Efficacy of commercial bacteriophage products against ESKAPE pathogens

Abstract

The ever-rising prevalence of multidrug-resistant bacteria necessitates the search for a therapeutic alternative to antibiotics. Using therapeutic products based on virulent bacteriophages might provide such an alternative. The aim of our study was to evaluate the efficacy of commercial phage products and natural bacteriophage monoisolates recovered from environmental sources against clinical strains of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa. We compiled a collection of 147 strains that were subsequently genotypes using the MLST method. The efficacy of bacteriophages was evaluated in spot tests. The highest efficacy was demonstrated by "Staphylococcal bacteriophage" (86%, effective against S. aureus), "Purified polyvalent pyobacteriophage" (87.8%, effective against K. pneumoniae), and a group of phage products against P. aeruginosa, including "Pseudomonas aeruginosa bacteriophage" (87.5%), "Complex pyobacteriophage" (79.5–90%) and "Purified polyvalent pyobacteriophage" (90–92.5%). The efficacy of "Intesti bacteriophage", which targets E. faecium, was 4.2%. The efficacy of commercial phage products against S. aureus and K. pneumoniae was higher than the efficacy of individual phage monoisolates (60% for the S. aureus phage vB_SauP-436-3w and 5.9% for the K. pneumoniae phage vB_Kp_M_ Seu621). Thus, all tested commercial phage products were highly effective against P. aeruginosa, K. pneumoniae and S. aureus. There are no commercial phage products on the market against other ESKAPE pathogens, including Acinetobacter baumannii and Enterobacter cloacae. Besides, there are no effective phage products against E. faecium. This dictates the need for new effective bacteriophages against these species.