Phage

Question 1

_____ is a major public health problem with the diminishing antibiotic pipeline

Answer 1

MDR bacteria

Question 2

What are the two mechanisms for bacteriophages?

Answer 2

lytic - infect and kill
lysogenic - integrate into genome

Question 3

When was the first evidence of bacteriophage use in controlling bacteria?

Answer 3

late 1800s by Hankin - antiseptic action of river water against Vibrio cholera

Question 4

When was birth of phage therapy?

Answer 4

1919 at Pasteur Institute by Felix dHerelle to treat 12yo with dysentery

Question 5

phages fall out of favor by West with discovery of _________ and association with ______

Answer 5

antibiotics
USSR

Question 6

When did antibiotic resistance criss begin?

Answer 6

2000s

Question 7

How does phage therapy operate in the US today?

Answer 7

Via clinical trial/compassionate use only - NOT FDA approved

Question 8

How does phage hunting begin?

Answer 8

waste water screening to create library

Question 9

What bacterial species can we find active phages for in order of likelihood?

Answer 9

P.aeruginosa
Enterococcus
Burkholderia

Question 10

Of the first 25 patients treated at P3, what were common organisms/syndrome

Answer 10

P. aeruginosa

Pneumonia/bacteremia

CF/structural lung disease/LVAD/prosthetic material/solid organ transplant

Question 11

phages probably won’t change outcome in ______, as shown in lung transplant CF patient with _______

Answer 11

septic shock
bulkholderia multivorans

Question 12

_____ method matters, as shown by PCR. The __________ has the lowest active phage delivery while vibrating mesh became the norm

Answer 12

nebulization
jet nebulizer

Question 13

a neutralizing ab response was seen after the _____ dose of phage therapy

Answer 13

2nd

Question 14

In the case of the 27yo CF patient with P.aeruginosa, how were phages helpful?

Answer 14

not in curing the bacterial infection, but in extending life and relieving symptoms of the infection

Question 15

AchromoPhage trial in Pittsburgh

Answer 15

4phage cocktail for CF patients with Achromobacter (works on 75% of isolates)

Question 16

what are goals of clinical trials?

Answer 16

primary goals: safety/tolerability
seconday goals: PK, FEV1, QOL, micro impact, humoral immunity

Question 17

PseudoPhage VAP trial is active against ____ of clinical P.aeruginosa isolates

Answer 17

70% with 5 phage cocktail

Question 18

VRELysin trial uses ______ volunteers

Answer 18

healthy