Bacteriophage Treatment as an Alternative Technology to Inactivate Pathogenic Bacteria: A Generalized Worldwide Growing Acceptance

Dear Colleagues,

The increasing world-wide rate of antibiotic resistance has led to a higher incidence of bacterial infections that require alternative methods for their control not only in human medicine, but also in other areas, such as in veterinary medicine, the agro-food field and wastewater treatment.

Phage therapy has emerged as an effective solution against bacterial resistant strains that can be used as a substitute or adjuvant to antibiotic therapy. Although in the Eastern Europe phage therapy traditions and practices started in 1919 and continue today in the clinical area, in Western Europe and USA, phage therapy continues to lack any market approval, but has been increasingly used as an experimental therapy for the compassionate treatment of patients experiencing antibiotic failure. Nonetheless, soon after the appearance of the first success results of phage therapy in human medicine, the knowledge was quickly translated to other areas such as veterinary medicine, the food industry, and agriculture and aquaculture, where this approach has been well received and some applications have already been approved.

Nevertheless, while the efficacy of phage therapy has proven to be an efficient alternative to conventional antibiotics, there is still need for new developments to translate the approach into routine treatments. Some important applications of phage therapy in the clinical field that require urgent development, besides fighting infections caused by multidrug-resistant bacteria, are the treatment of infections caused by intracellular bacteria, infections caused by bacteria capable of forming biofilms, bacterial chronic infections, and even the treatment of bacterial systemic infections. In non-clinical fields, it is imperative to study the impact of phage use on the environment and also the effect of abiotic factors on phage viability—such as temperature, pH, salinity and UV radiation—particularly if phage treatment will be used outside where these parameters vary greatly throughout the year. The structural and functional stabilization/preservation of phage particles in supports may be an important strategy to overcome the negative effect of these abiotic factors. Another important aspect, for both clinical and non-clinical applications, is the need to prevent potential bacterial regrowth after treatment due to the development of phage-resistant mutants, which can be hampered by the use of phage cocktails (which at the same time can broaden the action spectrum of the phages) and/or by the use of combined approaches, such as the use of antibiotics during phage treatment. Additionally, in general, more ex vivo and in vivo studies are also imperative to translate the technology to the field.

This Special Issue will gather the most recent knowledge from researchers that demonstrates that bacteriophages are promising candidates for controlling bacterial infection, not only in the clinical field, but also in other areas, such as in veterinary medicine, the food industry, and in agriculture and aquaculture.

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