Bacteriophage-Mediated Control of Extensively Drug-Resistant (XDR) Uropathogens

Urinary tract infections (UTIs) are the most common bacterial infections worldwide and are primarily caused by Escherichia coli and Pseudomonas aeruginosa. In developing countries like Bangladesh, the rapid emergence of antibiotic resistance is largely driven by irrational antibiotic use, over-the-counter availability of antimicrobial drugs, and limited diagnostic facilities. This study aimed to identify uropathogenic bacteria and study the potential of bacteriophages as an alternative antimicrobial strategy. Four bacterial isolates from urine samples of suspected UTI patients were identified as E. coli and P. aeruginosa using Gram staining, biochemical tests, 16S rRNA gene sequencing, and NCBI BLAST analysis. Antibiotic susceptibility testing against 14 antibiotics revealed extensive multidrug resistance; one P. aeruginosa isolate was pandrug-resistant, while the others showed resistance to 7–12 antibiotics. To explore an alternative treatment approach, bacteriophages were isolated from sewage samples using E. coli and P. aeruginosa as host bacteria. Five lytic bacteriophages (Phage-1 to Phage-5) were successfully isolated and confirmed by spot and double agar layer assays. These phages produced clear lytic zones and distinct plaques, showing effective antibacterial activity. Stability tests showed that the phages remained active between −20 °C and 50 °C and within a pH range of 5–9, although activity decreased under extreme temperature and pH conditions. These results suggest that bacteriophage therapy shows great promise as an alternative or adjunct therapy for UTIs caused by extensively drug-resistant uropathogens. Further studies on phage genomics, standardized production, clinical safety, and regulatory approval are needed before therapeutic application in humans.