Antibiotic-induced morphological changes enhance phage predation

Due to the high public health risk posed by antibioresistance, phage therapy - the use of bacteriophages as antibacterial agents - is experiencing renewed interest. As the combined administration of antibiotics and phages is a common practice in compassionate treatments, our research focuses on the effects of antibiotics on phage predation, which may be of crucial importance for phage therapeutic applications. A distinctive manifestation of phage infection in solid media is the appearance of lysis plaques, corresponding to the circular thinning of a bacterial lawn. During plaque formation, successive cycles of phage replication take place from a single point of infection and spread radially in a lawn of immobilized bacterial hosts. Many factors affect plaque size, such as the composition and the reticulation of the propagation matrix, the characteristics of the phage, but also parameters related to the physiology of the bacterial host. It has also been known for decades that some antibiotics enable phages to spread more rapidly, resulting in better bacterial eradication. This phenomenon, called Phage-Antibiotic Synergy (PAS), is evidenced by larger lysis plaques on solid media. Our previous experimental work has focused on the phage characteristics and pointed to enhanced adsorption as a key factor leading to more efficient predation. However, since sublethal antibiotic concentrations can drastically affect bacterial physiology - for instance halting cell division in the case of ciprofloxacin or ceftazidime - and since plaque formation is strongly influenced by host growth dynamics, a comprehensive model integrating both the host growth and phage infection parameters is required to investigate PAS. We characterized the epidemics of two different phages (T5 and T7) during E. coli MG1655 infection on semi-solid media in the presence of sublethal antibiotic concentrations that affect (or not) cell morphology in different ways (cell filamentation or cell bloating). We observed that in these conditions lysis plaque enlargement is linked to the host's morphological changes. We conclude this work with a mathematical model that captures such observations and explains the increase in plaque size observed in the presence of antibiotics.