Abstract
Bacteriophages (phages) are viruses that kill bacteria specifically but cannot infect other kinds of organisms. They have attracted new attention since the increasing antibiotic resistance developed into a global crisis. Phage therapy, a 100-year-old form of antibacterial treatment in medicine, is gaining momentum because phages represent a therapy concept without such negative side effects as toxicity; phages are the only therapeutic agent that regulates itself at the sites of infection and decays when the infectious bacteria have been killed. Nature is an almost infinite phage resource: New ones can be isolated for most kinds of problem bacteria as needed; bacteria and their phages constantly co-evolve. This is important as new pathogenic bacterial variants evolve and new challenging situations arise. In human therapy, “cocktails” of multiple phages may reduce the probability of selecting bacteria that developed resistance to a certain phage. Antibiotic agents can be applied together with phages in many circumstances; the two often function synergistically. Phages cannot be expected to replace antibiotic agents in our medical arsenal, but can be used where antibiotic agents fail. The selected phages, however, must be obligately virulent, well-characterized, and highly purified before application. Countless patients and their physicians are waiting for re-establishing phage therapy as a flexible, tailored medicine; infrastructures should be built in all countries urgently: The 2015 World Health Organization assembly resolution 68.7.3. called for national action plans by May 2017 to combat the antimicrobial drug resistance crisis. This article discusses the therapeutic potential of phages and describes challenges and recent developments.
Highlights
Bacteriophages are viruses that kill bacteria but cannot infect other kinds of organisms
A 100-year-old form of antibacterial treatment in medicine, is gaining momentum because phages represent a therapy concept without such negative side effects as toxicity; phages are the only therapeutic agent that regulates itself at the sites of infection and decays when the infectious bacteria have been killed
This is important as new pathogenic bacterial variants evolve and new challenging situations arise
Summary
Our healthy microbiome includes a virome that is, largely a phageome [16,17]. Because of the intensive relatedness to the human microbiome, most clinically important bacterial isolates, especially those of the ESKAPE group, contain both intact and residual partial prophage sequences in their genomes, which sometimes include these pathogenicity islands. It is our own dense gut microbiome habitat that inevitably causes constant genetic exchange and co-evolution of bacteria and their phages. There are already numerous animal models; a recent literature review sheds light on specific colonization and infection mechanisms, especially regarding S. aureus [30]
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