Development and Evaluation of Tripartite Therapy Combining Bacteriophages, Enzymes, and Endolysins to Target Dual-Species Biofilms of Antimicrobial-Resistant Priority Pathogens
The management of antimicrobial-resistant (AMR) pathogens is a critical global health challenge, with biofilm-forming bacteria posing a particularly formidable threat. Biofilms, structured microbial communities encased in a protective extracellular polymeric matrix, confer enhanced resistance to antibiotics and immune defenses, complicating the eradication of infections. Among AMR pathogens, Pseudomonas aeruginosa and Staphylococcus aureus are high-priority organisms often found together in dual-species biofilms in conditions such as cystic fibrosis lung infections, chronic wounds, burn wound infections, and otitis media. The development of effective treatments targeting these co-infections is an unmet clinical need. This project aims to address this gap by developing a novel tripartite therapeutic formulation comprising bacteriophages, biofilm-degrading enzymes, and endolysins to target dual-species biofilms of P. aeruginosa and S. aureus. Bacteriophages provide high specificity against their bacterial hosts, enzymes such as Dispersin B, DNase, amylase, protease, and lipase break down the biofilm matrix, and endolysins disrupt bacterial cell walls regardless of metabolic state. Together, these components create a synergistic mechanism capable of dismantling biofilms and eradicating AMR pathogens. While previous studies which explored the use of bacteriophages, enzymes, and antibiotics, they have primarily focused on monoculture models and have not considered the complexity of microbial communities. By utilizing dual-species co-culture biofilms, this study replicates real-world scenarios, enhancing the relevance and applicability of findings. In addition, there is a lack of studies on tripartite anti-microbial formulations targeting such dual-species biofilm models. This innovative approach has the potential to revolutionize infection management by offering a non-antibiotic alternative therapeutic strategy to combat co-infections, reduce reliance on traditional antibiotics, and curb the spread of AMR. Successful implementation could significantly reduce morbidity and mortality associated with biofilm-related infections and establish a foundation for integrating bacteriophage-enzyme therapies into mainstream clinical practice. This work aligns with the WHO’s AMR roadmap and represents a critical step toward combating the AMR crisis.