Susceptibility of extended-spectrum- β-lactamase-producing Escherichia coli to commercially available and laboratory-isolated bacteriophages.

Extended-spectrum b-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E), particularly Escherichia coli and Klebsiella pneumoniae, are resistant to b-lactam antibiotics, b-lactam combinations and often non-b-lactam antibiotics. ESBL-E infections are associated with longer hospital stays and often poorer outcomes. Alternative or complementary therapies for ESBL-E infections are required. In response to the global emergence of antibiotic resistance, there is renewed interest in bacteriophage treatment of bacterial infections. Bacteriophages have high specificity (owing to narrow host ranges), modes of action unrelated to antibiotic targets and self propagating and self-limiting activities, facilitating low dosing and bacteriophage elimination following infection resolution. We determined the in vitro susceptibility of 100 previously characterized ESBL-producing E. coli (ESBL-EC) to four bacteriophage cocktails, used as part of standard clinical practice in the Republic of Georgia. ESBL production by ESBL-EC was confirmed according to EUCAST criteria in Beaumont Hospital, Dublin, Ireland and ESBL-EC were mainly isolated from urine, blood and respiratory specimens. As found for other ESBL-EC collections, the majority belonged to phylogenetic groups B2 and D (80/100, 80%), but groups A and B1 were also represented. The activities of four bacteriophage cocktails (Pyo, Intesti, Enko and Ses) were determined against each isolate using in vitro spot tests. Isolates were susceptible if confluent, semi-confluent or opaque lysis or individual plaques (n≥1) were observed (single plaques may be propagated to generate bacteriophages with improved lytic spectra) and resistant if lysis was not visible. The bacteriophage cocktails originated in Georgia and are sterile filtrates of phage lysates of bacterial species, including E. coli serovar O25b

Combination of pre-adapted bacteriophage therapy and antibiotics for treatment of fracture-related infection due to pandrug-resistant Klebsiella pneumoniae

A 30-year-old bombing victim with a fracture-related pandrug-resistant Klebsiella pneumoniae infection after long-term (>700 days) antibiotic therapy is treated with a pre-adapted bacteriophage along with meropenem and colistin, followed by ceftazidime/avibactam. This salvage therapy results in objective clinical, microbiological and radiological improvement of the patient’s wounds and overall condition. In support, the bacteriophage and antibiotic combination is highly effective against the patient’s K. pneumoniae strain in vitro, in 7-day mature biofilms and in suspensions.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Eradication of a multidrug-resistant, carbapenemase-producing Klebsiella pneumoniae isolate following oral and intra-rectal therapy with a custom made, lytic bacteriophage preparation

In July 2017, a patient presented colonization with a multidrug-resistant, carbapenemase (KPC-3)-producing Klebsiella pneumoniae isolate. A custom-made, lytic bacteriophage preparation was administered to the patient in December 2017, with subsequent eradication of the microorganism and without adverse effects