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Phage therapy holds much promise as an alternative to antibiotics for fighting infection. However, this approach is no panacea as recent results show that a small fraction of cells survives lytic phage infection due to both dormancy (i.e. formation of persister cells) and resistance (genetic change). In this brief review, we summarize evidence suggesting phages induce the persister state. Therefore, it is predicted that phage cocktails should be combined with antipersister compounds to eradicate bacterial infections.

Section snippetsOverview

Since 5 million people died in 2019 due to bacterial infection associated with antimicrobial-resistant bacteria [1], it is important to identify potent antibacterial treatments. Phages are the main constraint on bacterial growth since they kill from 20 to 40% of bacteria [2]; hence, cocktails of phages are being considered to augment antibiotic treatments [3]. Therefore, it is important to delineate why some bacteria survive phage treatments.

We posit herein that persistence (dormancy) is

Perspectives

In this review, we present results to date that indicate that persister cells are formed during phage infection. The potential benefits to the host for the persister state during infection include (i) increased time for host-encoded, phage-defense systems to function, (ii) reduced viral propagation as a result of depriving the phage nucleotides and proteins, (iii) increased time for spacer accumulation for CRISPR–Cas [68], (iv) enhanced genetic diversity [69], and (v) reduced bacteria–phage

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

This work was supported by funds derived from the Novo Nordic Foundation Exploratory Interdisciplinary Synergy Programme (NNF19OC0058357) for TKW and the Vicerrectoría de Investigación y Extensión (UIS) for VST.

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