The pathogenic bacteria Clostridioides difficile and Clostridium perfringens are responsible for the development of numerous infections, especially in healthcare settings. These infections can range from localized intestinal disease to life-threatening systemic illness.
The ban on antibiotic growth promoters in the poultry industry has only added urgency to the search for alternative therapeutics to treat C. perfringens infections.
In this effort, bacteriophages have emerged as a promising treatment option. Bacteriophages, or phages for short, are viruses that specifically infect and kill bacteria.
In a recent review, scientists analyzed the current state of knowledge and the applicability of using these phages and phage-derived enzymes (endolysins) to treat infections caused by these Clostridium strains in intestinal diseases. Although more research is needed, the use of phages shows promising potential as a novel antimicrobial therapy in the fight against Clostridium infections.
The authors Jennifer Venhorst, Jos M B M van der Vossen, and Valeria Agamennone published their findings in the article Battling Enteropathogenic Clostridia: Phage Therapy for Clostridioides difficile and Clostridium perfringens, dated 13 June 2022.
- The pathogens Clostridioides difficile and Clostridium perfringens are responsible for many healthcare-associated infections as well as systemic and enteric diseases.
- Antibiotic resistance is a major problem associated with these pathogens, leading to the pursuit of new strategies to combat pathogenic infections.
- Bacteriophages (viruses that infect bacteria) are a promising therapeutic option against Clostridium infections, but there are some limitations that need to be considered.
- Reliable data from clinical trials for phage-derived products are needed for the future success of bacteriophage therapy.
The pathogenic Clostridioides difficile and Clostridium perfringens are responsible for many health care-associated infections as well as systemic and enteric diseases.
Therefore, they represent a major health threat to both humans and animals.
Concerns regarding increasing antibiotic resistance (related to C. difficile and C. perfringens) have caused a surge in the pursual of novel strategies that effectively combat pathogenic infections, including those caused by both pathogenic species. The ban on antibiotic growth promoters in the poultry industry has added to the urgency of finding novel antimicrobial therapeutics for C. perfringens.
These efforts have resulted in various therapeutics, of which bacteriophages (in short, phages) show much promise, as evidenced by the Eliava Phage Therapy Center in Tbilisi, Georgia (https://eptc.ge/).
Bacteriophages are a type of virus that infect bacteria. In this review, the (clinical) impact of clostridium infections in intestinal diseases is recapitulated, followed by an analysis of the current knowledge and applicability of bacteriophages and phage-derived endolysins in this disease indication.
Limitations of phage and phage endolysin therapy were identified and require considerations. These include phage stability in the gastrointestinal tract, influence on gut microbiota structure/function, phage resistance development, limited host range for specific pathogenic strains, phage involvement in horizontal gene transfer, and-for phage endolysins-endolysin resistance, -safety, and -immunogenicity.
Methods to optimize features of these therapeutic modalities, such as mutagenesis and fusion proteins, are also addressed.
The future success of phage and endolysin therapies require reliable clinical trial data for phage(-derived) products.
Meanwhile, additional research efforts are essential to expand the potential of exploiting phages and their endolysins for mitigating the severe diseases caused by C. difficile and C. perfringens.
Keywords: Clostridioides difficile; Clostridium perfringens; endolysin; enteropathogen; phage (bacteriophage); phage therapy.
Copyright © 2022 Venhorst, van der Vossen and Agamennone.