(LR-023) A Phage-Based Therapeutic for Preventing Surgical Site Infections and Improved Patient Outcome

Introduction: There is a significant and increasing threat from microbial infections caused by antibiotic resistant pathogens and their biofilms. Surgical related infections are serious healthcare associated complications. Infections with multiple antibiotic resistance is increasing at a higher rate making hospital acquired infections even more concerning. Surgical Site Infection which can be associated with any surgical procedures can lead to unfavorable patient outcome. These infections lead to extended hospital stay, readmission and clearly is a burden on our health care system.

Microorganisms from the patient’s skin such as Staphylococcus aureus, Staphylococcus epidermidis, and Propionibacterium acnes can cause surgical related infections. The current preventive measures have been ineffective for Propionibacterium acnes. This organism continues to be of a serious concern in orthopedic procedures particularly with shoulder surgeries due to its slow growth and emergence of antibiotic registrant strains. Therefore, safe and effective non-antibiotic-based therapies is urgently needed.

Methods: An alternative to antimicrobial chemicals and antibiotics is to apply phage therapy, which lytic bacteriophages (phages) are natural bacteriostatic or bactericidal effect against bacterial cells. Phages are generally regarded as safe (GRAS) medically and environmentally. Its specific lytic activity will bring about minimal disruptions to the local microbial community and can lyse and kill antibiotic resistant bacterial strains.



Our team has isolated and charactered novel bacteriophages against C. acnes. In addition, we cloned and expressed a novel endolysin (lysin) from one of these phages. Endolysins are double-stranded DNA bacteriophage-encoded peptidoglycan hydrolases. They are capable of degrading peptidoglycan when applied externally (ex. as recombinant protein) to the bacterial cell wall resulting in rapid lysis of the bacterial cell. Their ability to rapidly cleave peptidoglycan in a species-specific manner makes them one of the most promising antimicrobials.

Results: Our recombinant lysin enzyme was confirmed to have lytic activity against C. acnes strains. We believe the candidate lysin has significant potential against not only skin acne, but also strains associated with surgical infection.

Discussion: The proposed project is focused on conducting studies to help with development and advancement of an Over the counter (OTC) gel and/or wash as a preventive measure for post-surgical infections.