Original Research

Efficacy of diversely isolated lytic phages against multi-drug resistant Enterobacter cloacae isolates in Kenya

Ivy J. Mutai, Angela A. Juma, Martin I. Inyimili, Atunga Nyachieo, Anthony K. Nyamache
African Journal of Laboratory Medicine | Vol 11, No 1 | a1673 | DOI: https://doi.org/10.4102/ajlm.v11i1.1673 | © 2022 Ivy J. Mutai, Angela A. Juma, Martin I. Inyimili, Atunga Nyachieo, Anthony K. Nyamache | This work is licensed under CC Attribution 4.0
Submitted: 13 July 2021 | Published: 11 August 2022

About the author(s)

Ivy J. Mutai, Phage Biology Laboratory, Institute of Primate Research, Nairobi, Kenya; and, Department of Biochemistry, Biotechnology and Microbiology, Faculty of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya
Angela A. Juma, Phage Biology Laboratory, Institute of Primate Research, Nairobi, Kenya
Martin I. Inyimili, Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
Atunga Nyachieo, Phage Biology Laboratory, Institute of Primate Research, Nairobi, Kenya
Anthony K. Nyamache, Department of Biochemistry, Biotechnology and Microbiology, Faculty of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya


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Abstract

Background: Enterobacter cloacae causes nosocomial infections in 15% of patients in low- and middle-income countries with emergence of carbapenem resistance. The utilisation of bacteriophages for therapeutic purposes is crucial for eradicating these resistant bacterial strains.

Objective: This study evaluated the efficacy of lytic phages on bacterial isolates of E. cloacae and determined their stability in various physicochemical conditions.

Methods: Twenty-nine lytic phages were isolated from the waste water of six informal settlements in Nairobi County, Kenya, from July 2019 to December 2020 and cross-reacted with 30 anonymised clinical isolates of E. cloacae. Six phages were then selected for physicochemical property studies. Phages were described as potent upon lysing any bacterial strain in the panel.

Results: Selected phages were stable at 4 °C – 50 °C with a 5.1% decrease in titre in four of six phages and a 1.8% increase in titre in two of six phages at 50 °C. The phages were efficient following two weeks incubation at 4 °C with optimal activity at human body temperature (37 °C) and an optimal pH of 7.5. Phages were active at 0.002 M and 0.015 M concentrations of Ca2+ ions. The efficiency of all phages decreased with increased exposure to ultraviolet light. All phages (n = 29) showed cross-reactivity against anonymised clinical isolates of E. cloacae strains (n = 30). The most potent phage lysed 67.0% of bacterial strains; the least potent phage lysed 27.0%.

Conclusion: This study reveals the existence of therapeutic phages in Kenya that are potent enough for treatment of multi-drug resistant E. cloacae.


Keywords

lytic phages; Enterobacter cloacae; multi-drug resistance; nosocomial infections; Nairobi County; Kenya

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