Quality-controlled small-scale production of a well-defined bacteriophage cocktail for use in human clinical trials.
We describe the small-scale, laboratory-based, production and quality control of a cocktail, consisting of exclusively lytic bacteriophages, designed for the treatment of Pseudomonas aeruginosa and Staphylococcus aureus infections in burn wound patients. Based on successive selection rounds three bacteriophages were retained from an initial pool of 82 P. aeruginosa and 8 S. aureus bacteriophages, specific for prevalent P. aeruginosa and S. aureus strains in the Burn Centre of the Queen Astrid Military Hospital in Brussels, Belgium. This cocktail, consisting of P. aeruginosa phages 14/1 (Myoviridae) and PNM (Podoviridae) and S. aureus phage ISP (Myoviridae) was produced and purified of endotoxin. Quality control included Stability (shelf life), determination of pyrogenicity, sterility and cytotoxicity, confirmation of the absence of temperate bacteriophages and transmission electron microscopy-based confirmation of the presence of the expected virion morphologic particles as well as of their specific interaction with the target bacteria. Bacteriophage genome and proteome analysis confirmed the lytic nature of the bacteriophages, the absence of toxin-coding genes and showed that the selected phages 14/1, PNM and ISP are close relatives of respectively F8, phiKMV and phage G1. The bacteriophage cocktail is currently being evaluated in a pilot clinical study cleared by a leading Medical Ethical Committee.
Merabishvili
Maya
M
Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Georgia.
Pirnay
Jean-Paul
JP
Verbeken
Gilbert
G
Chanishvili
Nina
N
Tediashvili
Marina
M
Lashkhi
Nino
N
Glonti
Thea
T
Krylov
Victor
V
Mast
Jan
J
Van Parys
Luc
L
Lavigne
Rob
R
Volckaert
Guido
G
Mattheus
Wesley
W
Verween
Gunther
G
De Corte
Peter
P
Rose
Thomas
T
Jennes
Serge
S
Zizi
Martin
M
De Vos
Daniel
D
Vaneechoutte
Mario
M
D001435:Bacteriophages / Q000235:genetics* / Q000378:metabolism* / Q000648:ultrastructure; D002056:Burns / Q000150:complications / Q000382:microbiology; D002986:Clinical Trials as Topic; D016679:Genome, Viral; D006801:Humans; D020543:Proteome / Q000032:analysis / Q000235:genetics; D011552:Pseudomonas Infections / Q000628:therapy*; D011550:Pseudomonas aeruginosa / Q000235:genetics / Q000821:virology; D013203:Staphylococcal Infections / Q000628:therapy*; D013211:Staphylococcus aureus / Q000235:genetics / Q000821:virology; D014946:Wound Infection / Q000382:microbiology / Q000628:therapy
D020543:Proteome