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Antibacterial effects of single phage and phage cocktail against multidrug-resistant Klebsiella pneumoniae isolated from diabetic foot ulcer

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Abstract

Diabetic foot ulcer (DFU) is associated with long-term hospitalization and amputation. Antibiotic resistance has made the infection eradication more difficult. Hence, seeking alternative therapies such as phage therapy seems necessary. Bacteriophages are viruses targeting specific bacterial species. Klebsiella pneumoniae (K. pneumoniae) is among causative agents of the DFU. In this study, the therapeutic effects of single phage and phage cocktail were investigated against multidrug-resistant (MDR) K. pneumonia isolated from DFU. Bacteriophages were isolated from animal feces and sewage samples, and were enriched and propagated using K. pneumoniae as the host. Thirty K. pneumoniae clinical isolates were collected from hospitalized patients with DFU. The antibiotic susceptibility pattern was determined using agar disk diffusion test. The phages’ morphological traits were determined using transmission electron microscopy (TEM). The killing effect of isolated phages was assessed using plaque assay. Four phage types were isolated and recognized including KP1, KP2, KP3, and KP4. The bacterial rapid regrowth was observed following each single phage-host interaction, but not phage cocktail due to the evolution of mutant strains. Phage cocktail demonstrated significantly higher antibacterial activity than each single phage (p < 0.05) without any bacterial regrowth. The employment of phage cocktail was promising for the eradication of MDR-K. pneumoniae isolates. The development of phage therapy in particular, phage cocktail is promising as an efficient approach to eradicate MDR-K. pneumoniae isolated from DFU. The application of a specific phage cocktail can be investigated to try and achieve the eradication of various infections.

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Acknowledgements

This study has been written by the authors.

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This study did not receive any funding in any form.

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Authors and Affiliations

  1. School of Advanced Technologies in Medicine, Fasa University of Medical Science, Fasa, Iran

    Javad Jokar & Sohrab Najafipour

  2. Department of Tissue Engineering, Faculty of Medicine, Fasa University of Medical Science, Fasa, Iran

    Javad Jokar

  3. Department of Pathological Analysis, College of Applied Science, University of Fallujah, Al-Anbar, Iraq

    Raed Obaid Saleh

  4. Department of Biotechnology, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran

    Niloofar Rahimian & Elham Zarenezhad

  5. Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran

    Abdolmajid Ghasemian

  6. Department of Microbiology, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran

    Ghazal Ghaznavi

  7. Department of Medical Biotechnology, School of Advanced Medical Science, and Technologies, Shiraz University If Medical Sciences, Shiraz, Iran

    Ghazal Ghaznavi

  8. Department of Medical Parasitology, School of Advanced Medical Science, and Technologies, Shiraz University If Medical Sciences, Shiraz, Iran

    Amirhossein Radfar

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  1. Javad Jokar
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J.J., R.S., N.R. and A.G. wrote the manuscript. G.G., A.R., E.Z., and S.N. edited the manuscript. All authors reviewed the manuscript.

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Correspondence to Sohrab Najafipour.

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This study was ethically approved by Fasa University of Medical Sciences (Ethical Code: IR.FUMS.REC.1399.221).

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Jokar, J., Saleh, R.O., Rahimian, N. et al. Antibacterial effects of single phage and phage cocktail against multidrug-resistant Klebsiella pneumoniae isolated from diabetic foot ulcer. Virus Genes 59, 635–642 (2023). https://doi.org/10.1007/s11262-023-02004-z

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