Bacteriophages – an introduction to laboratory aspects: a laboratory-based study in South Africa

Abstract

Bacteriophages are viruses that selectively kill specific bacterial species. There is extensive experience in Eastern Europe in using bacteriophages for infections that are difficult to treat. Globally increasing antimicrobial resistance renders many infections untreatable with limited or no antibiotic options. Bacteriophages are not currently used in South Africa, with limited research, laboratory and clinical experience. The authors introduce the use of bacteriophages and demonstrate its activity on laboratory strains of bacteria using a commercial bacteriophage cocktail. This study aims to promote knowledge and develop protocols for bacteriophage susceptibility testing in South African laboratories and thus, eventually, use in clinical settings. The authors used a commercial phage preparation against laboratory strains of bacteria to describe a laboratory protocol that can be used by routine diagnostic laboratories for phage-bacteria susceptibility testing. Routine diagnostic laboratories can easily develop the skills to provide phage-bacteria susceptibility testing. Although only the Pseudomonas aeruginosa ATCC strain was susceptible to the commercial phage cocktail, this study showed that testing is important due to phage specificity and that clinical isolates would need to be tested before therapy with a commercial cocktail is initiated. Phage therapy will become essential as antibiotic resistance is inevitable. Commercial phage cocktails are a possible solution to multidrug resistant pseudomonal infections in South Africa. The authors will test the commercial phage against clinical Pseudomonas aeruginosa strains in the next phase of the study and recommend that diagnostic laboratories become familiar with phage susceptibility testing should phage therapy become a reality.