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Bacteriophage Challenge Drives Genomic and Proteomic Remodeling and Alters Antibiotic Resistance in a Methicillin-Resistant Staphylococcus aureus

Aug 2026 · Antibiotics · Vol 15, pp. 800 · 0 citations · 61 references
Medicine

TL;DR

Bacteriophage exposure drives phenotypic and molecular adaptation in MRSA and may create evolutionary trade-offs that weaken resistance mechanisms, support the potential of bacteriophages as both direct antibacterial agents and modulators of antibiotic susceptibility.

Abstract

Background/Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a major therapeutic challenge due to its extensive antibiotic resistance. This study examined how bacteriophage exposure affects the genome, proteome and antibiotic susceptibility of a clinical MRSA isolate. Methods: The MRSA isolate was exposed to the PYOFAG bacteriophage cocktail, and small colony variants (SCVs) of the surviving bacteria were compared with the untreated parental strain by phenotypic testing, whole-genome sequencing, comparative proteomics, and transmission electron microscopy. Results: Phage exposure induced marked remodeling in MRSA, including altered growth, colony morphology, and increased susceptibility to various antibiotics, especially β-lactams and aminoglycosides. Genomic analysis identified multiple mutations and the loss of two genomic regions, including changes in tarS, a gene linked to wall teichoic acid glycosylation, phage adsorption, and β-lactam resistance. Proteomic analysis revealed broad changes in metabolic, stress-response, and cell-envelope-associated pathways. Transmission electron microscopy showed a significant reduction in cell wall thickness after phage treatment. Conclusions: Bacteriophage exposure drives phenotypic and molecular adaptation in MRSA and may create evolutionary trade-offs that weaken resistance mechanisms. These findings support the potential of bacteriophages as both direct antibacterial agents and modulators of antibiotic susceptibility.

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