Benefits and Challenges of Applying Bacteriophage Biocontrol in the Consumer Water Cycle.

Bacteria (including disinfection- and antibiotic-resistant bacteria) are abundant in the consumer water cycle, where they may cause disease, and lead to biofouling and infrastructure damage in distributions systems, subsequently resulting in significant economic losses. Bacteriophages and their associated enzymes may then offer a biological control solution for application within the water sector. Lytic bacteriophages are of particular interest as biocontrol agents as their narrow host range can be exploited for the targeted removal of specific bacteria in a designated environment. Bacteriophages can also be used to improve processes such as wastewater treatment, while bacteriophage-derived enzymes can be applied to combat biofouling based on their effectiveness against preformed biofilms. However, the host range, environmental stability, bacteriophage resistance and biosafety risks are some of the factors that need to be considered prior to the large-scale application of these bacterial viruses. Characteristics of bacteriophages that highlight their potential as biocontrol agents are thus outlined in this review, as well as the potential application of bacteriophage biocontrol throughout the consumer water cycle. Additionally, the limitations of bacteriophage biocontrol and corresponding mitigation strategies are outlined, including the use of engineered bacteriophages for improved host ranges, environmental stability and the antimicrobial re-sensitisation of bacteria. Finally, the potential public and environmental risks associated with large-scale bacteriophage biocontrol application are considered, and alternative applications of bacteriophages to enhance the functioning of the consumer water cycle, including their use as water quality or treatment indicators and microbial source tracking markers, are discussed.

Prevalence of ESKAPE pathogens in the environment: Antibiotic resistance status, community-acquired infection and risk to human health.

The ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) pathogens are characterised by increased levels of resistance towards multiple classes of first line and last-resort antibiotics. Although these pathogens are frequently isolated from clinical environments and are implicated in a variety of life-threatening, hospital-associated infections; antibiotic resistant ESKAPE strains have been isolated from environmental reservoirs such as surface water, wastewater, food, and soil. Literature on the persistence and subsequent health risks posed by the ESKAPE isolates in extra-hospital settings is however, limited and the current review aims to elucidate the primary reservoirs of these pathogens in the environment, their antibiotic resistance profiles, and the link to community-acquired infections. Additionally, information on the current state of research regarding health-risk assessments linked to exposure of the ESKAPE pathogens in the natural environment, is outlined.

Biological Control of Acinetobacter baumannii: In Vitro and In Vivo Activity, Limitations, and Combination Therapies.

The survival, proliferation, and epidemic spread of Acinetobacter baumannii (A. baumannii) in hospital settings is associated with several characteristics, including resistance to many commercially available antibiotics as well as the expression of multiple virulence mechanisms. This severely limits therapeutic options, with increased mortality and morbidity rates recorded worldwide. The World Health Organisation, thus, recognises A. baumannii as one of the critical pathogens that need to be prioritised for the development of new antibiotics or treatment. The current review will thus provide a brief overview of the antibiotic resistance and virulence mechanisms associated with A. baumannii's "persist and resist strategy". Thereafter, the potential of biological control agents including secondary metabolites such as biosurfactants [lipopeptides (surfactin and serrawettin) and glycolipids (rhamnolipid)] as well as predatory bacteria (Bdellovibrio bacteriovorus) and bacteriophages to directly target A. baumannii, will be discussed in terms of their in vitro and in vivo activity. In addition, limitations and corresponding mitigations strategies will be outlined, including curtailing resistance development using combination therapies, product stabilisation, and large-scale (up-scaling) production.

Interaction of Bdellovibrio bacteriovorus with Gram-Negative and Gram-Positive Bacteria in Dual Species and Polymicrobial Communities.

The interaction of Bdellovibrio bacteriovorus PF13 with mixed bacterial communities, consisting of Gram-negative (Pseudomonas fluorescens and Klebsiella pneumoniae) and Gram-positive (Staphylococcus aureus and Enterococcus faecium) bacteria, was investigated to determine if this wild-type predator preferentially preys on certain bacteria and whether the presence of Gram-positive organisms influences its predation efficiency. In co-culture with P. fluorescens and K. pneumoniae, the cell counts (PFU/mL) of PF13 increased by 5.79 and 5.17 logs (48 h), respectively, while in the dual species assay (P. fluorescens, K. pneumoniae and PF13), the cell counts of PF13 increased by 1.95 logs (24 h). Using ethidium monoazide bromide quantitative polymerase chain reaction (EMA-qPCR), the concentration of PF13 increased by 1.25 to 3.62 logs in the co-culture experiments, by 1.41 to 5.05 logs in dual species cultures and by 2.65 logs in a polymicrobial culture. However, PF13 preferentially preyed on K. pneumoniae in the dual species and polymicrobial cultures, highlighting that the presence of Gram-positive bacteria did not affect the predation efficiency of PF13. This is significant as it implies that the predator can be applied in mixed microbial communities to target Gram-negative pathogens which may pose a health risk to patients, consumers or for the treatment of contaminated water.