Phage Therapy Experience at the Eliava Phage Therapy Center: Three Cases of Bacterial Persistence

• Published in: Viruses Vol. 13; no. 10; p. 1901
• Main Authors: Zaldastanishvili, Elisabed, Leshkasheli, Lika, Dadiani, Mariam, Nadareishvili, Lia, Askilashvili, Lia, Kvatadze, Nino, Goderdzishvili, Marina, Kutateladze, Mzia, Balarjishvili, Nana
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 23.09.2021; MDPI
• Subjects: Adult; Aged; Antibiotics; Bacteria; Bacteria - virology; Bacterial Infections - therapy; Bacteriophages; Bronchopulmonary infection; Case Report; Clinical trials; descriptive studies; Drug resistance; E coli; Electrophoresis, Gel, Pulsed-Field; Female; Gel electrophoresis; genome; Genomes; Georgia (Republic); Humans; Infectious diseases; Klebsiella Infections - therapy; Klebsiella pneumoniae; lungs; Male; Middle Aged; Nosocomial infections; Pathogens; Patients; Phage Therapy; Phages; Pseudomonas aeruginosa; Pseudomonas aeruginosa - virology; Pseudomonas Infections - therapy; pulsed-field gel electrophoresis; Respiratory tract diseases; Respiratory Tract Infections - therapy; Retrospective Studies; Strains (organisms); Urinary tract; urinary tract diseases; Urinary Tract Infections - therapy; Viral infections; Georgia (Republic); Pseudomonas aeruginosa; Klebsiella pneumoniae; phage therapy
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v13101901

In this retrospective descriptive study we focus on cases of three patients who underwent phage therapy procedures at Eliava Phage Therapy Center (EPTC) in Tbilisi, Georgia. Patients with chronic infectious diseases related to Pseudomonas aeruginosa (two patients, lower respiratory tract infection (LRTI)) and Klebsiella pneumoniae (one patient, urinary tract infection (UTI)) are among those very few EPTC patients whose pathogens persisted through phage therapy. By looking at bacterial strains and personalized phages used against them we tried to point towards possible adaptation strategies that are employed by these pathogens. Genome restriction-based Pulsed Field Gel Electrophoresis (PFGE) profiling of strains isolated before and after phage therapy hints towards two strategies of adaptation. In one patient case (Pseudomonas aeruginosa related lung infection) bacterial strains before and after phage therapy were indistinguishable according to their PFGE profiles, but differed in their phage susceptibility properties. On the other hand, in two other patient cases (Pseudomonas aeruginosa related LRTI and Klebsiella pneumoniae related UTI) bacterial adaptation strategy seemed to have resulted in diversification of infecting strains of the same species. With this work we want to attract more attention to phage resistance in general as well as to its role in phage therapy.