# Use of the Naturally Occurring Bacteriophage Grouping Model for the Design of Potent Therapeutic Cocktails

## TL;DR

This study explores how naturally occurring phage groups can be used to create effective therapeutic cocktails for treating antibiotic-resistant bacterial infections.

## Contribution

The study introduces a new method for designing phage cocktails by mimicking natural phage groupings and evaluating their therapeutic potential.

## Key findings

- Natural phage cocktails inhibited the growth of phage-resistant mutants in bacterial cultures.
- Phage cocktails showed synergistic or proto-cooperative effects in inhibiting bacterial growth.
- The study identified 13 P. aeruginosa and 11 K. pneumoniae phages from 18 different genera for therapeutic use.

## Abstract

The specificity of phages and their ability to evolve and overcome bacterial resistance make them potentially useful as adjuncts in the treatment of antibiotic-resistant bacterial infections. The goal of this study was to mimic a natural grouping of phages of interest and to evaluate the nature of their proliferation dynamics with bacteria. We have, for the first time, transferred naturally occurring phage groups directly from their sources of isolation to in vitro and identified 13 P. aeruginosa and 11 K. pneumoniae phages of 18 different genera, whose host range was grouped as 1.2–17%, 28–48% and 60–87%, using a large collection of P. aeruginosa (n = 102) and K. pneumoniae (n = 155) strains carrying different virulence factors and phage binding receptors. We introduced the interpretation model curve for phage liquid culturing, which allows easy and quick analysis of bacterial and phage co-proliferation and growth of phage-resistant mutants (PRM) based on qualitative and partially quantitative evaluations. We assayed phage lytic activities both individually and in 14 different cocktails on planktonic bacterial cultures, including three resistotypes of P. aeruginosa (PAO1, PA14 and PA7) and seven K. pneumoniae strains of different capsular serotypes. Based on the results, the natural phage cocktails designed and tested in this study largely performed well and inhibited PRM growth either synergistically or in proto-cooperation. This study contributes to the knowledge of phage behavior in cocktails and the formulation of therapeutic phage preparations. The paper also provides a detailed description of the methods of working with phages.