Bacteriophage and Antibiotic Resistance Are Positively Associated across a Phylogenetically Diverse Set of Clinical Pseudomonas aeruginosa Isolates
Year: 2026
Type: preprint
Abstract: Co-administration of phages and antibiotics has been proposed as a therapeutic approach against antibiotic-resistant bacteria. The relationship, however, between antibiotic resistance and phage resistance in clinical isolates is unclear. Here, we examine associations between phage and antibiotic resistance profiles across a panel of Pseudomonas aeruginosa clinical isolates from the Centers for Disease Control (CDC) and Food and Drug Administration (FDA) Antimicrobial Resistance Isolate (ARI) Bank comprising 55 clinical strains with full genome sequences and antibiotic susceptibility testing (AST) data for 11 clinically relevant antibiotics. As phages in this study, we use three well-characterized, morphologically distinct phages, OMKO1, Luz19, and PAML31-1. We screen for phage resistance using a growth suppression assay, then conduct statistical analysis against antibiotic MIC (Minimum Inhibitory Concentration) data provided by the CDC to define association patterns across this dataset. We find multiple significant susceptibility correlations between pairs of antibiotics and phages, and a positive overall association between average phage resistance and antibiotic resistance across the 55 strains, even controlling for phylogenetic associations ( r =0.358, p<0.005). We conclude that phage and antibiotic resistance are positively associated across this clinical isolate collection, suggesting that the two resistance phenotypes are not independent in P. aeruginosa . These findings have implications for the development of phage-antibiotic cocktails. Importance Antimicrobial resistance causes substantial and increasing global mortality. Understanding how bacteria develop resistance to different antimicrobial agents, particularly antibiotics and bacteriophages, is essential for identifying shared and distinct resistance mechanisms and developing more effective therapies.
Institutions: Stanford Medicine, Stanford University
Language: English
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: green
Awards: G1753091154, Pathogenesis of Pf Bacteriophages in Pseudomonas Cystic Fibrosis lung Infections, The role of macrophages in chronic suppurative otitis media associated sensory hearing loss, Studies on bacteriophages in respiratory diseases, Hydrogel Delivery of Bacteriophage to Treat Wound Infections
OpenAlex ID: W7214773329