Phage Therapy Potentiates Second-Line Antibiotic Treatment against Pneumonic Plague

Yaron Vagima, David Gur, Moshe Aftalion, Sarit Moses, Yinon Levy, Arik Makovitzki, Tzvi Holtzman, Ziv Oren, Yaniv Segula, Ella Fatelevich, Avital Tidhar, Ayelet Zauberman, Shahar Rotem, Emanuelle Mamroud, Ida Steinberger-Levy

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Plague pandemics and outbreaks have killed millions of people during the history of humankind. The disease, caused by the bacteria Yersinia pestis, is currently treated effectively with antibiotics. However, in the case of multidrug-resistant (MDR) bacteria, alternative treatments are required. Bacteriophage (phage) therapy has shown efficient antibacterial activity in various experimental animal models and in human patients infected with different MDR pathogens. Here, we evaluated the efficiency of фA1122 and PST phage therapy, alone or in combination with second-line antibiotics, using a well-established mouse model of pneumonic plague. Phage treatment significantly delayed mortality and limited bacterial proliferation in the lungs. However, the treatment did not prevent bacteremia, suggesting that phage efficiency may decrease in the circulation. Indeed, in vitro phage proliferation assays indicated that blood exerts inhibitory effects on lytic activity, which may be the major cause of treatment inefficiency. Combining phage therapy and second-line ceftriaxone treatment, which are individually insufficient, provided protection that led to the survival of all infected animals—a synergistic protective effect that represents a proof of concept for efficient combinatorial therapy in an emergency event of a plague outbreak involving MDR Y. pestis strains.

Original languageEnglish
Article number688
JournalViruses
Volume14
Issue number4
DOIs
StatePublished - 26 Mar 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

Funding: This research was funded by the Israel Institute for Biological Research (IIBR), Ness-Ziona, Israel (SB-20).

FundersFunder number
IIBRSB-20
Israel Institute for Biological Research

    Keywords

    • PST
    • Yersinia pestis
    • antibiotic resistance
    • antibiotic therapy
    • ceftriaxone
    • phage therapy
    • phage–antibiotic combination
    • plague
    • фA1122

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