Abstract

Antimicrobial resistance necessitates action to reduce and eliminate infectious disease, ensure animal and human health, and combat emerging diseases. Species such as Acinetobacter baumanniii, vancomycin resistant Enterococcus, methicillin resistance Staphylococcus aureus, and Pseudomonas aeruginosa, as well as other WHO priority pathogens, are becoming extremely difficult to treat. In 2017, the EU adopted the “One Health” approach to combat antibiotic resistance in animal and human medicine and to prevent the transmission of zoonotic disease. As the current therapeutic agents become increasingly inadequate, there is a dire need to establish novel methods of treatment under this One Health Framework. Bacteriophages (phages), viruses infecting bacterial species, demonstrate clear antimicrobial activity against an array of resistant species, with high levels of specificity and potency. Bacteriophages play key roles in bacterial evolution and are essential components of all ecosystems, including the human microbiome. Factors such are their specificity, potency, biocompatibility, and bactericidal activity make them desirable options as therapeutics. Issues remain, however, relating to their large-scale production, formulation, stability, and bacterial resistance, limiting their implementation globally. Phages used in therapy must be virulent, purified, and well characterized before administration. Clinical studies are warranted to assess the in vivo pharmacokinetics and pharmacodynamic characteristics of phages to fully establish their therapeutic potential.

Highlights

  • Antimicrobial resistance (AMR) and multidrug resistance (MDR) are increasing issues globally, as more microbial species gain resistance to currently available therapeutic options

  • This review aims to outline the potential for bacteriophages to act as antimicrobial agents for use in line with One Health

  • While the aim was to use different antibiotic classes for human and animal therapies to reduce AMR as part of One Health, there is some overlap between both systems, such as the macrolides, aminoglycosides, cephalosporins, and polymyxins, which are listed as both World Health Organization (WHO) critically important antimicrobials (CIA) and veterinary critically important antimicrobial agents (VCIA)

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Summary

Introduction

Antimicrobial resistance (AMR) and multidrug resistance (MDR) are increasing issues globally, as more microbial species (bacteria, virus, fungi, protozoan) gain resistance to currently available therapeutic options. 0.7 million people die annually from drug-resistant disease, with 230,000 deaths directly related to MDR tuberculosis (TB) alone. It is estimated that ABR infections and complications cost €9 billion annually in Europe [5] alone Bacterial species such as carbapenem-resistant Gram-negative Klebsiella. Phage therapy using bactericidal viruses termed bacteriophages shows potential in the treatment of AMR infectious disease. These viruses are strict bacterial parasites that bind to bacterial surface receptors and inject their nucleic acid [13], hijacking the bacterial cell to reproduce, subsequently causing cell lysis and death. This descriptive review outlining bacteriophages and their application, limitations, and development will inform readers on a promising area of research and pharmaceutical development

One Health
Bacteriophages
Phages as Human Therapy against Zoonotic Pathogens
Phages in Food Production and Animal Therapy Contributing to One Health
The Issue of Phages Promoting Pathogenesis and AMR
Findings
Conclusions
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