Simple catheter biofilm flow-model: Klebsiella phages disrupt E. coli biofilms on urinary catheters under static and dynamic flow conditions

Biofilms pose a significant challenge in medical settings, leading to persistent infections. Phage therapy shows promise in biofilm eradication, but its effectiveness under dynamic flow conditions remains unclear. We use two novel phages isolated on Klebsiella, Llofrudd and Samara, and characterized their genomes, host range, virulence and impact on biofilms. In this study, we built a simple catheterised bladder model with flow to investigate the impact of phage treatment on biofilm viability in a flow-based catheter model. These analyses demonstrate that phages Llofrudd and Samara are the same species and infect a limited number of strains (3/221), but crucially across three species: Klebsiella aerogenes, Klebsiella pneumoniae and E. coli. Phage treatment significantly reduced E. coli biofilm viability in catheters both in static conditions and under flow and liberated bacteria from the biofilms, highlighting the potential of phage therapy as an intervention strategy for catheter associated urinary tract infections (CAUTI).