Identification and impact on Pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapy

ABSTRACT Phage therapy represents a promising strategy for curing bacterial infections refractory to antibiotics. However, the success rate of phage therapy may be lowered by the emergence of bacterial resistance to the phages used for therapy. In this work, we studied the resistance to the CK4 cock...

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Main Authors: Francesca Forti, Claudia Bertoli, Marco Cafora, Sara Gilardi, Anna Pistocchi, Federica Briani
Format: Article
Language:English
Published: American Society for Microbiology 2023-12-01
Series:Microbiology Spectrum
Subjects:
Online Access:https://journals.asm.org/doi/10.1128/spectrum.01477-23
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author Francesca Forti
Claudia Bertoli
Marco Cafora
Sara Gilardi
Anna Pistocchi
Federica Briani
author_facet Francesca Forti
Claudia Bertoli
Marco Cafora
Sara Gilardi
Anna Pistocchi
Federica Briani
author_sort Francesca Forti
collection DOAJ
description ABSTRACT Phage therapy represents a promising strategy for curing bacterial infections refractory to antibiotics. However, the success rate of phage therapy may be lowered by the emergence of bacterial resistance to the phages used for therapy. In this work, we studied the resistance to the CK4 cocktail, which is a mixture composed of four phages able to cure Pseudomonas aeruginosa infections in animal models. CK4-resistant mutants were easily isolated from cultures grown in either a standard laboratory medium or an artificial sputum medium mimicking the composition of the airway fluid of cystic fibrosis (CF) patients, who are highly susceptible to P. aeruginosa chronic lung infections. In both cases, CK4-resistant mutants resulted in being defective in lipopolysaccharide (LPS) biosynthesis. Accordingly, all CK4 phages were unable to infect wzy mutants lacking the O-antigen polymerase. A survey of the other 15 P. aeruginosa phages isolated from different environmental sources showed that they all needed either wzy or the Type IV-pilus (T4P) biosynthetic gene pilQ for the infection. Overall, our data suggest that 16 out of the 19 analyzed Pseudomonas phages may use either the LPS or the T4P as a receptor. Interestingly, CK4-resistant mutants devoid of the O-antigen had strongly attenuated virulence in a zebrafish embryo infection model, and the lack of T4P also decreased virulence in zebrafish. With respect to isolates from patients with CF, phages not reproducing in the Δwzy mutant had a wider host range than those requiring pilQ, suggesting that phages dependent on PAO1-type T4P may have limited therapeutic value for treating CF-related infections. IMPORTANCE In this work, we identified the putative receptors of 16 Pseudomonas phages and evaluated how resistance to phages recognizing different bacterial receptors may affect the virulence. Our findings are relevant for the implementation of phage therapy of Pseudomonas aeruginosa infections, which are difficult to treat with antibiotics. Overall, our results highlight the need to modify natural phages to enlarge the repertoire of receptors exploited by therapeutic phages and suggest that phages using the PAO1-type T4P as receptor may have limited value for the therapy of the cystic fibrosis infection.
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spelling doaj.art-23dbef7b5ee04e55b332fc657aa143c62023-12-12T13:17:19ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972023-12-0111610.1128/spectrum.01477-23Identification and impact on Pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapyFrancesca Forti0Claudia Bertoli1Marco Cafora2Sara Gilardi3Anna Pistocchi4Federica Briani5Dipartimento di Bioscienze, Università degli Studi di Milano , Milano, ItalyDipartimento di Bioscienze, Università degli Studi di Milano , Milano, ItalyDipartimento di Biotecnologie Mediche e Medicina Traslazionale, Università degli Studi di Milano , Milano, ItalyDipartimento di Bioscienze, Università degli Studi di Milano , Milano, ItalyDipartimento di Biotecnologie Mediche e Medicina Traslazionale, Università degli Studi di Milano , Milano, ItalyDipartimento di Bioscienze, Università degli Studi di Milano , Milano, ItalyABSTRACT Phage therapy represents a promising strategy for curing bacterial infections refractory to antibiotics. However, the success rate of phage therapy may be lowered by the emergence of bacterial resistance to the phages used for therapy. In this work, we studied the resistance to the CK4 cocktail, which is a mixture composed of four phages able to cure Pseudomonas aeruginosa infections in animal models. CK4-resistant mutants were easily isolated from cultures grown in either a standard laboratory medium or an artificial sputum medium mimicking the composition of the airway fluid of cystic fibrosis (CF) patients, who are highly susceptible to P. aeruginosa chronic lung infections. In both cases, CK4-resistant mutants resulted in being defective in lipopolysaccharide (LPS) biosynthesis. Accordingly, all CK4 phages were unable to infect wzy mutants lacking the O-antigen polymerase. A survey of the other 15 P. aeruginosa phages isolated from different environmental sources showed that they all needed either wzy or the Type IV-pilus (T4P) biosynthetic gene pilQ for the infection. Overall, our data suggest that 16 out of the 19 analyzed Pseudomonas phages may use either the LPS or the T4P as a receptor. Interestingly, CK4-resistant mutants devoid of the O-antigen had strongly attenuated virulence in a zebrafish embryo infection model, and the lack of T4P also decreased virulence in zebrafish. With respect to isolates from patients with CF, phages not reproducing in the Δwzy mutant had a wider host range than those requiring pilQ, suggesting that phages dependent on PAO1-type T4P may have limited therapeutic value for treating CF-related infections. IMPORTANCE In this work, we identified the putative receptors of 16 Pseudomonas phages and evaluated how resistance to phages recognizing different bacterial receptors may affect the virulence. Our findings are relevant for the implementation of phage therapy of Pseudomonas aeruginosa infections, which are difficult to treat with antibiotics. Overall, our results highlight the need to modify natural phages to enlarge the repertoire of receptors exploited by therapeutic phages and suggest that phages using the PAO1-type T4P as receptor may have limited value for the therapy of the cystic fibrosis infection.https://journals.asm.org/doi/10.1128/spectrum.01477-23bacteriophage therapyphage receptorsPseudomonas aeruginosa phageszebrafish infection model
spellingShingle Francesca Forti
Claudia Bertoli
Marco Cafora
Sara Gilardi
Anna Pistocchi
Federica Briani
Identification and impact on Pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapy
Microbiology Spectrum
bacteriophage therapy
phage receptors
Pseudomonas aeruginosa phages
zebrafish infection model
title Identification and impact on Pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapy
title_full Identification and impact on Pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapy
title_fullStr Identification and impact on Pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapy
title_full_unstemmed Identification and impact on Pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapy
title_short Identification and impact on Pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapy
title_sort identification and impact on pseudomonas aeruginosa virulence of mutations conferring resistance to a phage cocktail for phage therapy
topic bacteriophage therapy
phage receptors
Pseudomonas aeruginosa phages
zebrafish infection model
url https://journals.asm.org/doi/10.1128/spectrum.01477-23
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