Investigation and characterization of bacteriophages with lytic activity against the main epidemic bacterial clones recovered from Brazilian hospitals

Abstract

Health-care-related infections caused by multidrug-resistant bacteria (MDR) have often been related to a poorer clinical outcome of hospitalized patients. Since the 1990s, hospital infection control services have encountered different barriers to the containment of MDR microorganisms, mainly due to the absence of efficient antimicrobial therapies against such pathogens. The scarcity of effective therapeutic options was the starting point for the search for new forms of treatment. The use of bacteriophages is one of these alternatives that has been gaining ground in recent years despite having been described even before the discovery of penicillin by Alexander Fleming. Bacteriophages, also known as phages, are viruses that infect and have the ability to kill the bacterial cell during its lytic cycle, being widely detected in aquatic environments or even in sewage. Some countries, such as Georgia, Russia and, most recently, the United States, have recognized the high therapeutic potential of phages and have developed specific centers of phage therapy as an alternative to the use of antimicrobials. Despite the great tendency and worldwide investment in the discovery of new phages with therapeutic potential, few Brazilian studies have been dedicated to this subject. Thus, the objective of this study is to investigate the presence of phages with lytic activity against the major bacterial clones MDR (Klebsiella pneumoniae ST258 producer of KPC-2; Acinetobacter baumannii ST79 producer of OXA-23 and OXA-72; Pseudomonas aeruginosa ST277 SPM-1) disseminated in Brazilian hospitals. The presence of these phages will be investigated in the untreated effluents from three tertiary hospitals located in the State of São Paulo. Different analyzes will be carried out in order to guarantee the stability, the low pathogenicity, the high lithic activity and the high spectrum of action of the phage selected during this investigation. With the accomplishment of this study, it is expected to detect different phages with activity against the main bacterial pathogens MDR that are disseminated in Brazilian hospitals. This would be a quick, low-cost, efficient and innovative option in a country like ours where antimicrobial resistance rates are alarming. (AU)