Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
Ann Clin Microbiol Antimicrob. 2020 Sep 30;19(1):45. doi: 10.1186/s12941-020-00389-5.
Multi-Drug Resistant (MDR) Pseudomonas aeruginosa is one of the most important bacterial pathogens that causes infection with a high mortality rate due to resistance to different antibiotics. This bacterium prompts extensive tissue damage with varying factors of virulence, and its biofilm production causes chronic and antibiotic-resistant infections. Therefore, due to the non-applicability of antibiotics for the destruction of P. aeruginosa biofilm, alternative approaches have been considered by researchers, and phage therapy is one of these new therapeutic solutions. Bacteriophages can be used to eradicate P. aeruginosa biofilm by destroying the extracellular matrix, increasing the permeability of antibiotics into the inner layer of biofilm, and inhibiting its formation by stopping the quorum-sensing activity. Furthermore, the combined use of bacteriophages and other compounds with anti-biofilm properties such as nanoparticles, enzymes, and natural products can be of more interest because they invade the biofilm by various mechanisms and can be more effective than the one used alone. On the other hand, the use of bacteriophages for biofilm destruction has some limitations such as limited host range, high-density biofilm, sub-populate phage resistance in biofilm, and inhibition of phage infection via quorum sensing in biofilm. Therefore, in this review, we specifically discuss the use of phage therapy for inhibition of P. aeruginosa biofilm in clinical and in vitro studies to identify different aspects of this treatment for broader use.
耐多药铜绿假单胞菌是引起感染的最重要的细菌病原体之一，由于对不同抗生素的耐药性，其死亡率很高。该细菌具有多种毒力因子，可导致广泛的组织损伤，其生物膜的产生可导致慢性和抗生素耐药性感染。因此，由于抗生素无法破坏铜绿假单胞菌生物膜，研究人员考虑了替代方法，噬菌体治疗就是这些新的治疗方法之一。噬菌体可通过破坏细胞外基质、增加抗生素进入生物膜内层的渗透性以及通过阻止群体感应活性来抑制其形成，从而用于消除铜绿假单胞菌生物膜。此外，噬菌体与其他具有抗生物膜特性的化合物（如纳米颗粒、酶和天然产物）联合使用可能更具吸引力，因为它们通过多种机制侵入生物膜，并且比单独使用一种化合物更有效。另一方面，噬菌体用于生物膜破坏存在一些限制，例如宿主范围有限、高密度生物膜、生物膜中噬菌体亚群耐药性以及生物膜中群体感应抑制噬菌体感染。因此，在本综述中，我们专门讨论了噬菌体治疗在临床和体外研究中抑制铜绿假单胞菌生物膜的应用，以确定该治疗方法的不同方面，以更广泛地应用。
