The presentation provides an overview of the applications of phage therapy in different sectors.

1. Phage therapy in veterinary sector and beyond to
tackle emerging antibiotic resistance
Taruna Anand*, B.C. Bera, Ntin Virmani, R.K. Vaid
National Centre for Veterinary Type Cultures,
ICAR-National Research Centre on Equines, Hisar, Haryana-125 001,
India

2. Sections
 Emerging Antimicrobial Resistance
 What phages can offer to tackleAMR?
 The Real application - Phage therapy
 Where doWe Stand?

3. Emerging Antimicrobial Resistance

4. National
Centre for
Veterinary
TypeCultures
(NCVTC)

5. 5
What phages can
offer to tackle
AMR?

7. 7
+
Sample Targeted host
Enrichment of bacteriophages

8. Intravenous and percutaneous delivery of
phage cocktail resulted in curing of a 68-year
old patient infected with multidrug resistant
(MDR) Acinetobacter baumani (Shooley et al.,
2017).
“The Perfect Predator”
Recent cases of Human PhageTherapy

9. PotentialApplications of bacteriophages inVeterinarySector
Livestock
Aquaculture
Poultry

10. (FAO “Meat market review” 2020)
Poultry
• The most common infections associated with poultry are
 Salmonellosis,Colibacillosis and Campylobacteriosis.
 Prevalence rate of
 Salmonellosis (about 75-90%)
 E. coli (90-95%)
 Campylobacter positive poultry flocks in European countries varies
from 18% to 90%. In the United States, the prevalence of infected
flocks is nearly 90%.

11. Recentadvancementsinphagetherapyapplicationsin
aquacultureandfisheries
In the aquaculture sector, phage therapy efforts have targeted various pathogenic bacteria, such
as Vibrio spp., Aeromonas spp., Flavobacterium spp., Pseudomonas spp., and Edwardsiella
spp. focusing, e.g., on the isolation and characterization of virulent phages, cocktail formulations,
dose and route of phage administration (Donati et al., 2021)

13. 13
Investigation of the synergistic effect of
bacteriophages and antibiotics
PA S

14. ADVANTAGES
• Bactericidal agents
• Auto “dosing”
• Low inherent toxicity
• Minimal disruption of normal flora
• Lack of cross-resistance with antibiotics
• Rapid discovery
• Formulation and application versatility
• Biofilm clearance
PAS (Phage Antibiotic Synergy) effect
 At sub-lethal concentrations, antibiotics increase the biosynthetic
capacity of bacterial cells.
 Virulent phages take advantage of this altered host cell state to
increase their own production.
 Accelerated lysis of the infected cell allow phages to be synthesized
at high rate and hence spread more rapidly.
Bacteriophages… alternate to antibiotics???

15. 15
 Disk diffusion susceptibility test - The synergistic effect of phage and
antibiotic against bacteria was determined using a disk diffusion
susceptibility test (Bauer et al. 1966; Comeau et al., 2007). Plaque size of
bacteriophages was measured with and without the antibiotics in medium.
 Time-kill curve analysis- The antimicrobial activity of antibiotic, phage and
both in combination was evaluated by the time-kill assay.
(PAS effect)

16. Future Perspectives of PT
 Supportive therapy in treatment and prophylaxis,
 Combination therapy with antibiotics (Phage-Antibiotic
synergy) and with enzymes such as polysaccharide
depolymerases for biofilm elimination,
 PersonalizedTherapy,
 Development of vast phage libraries and genome bank for
distribution,
 Development of Synthetic phages with improved spectra,
 Artificial intelligence (AI)-based in silico phage matching and
design programs for quick decision making in selecting phage
cocktails,
 Cargo delivery through engineered phages.
16
Knezevic et al., 2021

17. Personalized Medicine
Personalized medicine – It aims to use targeted medicines taking into account the
individual information to tailor the treatment and management of the patient. It is used to
ensure the best outcome and reduce the risk of side effects.

18. Development of resistance
Immune response against phages
Endotoxins
Patenting issues
No regulatory framework in India
Challenges……….