that recorded the emergence of phage resistance. On the other hand, recent animal studies suggest that bacterial mutations that confer phage-resistance may result in fitness costs in the resistant bacterium, which, in turn, could benefit the host. Thus, phage resistance should not be underestimated and efforts should be made to develop methodologies for monitoring and preventing it. Moreover, understanding and taking advantage of the resistance-induced fitness costs in bacterial pathogens is a potentially promising avenue.
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              Phages for Phage Therapy: Isolation, Characterization, and Host Range Breadth

              For a bacteriophage to be useful for phage therapy it must be both isolated from the environment and shown to have certain characteristics beyond just killing strains of the target bacterial pathogen. These include desirable characteristics such as a relatively broad host range and a lack of other characteristics such as carrying toxin genes and the ability to form a lysogen. While phages are commonly isolated first and subsequently characterized, it is possible to alter isolation procedures to bias the isolation toward phages with desirable characteristics. Some of these variations are regularly used by some groups while others have only been shown in a few publications. In this review I will describe (1) isolation procedures and variations that are designed to isolate phages with broader host ranges, (2) characterization procedures used to show that a phage may have utility in phage therapy, including some of the limits of such characterization, and (3) results of a survey and discussion with phage researchers in industry and academia on the practice of characterization of phages.
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                Author and article information

                Journal
                Infect Drug Resist
                Infect Drug Resist
                idr
                Infection and Drug Resistance
                Dove
                1178-6973
                25 January 2024
                2024
                : 17
                : 293-303
                Affiliations
                [1 ]School of Medical Laboratory Sciences, Jimma University , Jimma, Ethiopia
                [2 ]Department of Medical Laboratory Sciences, Dambi Dollo University , Dambi Dollo, Ethiopia
                [3 ]Department of Medical Laboratory, Accra Medical Centre , Accra, Ghana
                [4 ]Medical Microbiology Laboratory Unit, Jimma Medical Center , Jimma, Ethiopia
                [5 ]Department of Public Health Emergency Management, Kelem Wollega Zone Health Office , Dambi Dollo, Ethiopia
                [6 ]Department of Medical Laboratory, Wollega University , Nekemte, Ethiopia
                Author notes
                Correspondence: Tesfaye Kassa, School of Medical Laboratory Sciences, Jimma University , P. O. Box 788, Jimma, Ethiopia, Tel +251931057195, Email ktes36@gmail.com; tesfaye.kassa@ju.edu.et
                Author information
                http://orcid.org/0000-0001-9414-6104
                http://orcid.org/0000-0002-0397-5810
                http://orcid.org/0000-0003-4050-8370
                http://orcid.org/0000-0002-6833-6665
                http://orcid.org/0000-0001-5259-2245
                Article
                441085
                10.2147/IDR.S441085
                10825468
                38293311
                bfa338c2-2fe0-4b42-8e2e-3c298cd9d0fc
                © 2024 Fikadu et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 12 October 2023
                : 22 January 2024
                Page count
                Figures: 4, Tables: 2, References: 31, Pages: 11
                Categories
                Methodology

                Infectious disease & Microbiology
                phage,phage-resistance,e. coli,multidrug resistance,sewage,jimma medical center

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