By: Harald Eriksson

Title: Bacterial viruses targeting multi-resistant Klebsiella pneumoniae and Escherichia coli

Abstract

The global increase in antibiotic resistance levels in bacteria is a growing concern to our society and highlights the need for alternative strategies to combat bacterial infections. Bacterial viruses (phages) are the natural predators of bacteria and are as diverse as their hosts, but our understanding of them is limited. The current levels of knowledge regarding the role that phage play in the control of bacterial populations are poor, despite the use of phage therapy as a clinical therapy in
Eastern Europe.

The aim of this doctoral thesis is to increase knowledge of the diversity and  characteristics of bacterial viruses and to assess their potential as therapeutic agents towards multi-resistant bacteria.

Paper I is the product of de novo sequencing of newly isolated phages that infect and kill multi-resistant Klebsiella pneumoniae. Based on similarities in gene arrangement, lysis cassette type and conserved RNA polymerase, the creation of a new phage genus within Autographivirinae is proposed.

Paper II describes the genomic and proteomic analysis of a phage of the rare C3 morphotype, a Podoviridae phage with an elongated head that uses multi-resistant Escherichia coli as its host.

Paper III describes the study of a pre-made phage cocktail against 125 clinical K. pneumoniae isolates. The phagecocktail inhibited the growth of 99 (79 %) of the bacterial isolates tested. This study also demonstrates the need for common
methodologies in the scientific community to determine how to assess phages that infect multiple serotypes to avoid false positive results.

Paper IV studies the effects of phage predation on bacterial virulence: phages were first allowed to prey on a clinical K. pneumoniae isolate, followed by the isolation of phage-resistant bacteria. The phage resistant bacteria were then assessed for their growth rate, biofilm production in vitro. The virulence of the phage resistant bacteria was then assessed in Galleria mellonella. In the single phage treatments, two out of four phages showed an increased virulence in the in G. mellonella, which was also linked to an increased growth rate of the phage resistant bacteria. In multi-phage treatments however, three out of five phage cocktails decreased the bacterial virulence in G. mellonella compared to an untreated control.

Keywords: Bacterial viruses, Bacteriophage, Phage, Phage therapy, multi-resistant bacteria, Klebsiella pneumoniae.