Discussion

Question 1

What would you do differently?

Answer 1

• I would have done the experiments to dismiss 80a lysogeny from the start
• I would do further experiments for chapter 4, but of course that was complicated with covid and fortunately ongoing now
• I would have asked for the genotypic data from GOSH earlier, would have hopefully been able to look at it

Question 2

How should future trials of phage therapy take into consideration your results?

Answer 2

By considering impact of timing and concentration of abx and phage, and by frequently sampling patient bacterial population during treatment to monitor changes in diversity. But tbh these things could also be done in vitro before the trial phase!

Question 3

Phage are very specific, so how generalisable are your results?

Answer 3

Model is generalisable, parameter values not

Question 4

What would be potential interventions created that are informed by your results?

Answer 4

Firstly, all implications for phage therapy. Then, if just want to say “stop transduction”, could stop phage action with sodium citrate. Raises the question of safety of this though as would remove bacterial predators though. Currently no easy way to just stop phage from doing transduction whilst keeping everything else happening.

Question 5

Could you count phage in vivo?

Answer 5

Problem is that their host range is narrow and can be complicated to design assay to plaque them. Was seen in S aureus phage from clinical samples, despite plaquing on RN4220 which in theory is fully susceptible, worked less well than 80a.