Antimicrobial resistance is a growing concern for people with chronic respiratory infection. Phage Therapy offers a promising avenue for cheap, safe and personalised antimicrobials. Due to the high specificity of phages, phages specific to a patient?s infecting strain need to be identified, isolated and characterised. This process can take months and poses a challenge for providing phages both for compassionate use and for developing successful clinical trials. 

The Citizen Phage Library (https://citizenphage.com) (CPL) was established as a Phage Biobank within the UK for rapid provision of clinical phages obtained through Citizen Science. Citizens collect samples from freshwater, which are sent back to the laboratory for processing to isolate phages. Combining a bank of citizen samples with those collected from across the UK wastewater national infrastructure enables the CPL to respond rapidly to provide personalised phage cocktails on demand within 2-3 weeks of receiving the pathogenic strain. 

To date, we have processed ~450 samples from citizen phage hunters and isolated >800 phages.?Each phage is purified, sequenced and selected for clinical use through genomic screening, time-lapse plaque imaging and high throughput assays for synergy and antagonism with antibiotics.

A specific area of interest with the CPL is infection in chronic suppurative lung disease. Initial screening for phages for a patient with bronchiectasis under consideration for compassionate use of phage against Pseudomonas aeruginosa, found over 60 relevant phages. Further screening is ongoing against relevant pathogens. With growing interest in phage, and high-quality research needed in this field, Phage Biobanks such as the CPL are vital.