Abstract
There are real concerns that Neisseria gonorrhoeae may become untreatable in the near future due to the rapid emergence of antimicrobial resistance. Alternative therapies are thus urgently required. Bacteriophages active against N. gonorrhoeae could play an important role as an antibiotic-sparing therapy. To the best of our knowledge, no bacteriophages active against N. gonorrhoeae have ever been found. The aim of this study was to screen for bacteriophages able to lyse N. gonorrhoeae in oropharyngeal and anorectal swabs of 74 men who have sex with men attending a sexual health clinic in Antwerp, Belgium. We screened 210 swabs but were unable to identify an anti-gonococcal bacteriophage. This is the first report of a pilot screening that systematically searched for anti-gonococcal phages directly from clinical swabs. Further studies may consider screening for phages at other anatomical sites (e.g., stool samples, urine) or in environmental settings (e.g., toilet sewage water of sex clubs or sexually transmitted infection clinics) where N. gonorrhoeae can be found.
Highlights
Bacteriophages are viruses that interact with and invade bacterial cells resulting in the lysis of the infected host or the integration of the phage genome in the chromosome of the host cell
A total of 194 oropharyngeal and 18 anorectal ESwabsTM from 74 men who have sex with men (MSM) were screened for the presence of phages able to infect N. gonorrhoeae
Oropharyngeal and anorectal ESwabsTM (COPAN Diagnostics Inc., Brescia, Italy) were collected from men who have sex with men (MSM) as part of two clinical studies conducted at the Institute of Tropical Medicine (ITM) in Antwerp, Belgium
Summary
Bacteriophages (or phages) are viruses that interact with and invade bacterial cells resulting in the lysis of the infected host (virulent phage) or the integration of the phage genome in the chromosome of the host cell (temperate phage). As an antibiotic-sparing therapy, which could reduce the selection pressure for the emergence of resistance against conventional antimicrobials. They could be used in combination with antimicrobial agents to treat multi-resistant N. gonorrhoeae [9,10]. Phages have a number of advantages over antimicrobial therapy They can be extremely species- and strain-specific and could be chosen not to have a major impact on the commensal flora [11]. They will not select for antimicrobial resistance (AMR) in commensal bacteria. This property might especially be beneficial for N. gonorrhoeae since anti-gonococcal antimicrobial therapy selects for AMR in commensal Neisseria, and these resistance determinants can be taken up by the pathogenic N. gonorrhoeae via horizontal gene transfer [12,13,14,15]
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