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Introduction: Pseudomonas aeruginosa is a highly resistant opportunistic pathogen and is capable of forming biofilms on
medical devices. Bacterial biofilms, which are micro-colonies encased in extracellular polysaccharide material are so difficult
to be treated by conventional antibiotics. During the last decade, P. aeruginosa phages have been extensively examined as an
alternative to antimicrobial agents.
Aim: The aim of the study was to assess bacteriophage-antibiotic combination on planktonic and biofilm states of P. aeruginosa
isolates.
Materials: In this study, we isolated 6 lytic phages from hospital effluents; they were tested against 50 P. aeruginosa strains,
isolated from different clinical specimens delivered to the Diagnostic Microbiology Laboratories, Faculty of Medicine,
Alexandria University.
Results: Out of the 50 isolates, 15 were susceptible to these phages. So the biofilm forming capacity of these 15 isolates was
investigated. The results showed that 14 isolates (93.33%) produced detectable biofilm. The minimum inhibitory concentration
(MIC) and minimum biofilm eradication concentration (MBEC) assays were used to evaluate the antibiotic sensitivity patterns
of these P. aeruginosa isolates in their planktonic and biofilm phases to amikacin and meropenem. Also, the effects of phage on
the planktonic and biofilm states of isolates at different multiplicities of infections (MOI) were tested. On the planktonic state,
Amikacin-phage combination showed synergistic effect (P=0.001) and Meropenem-phage combination showed synergistic
effect (P=0.003). On the biofilm state, Amikacin-phage combination showed biofilm eradication in 50% of the isolates
(P=0.003). On the other hand, Meropenem-phage combination showed biofilm eradication in only 14.3% of the strains.
Conclusion: The combination of phage and antibiotics could have potentially more benefits on P. aeruginosa planktonic and
biofilm states than just using phages or antibiotics alone.