Phage susceptibility testing methods or 'phagograms': where do we stand and where should we go?

Area of Science:

• Microbiology
• Biotechnology
• Infectious Diseases

Background:

• Antimicrobial resistance (AMR) is a growing global health threat.
• Phage therapy, using bacteriophages to treat bacterial infections, is a viable alternative.
• Phage susceptibility testing (PST) is crucial for selecting effective phages due to their specificity.

Purpose of the Study:

• To review current phage susceptibility testing (PST) methods.
• To identify challenges and limitations in existing PST techniques.
• To highlight the need for standardized and automated PST for clinical application.

Main Methods:

• Description of plaque assays and growth kinetic assays for PST.
• Analysis of the principles, advantages, and disadvantages of each method.
• Discussion of labor-intensive and time-consuming aspects of current PST.

Main Results:

• Plaque and growth kinetic assays are routinely used but are labor-intensive.
• Current PST methods require automation for efficiency in preparation, incubation, reading, and analysis.
• A standardized reference method for PST is urgently needed.

Conclusions:

• Standardization and automation are critical for efficient phage selection in phage therapy.
• Further research is needed to address knowledge gaps and establish a reference PST method.
• Developing efficient PST techniques will facilitate the clinical application of phage therapy.