Effectiveness of bacteriophages in the sputum of cystic fibrosis patients

• Published in: Clinical microbiology and infection Vol. 20; no. 12; pp. O983 - O990
• Main Authors: Saussereau, E., Vachier, I., Chiron, R., Godbert, B., Sermet, I., Dufour, N., Pirnay, J.-P., De Vos, D., Carrié, F., Molinari, N., Debarbieux, L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2014; Elsevier Limited; Elsevier for the European Society of Clinical Microbiology and Infectious Diseases
• Subjects: Adolescent; Adult; Bacteria; Bacterial Load; Bacteriology; Biological Therapy; Biological Therapy - methods; Chronic infection; Cross-Sectional Studies; Cystic Fibrosis; Cystic Fibrosis - complications; Female; Humans; Life Sciences; Male; Microbial Viability; Microbiology and Parasitology; Middle Aged; phage therapy; Pseudomonas aeruginosa; Pseudomonas aeruginosa - virology; Pseudomonas Infections; Pseudomonas Infections - microbiology; Pseudomonas Phages; Pseudomonas Phages - growth & development; pulmonary infection; Sputum; Sputum - microbiology; Sputum - virology; Time Factors; Young Adult; Chronic infection; Pseudomonas aeruginosa; pulmonary infection; phage therapy
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1111/1469-0691.12712

Bacteriophages have been shown to be effective for treating acute infections of the respiratory tract caused by antibiotic-resistant bacteria in animal models, but no evidence has yet been presented of their activity against pathogens in complex biological samples from chronically infected patients. We assessed the efficacy of a cocktail of ten bacteriophages infecting Pseudomonas aeruginosa following its addition to 58 sputum samples from cystic fibrosis (CF) patients collected at three different hospitals. Ten samples that did not contain P. aeruginosa were not analysed further. In the remaining 48 samples, the addition of bacteriophages led to a significant decrease in the levels of P. aeruginosa strains, as shown by comparison with controls, taking two variables (time and bacteriophages) into account (p = 0.024). In 45.8% of these samples, this decrease was accompanied by an increase in the number of bacteriophages. We also tested each of the ten bacteriophages individually against 20 colonies from each of these 48 samples and detected bacteriophage-susceptible bacteria in 64.6% of the samples. An analysis of the clinical data revealed no correlation between patient age, sex, duration of P. aeruginosa colonization, antibiotic treatment, FEV1 (forced expiratory volume in the first second) and the efficacy of bacteriophages. The demonstration that bacteriophages infect their bacterial hosts in the sputum environment, regardless of the clinical characteristics of the patients, represents a major step towards the development of bacteriophage therapy to treat chronic lung infections.