Department of Medicine, University of California, San Diego, La Jolla, California, USA
Biological Defense Research Directorate, Naval Medical Research Center, Frederick, Maryland, USA.
Antimicrob Agents Chemother. 2017 Sep 22;61(10). doi: 10.1128/AAC.00954-17. Print 2017 Oct.
Widespread antibiotic use in clinical medicine and the livestock industry has contributed to the global spread of multidrug-resistant (MDR) bacterial pathogens, including We report on a method used to produce a personalized bacteriophage-based therapeutic treatment for a 68-year-old diabetic patient with necrotizing pancreatitis complicated by an MDR infection. Despite multiple antibiotic courses and efforts at percutaneous drainage of a pancreatic pseudocyst, the patient deteriorated over a 4-month period. In the absence of effective antibiotics, two laboratories identified nine different bacteriophages with lytic activity for an isolate from the patient. Administration of these bacteriophages intravenously and percutaneously into the abscess cavities was associated with reversal of the patient's downward clinical trajectory, clearance of the infection, and a return to health. The outcome of this case suggests that the methods described here for the production of bacteriophage therapeutics could be applied to similar cases and that more concerted efforts to investigate the use of therapeutic bacteriophages for MDR bacterial infections are warranted.
广泛应用抗生素于临床医学和畜牧业导致了多重耐药(MDR)细菌病原体在全球范围内的传播,包括我们报告的一种用于为一名 68 岁的糖尿病合并坏死性胰腺炎并发 MDR 感染的患者生产个体化噬菌体治疗的方法。尽管进行了多次抗生素疗程和经皮引流胰腺假性囊肿的努力,患者在 4 个月内病情恶化。在缺乏有效抗生素的情况下,两个实验室鉴定出了针对从患者分离出的一株菌具有裂解活性的九种不同噬菌体。静脉内和经皮向脓肿腔内给予这些噬菌体与患者临床轨迹的逆转、感染的清除以及恢复健康相关。该病例的结果表明,此处描述的生产噬菌体疗法的方法可应用于类似病例,并且有必要更加协调一致地努力研究治疗性噬菌体用于 MDR 细菌感染的用途。