Bacteriophages as an alternative for biofilm eradication in Klebsiella Pneumonia Strains.

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Abstract

Background -Biofilms are a cause for a variety of infectious diseases given its abundant existence throughout nature. With the help of biofilm, the pathogenic bacteria are protected from unfavorable environments and conditions like extreme pH and temperature, high salinity, UV radiation. Most importantly is that it increases the resistance to antibiotics by 1000 times. Antimicrobial resistance has serious consequences not only in health care but also in food processing, drinking water distribution system, the paper industry, and others.   Materials and Methods – In our study were used three K. pneumoniae (kp41, kp42, kp47), and two P. aeruginosa strains (PA315, PA88). Klebsiella pneumoniae and P. aeruginosa specific bacteriophages (vB-kB-41, vB-Kp-42, vB-kp-47, vB-Psa-315, and vB-Psa-88) were used to test the formation of biofilm by using the Microtiter plate method (TCP) and Tube method (TM).   Results – All the tested bacteria showed to form biofilms in tubes, while on 96 well plates we could observe obvious biofilm with P.aeruginosa N88. With both methods, we had biofilm reduction that was treated with appropriate bacteriophages and incubated for 24 hours.   Conclusion- Emerging antimicrobial resistance needs to be addressed before we run out of our potential antibiotics. Usage of biofilms can be one of the alternatives to effectively and specifically treat these serious gram-negative infections. A more standardized approach should be established for identification of such specific bacteriophage strains which curb the bacterial growth efficiently.

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  1. In this manuscript, Chipurupalli et al describe the effect of phages on K. pneumoniae and P. aeruginosa biofilms. However, there are several major concerns with the text and the work itself. The most important ones are: • The Introduction section gives very basic notions of the current knowledge on biofilms and phages, and yet there are statements that are vague or not entirely true (For example: L37-38: “Biofilm usually prefers a harsh, nutrient-deficient, and toxic environment”. L48: “Only several species of bacteria can form biofilms”. L150-151: “Usage of biofilms can be one of the alternatives to effectively and specifically treat these serious gram negative infections”. L151-152: “This also explains the formation of biofilms can be initiated by only some pathogenic bacterial species”). Furthermore, the use of the literature to justify the information is scarce and outdated. • The methodology is poorly described in terms of details and the source of the biological material (bacterial strains and phages) is not mentioned. Additionally, details such as the changes of culture media in a simple biofilm formation assay are not justified by the authors. • The authors mention different details in the Methods and the Results sections that question the validity of the conclusions. Examples are: o First, the authors say that the phages are added to the culture from the beginning of the incubation (L113-114), before the biofilm is formed. This would mean that phages are killing the bacterial cells, not inhibiting the biofilm formation itself. o L123-124: “This shows that only PA#88 had the desired fimbriae to exclusively for biofilm on the plate”. The authors cannot know this. Furthermore, specific types of fimbriae will be more or less suited for attachment to different materials, not to different containers. o Figure 1: It is not possible for the reader to distinguish what is shown in each image because of the ineffective labelling. o Figure 1a: The authors show here a picture of two treated cultures and two untreated cultures and say that there are “visible biofilms” in there (L136). What the picture shows is liquid cultures and it is not possible to distinguish whether there is a biofilm or not with this direct visualisation. This reinforces the fact that the phage treatment from the beginning of the incubation is killing the cells, not inhibiting biofilm formation or disrupting the biofilm. For these reasons, I regret to inform you that this manuscript is no longer considered to progress to peer-review and publication.