Abstract

The presence and the emergence of difficult to treat multi-drug resistant (MDR) bacteria in people and animals has led to a reexamination of options for responding to these organisms through prevention and direct alternative therapeutic approaches.^1,2,3 While antibiotic therapy has been the traditional model for bacterial infections, increases in concern for resistance and possible carrier states for MDR organisms and reluctance to use the last few drugs available has resulted in a revival of past efforts with phage therapy for MDR organisms such as Staph aureus, E. coli, and Pseudomonas.^4,5,6 Following a successful treatment for a MDR E. coli in two African white pelicans utilizing a lytic bacteriophage cocktail,⁷ the technique was investigated for application in dolphins known to harbor similar species of organisms. A multiphage cocktail was administered to 3 individuals by different routes and the effectiveness was gauged by the recurrence of the bacterial targets post therapy. Alternate delivery techniques and volumes were investigated during the treatment attempts.

Challenges to the use of this technique includes a lack of acceptance of the techniques capability due to poor exposure to the science, expense, since it is not widely available, and fear of potential complications. MDR organisms like E. coli may be present in the intestinal tract, reproductive system, and the upper respiratory system. Phage are sensitive to pH levels lower than 5.5 so oral seeding of the organism requires raising the pH of the stomach to allow passage through the tract. Other complications include detection and elimination of the source whether the environment, contamination or self-inoculation. Despite the potential drawbacks this technique does provide an option for a number of organisms known to result in morbidity and mortality in cetaceans. Where the biggest challenge lies is investigating and applying techniques unfamiliar to the clinician and administrators requiring a pioneer spirit we all have but may not tap into enough.

Acknowledgements

Our sincere appreciation to those who supported a bacteriophage treatment approach at Intralytix, Clearwater Marine Aquarium and the Emerging Pathogens Institute at University of Florida.

* Presenting author

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