Pf Phage In Chronic Pseudomonas Aeruginosa Wound Infections
Michelle S. Bach, Jolien Sweere, Elizabeth B. Burgener, Paul L. Bollyky, Gina A. Suh.
Stanford University, Stanford, CA, USA.
Background: We recently reported that a filamentous bacteriophage, Pf phage, contributes to the virulence of Pseudomonas aeruginosa (P. aeruginosa) infections in animal models but Pf contributions to human chronic wound infections are unknown. Here, we examine the clinical significance of Pf phage in patients with chronic wound infections infected with P. aeruginosa.
Methods: We performed a cross-sectional study of 23 patients with chronic wound infections seen at the Stanford University Advanced Wound Care Center. We collected wound swab samples and assayed these for P. aeruginosa and Pf phage levels. A chart review was performed to assess potential links to patient characteristics, including age, gender, diabetes status, body mass index (BMI), co-morbidities, and wound chronicity.
Results: Fifty-two samples from 23 patients were analyzed. We detected P. aeruginosa in 41 of 52 samples. Of these 41, 31 were positive for Pf phage, or just over 75%. On average these patients had 105 copies of Pf / swab (range = 103-109). Average wound chronicity for Pf positive samples was 3.26 years compared to 0.61 years in Pf negative samples, indicating a greater than five-fold increase in chronicity. Levels of Pf phage were directly correlated with P. aeruginosa virulence and decreased wound healing.
Conclusions: Pf phage in chronic wound infections is associated with exacerbated chronic wound infections and decreased wound healing. This data demonstrates that Pf phage may contribute to the clinical outcomes of chronic P. aeruginosa wound infections. This is the first report, to our knowledge, of a filamentous bacteriophage being associated with human chronic wound infections.
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