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Front. Microbiol. | doi: 10.3389/fmicb.2018.00856

Evaluating bacteriophage particles containing antibiotic resistance genes in the sputum of cystic fibrosis patients

Maryury Brown-Jaque1, Lirain Rodriguez-Oyarzun1, Thais Cornejo Sánchez2, 3,  Maria Teresa Martin-Gomez2, Silvia Gartner4,  Javier de Gracias4, Sandra Rovira4,  Antonio Alvarez4, Juan Jofre1,  Juan Jose Gonzalez-Lopez2 and  Maite Muniesa1*
  • 1Dept. microbiology, Universitat de Barcelona, Spain
  • 2División de Micología Clínica, Departamento de Microbiología, Hospital Universitario Vall d'Hebron, Spain
  • 3Microbiology, Vall d'Hebron Research Institute, Spain
  • 4Cystic fibrosis unit, Hospital Universitari Vall d'Hebron, Spain

Cystic fibrosis (CF) is a chronic disease in which the bacterial colonization of the lung is linked to an excessive inflammatory response that leads to respiratory failure. The microbiology of CF is complex. Staphylococcus aureus is the first bacterium colonizing the lungs in a 30% of paediatric patients. Later, a 80 % of adult CF patients develop a chronic Pseudomonas aeruginosa infection, and other microorganisms can also be found.

The use of antibiotics is essential to treat the disease, but antibiotic performance is compromised by resistance mechanisms. Bacteriophages have recently been reported to constitute one of the various mechanisms of transfer of antibiotic resistance genes (ARGs), and are the least explored in clinical settings. Here we evaluate their presence in CF patients. 71 sputum samples of CF patients were used to quantify eight ARG (blaTEM, blaCTX-M-1-group, blaCTX-M-9-group, blaOXA-48, blaVIM, mecA, qnrA and qnrS) in the bacteriophage DNA fraction. The phages found were also purified and observed using electron microscopy. 32.4 % of CF patients contain ARGs in phage DNA. β -lactamase genes, particularly blaVIM and blaTEM, were the most prevalent and abundant, whereas mecA, qnrA and qnrS were very rare. Siphoviridae phage particles capable of infecting P. aeruginosa and Klebsiella pneumoniae were detected in the CF sputum. Phage particles harbouring ARGs were abundant in the lungs of both CF patients and healthy people and could contribute to the colonization of multiresistant strains.

Keywords: Cystic Fibrosis, bacteriophages with antibiotic resistance genes, horizontal gene transfer, Sputum, Betalactamases

Received: 19 Jan 2018; Accepted: 13 Apr 2018.

Edited by:

Patrick R. Butaye, Ross University School of Veterinary Medicine, Saint Kitts and Nevis

Reviewed by:

Grzegorz Wegrzyn, University of Gdansk, Poland
Friederike Hilbert, Veterinärmedizinische Universität Wien, Austria  

Copyright: © 2018 Brown-Jaque, Rodriguez-Oyarzun, Cornejo Sánchez, Martin-Gomez, Gartner, de Gracias, Rovira, Alvarez, Jofre, Gonzalez-Lopez and Muniesa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Maite Muniesa, Universitat de Barcelona, Dept. microbiology, Diagonal 643. annex. Floor 0, Barcelona, 08028, Spain,