The influence of temperate phage on Pseudomonas aeruginosa and their effect on Chronic Respiratory Disease sufferers

Bronchiectasis arising from either congenital (Cystic Fibrosis/CF) or acquired (non-Cystic Fibrosis Bronchiectasis/nCFBR) chronic respiratory disorders are partially characterised through sequential inflammation events in the lung. Both diseases elicit increased mucus production due to their pathophysiology and diminished mucocilliary clearance offers an environment for opportunistic pathogens e.g. Pseudomonas aeruginosa (PA) to colonise. Adaptation by PA to the chronic lung occurs progressively alongside the onset of disease. It is also possible to clinically attenuate/negate bacterial colonisation in nCFBR whereas in CF, we use this to discriminate between induced phages when modelling their adaptation over time. This study models phage induction, cross infection, phage genome comparison and twitching studies linking the results to clinical data. This allows identification/stratification of markers of adaptation between the phages/host and how this relates to the deriving disease state. The data describes how phages derived from PA in older CF patients are: (i) highly adapted to infect PA that can colonise the lung, (ii) have higher rates of self-infection, (iii) have distinct infection profiles that prescribe the bacterial origin of the phage and (iv) how the addition of phage encoded genetic traits offer positive selection for their bacterial host.