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.
Understanding integron dynamics in S. aureus is crucial for informing antimicrobial stewardship, infection control strategies, and future interventions aimed at limiting the spread of MDR pathogens.
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