Phage Biology

Lika Kvitsinadze, Ketie Gabitashvili, Nana Topuria, Lia Tkemaladze, Tina Kvelashvili, Nana Cholokashvili, Ketevan Gachechiladze, Elizabeth Kutter, Inga Georgadze

G. Eliava Institute of Bacteriophage, Microbiology and Virology, Tbilisi, Republic of Georgia.
The Evergreen State College, Olympia, WA, USA

The importance of pathology development in extreme conditions has been growing bigger recently, namely burn, radiation and traumatic injuries complicated by bacterial infections. Purulent-septic infections play a leading role in the complicated structure of hospital infections, thus presenting 85% of all hospital complications. In the USA alone the loss caused by hospital infections amounts to $4 billion annually, while 3.4 - 5.3% of hospitalized patients are victims of bacterial complications.

In this connection, timely detection and assessment of the microbial agent is of crucial importance, as the type of agent determines the severity of clinical condition and outcome of the infectious process.

In the beginning of the 20th century, anaerobic clostridial microflora were considered to be the scourge of bacterial complications, but after the introduction of asepsis and antisepsis techniques hemolytic streptococci occupied the leading position; later they were joined by staphylococci. The introduction of sulfonamides and later antibiotics clearly altered the microbial picture. The first information on the increase of the role of Pseudomonas aeruginosa in the etiology of purulent-inflammatory processes appears in the 1960s. The application of wide-spectrum antibiotics for the treatment and prevention of bacterial complications helps suppress facultative automicroflora, generating pre-conditions for colonization of the wound area by conditionally-pathogenic gram-negative microorganisms, causing opportunistic infections[1].

By the 1990s, gram-negative bacteria not only kept pace with gram-positive bacteria as far as quantity was concerned, but surpassed them in certain cases, especially in the severity of the process. The staphylococci initially isolated from burn wounds later gradually gave way to P. aeruginosa, E. coli, Proteus. The study of the etiologic structure of the microorganisms isolated from purulent wounds and cavernous abscesses has demonstrated that, together with intestinal bacilli, Proteus and Pseudomonas are also found - 26.2% and 24% respectively. It should be noted that the mentioned microbes are most frequently found as agents of secondary infections. What is more important, associations of Pseudomonas and Proteus are found in infected wounds of various origins more and more frequently.

The infections caused by pseudomonads and protei do not yield easily to antibiotic therapy due to multiple-antibiotic resistance transmitted by R-plasmids. Creation and application of the new generation of antibiotics was rapidly followed by the introduction of microbial cultures resistant to antibiotics.

The growing role of mixed secondary infections, wide expansion of antibiotic resistance, and multitude of side effects of antibiotic therapy provoke the necessity to review the tactics of treating wounds and burns, generating and applying alternative approaches. One of the most promising is bacteriophages, which have been shown to be both safe and highly effective for external applications through extensive experience in Georgia.

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Last Updated: May 29, 2008

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