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Abstract
Multi-drug resistance has become a major problem for the treatment of pathogenic bacterial infections. The use of bacteriophages is an attractive approach to overcome the problem of drug resistance in several pathogens that cause fatal diseases. Our study aimed to isolate multi drug resistant bacteria from patients with septic wounds and then isolate and apply bacteriophages in vitro as alternative therapeutic agents. Pus samples were aseptically collected from Rajiv Gandhi Institute of Medical Science (RIMS), Kadapa, A.P., and samples were analyzed by gram staining, evaluating morphological characteristics, and biochemical methods. MDR-bacterial strains were collected using the Kirby-Bauer disk diffusion method against a variety of antibiotics. Bacteriophages were collected and tested in vitro for lytic activity against MDR-bacterial isolates. Analysis of the pus swab samples revealed that the most of the isolates detected had Pseudomonas aeruginosa as the predominant bacterium, followed by Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli. Our results suggested that gram-negative bacteria were more predominant than gram-positive bacteria in septic wounds; most of these isolates were resistant to ampicillin, amoxicillin, penicillin, vancomycin and tetracycline. All the gram-positive isolates (100%) were multi-drug resistant, whereas 86% of the gram-negative isolates had a drug resistant nature. Further bacteriophages isolated from sewage demonstrated perfect lytic activity against the multi-drug resistant bacteria causing septic wounds. In vitro analysis of the isolated bacteriophages demonstrated perfect lysis against the corresponding MDR-bacteria, and these isolated phages may be promising as a first choice for prophylaxis against wound sepsis, Moreover, phage therapy does not enhance multi-drug resistance in bacteria and could work simultaneously on a wide variety of MDR-bacteria when used in a bacteriophage cocktail. Hence, our results suggest that these bacteriophages could be potential therapeutic options for treating septic wounds caused by P. aeruginosa, S. aureus, K. pneumoniae and E. coli.
Highlights
The skin is the largest sensory organ, and it provides innate immunity and protects the underlying tissues of the human body
According to Tayfour, 10–33% of septic wounds were observed in India [34], and wound infections were primarily caused by different microbes, such as S. aureus, Non-coagulase Streptococcus, Enterococci, E.coli, P. aeruginosa, K. pneumoniae, Enterobacter, Streptococci, Candida and Acinetobacter [35]
Sankaran noted that E. coli was the predominant isolate, but this observation contradicts our findings, where we report P. aeruginosa as the predominant bacterium ([46] Klebsiella spp. (19.4%), [47] S. aureus, and
Summary
The skin is the largest sensory organ, and it provides innate immunity and protects the underlying tissues of the human body. The loss of skin integrity by any mechanical injuries exposes subcutaneous tissues to the environment, which leads to microbial colonization and proliferation [2]. Mechanical disruption of the skin results in a wound, and it is the major cause of the establishment of infections by microorganisms ranging from bacteria and fungi to parasites and viruses [3]. Septic infections are caused mostly by bacteria; they break the protection barrier [4,5] and may establish deep infections. A septic wound is a type of infection that can have an antagonistic impact on the human body, quality of life and on the healing rate of the wound. Wounds usually provide adequate warmth, moisture and nutrition conditions for favorable growth and proliferation of microorganisms [8]
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