Division of Obstetrics and Gynecology, School of Medicine, The University of Western Australia, Crawley, WA, Australia.
The Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, The University of Western Australia, Crawley, WA, Australia.
Front Cell Infect Microbiol. 2018 Oct 23;8:376. doi: 10.3389/fcimb.2018.00376. eCollection 2018.
Increasing reports of antimicrobial resistance and limited new antibiotic discoveries and development have fuelled innovation in other research fields and led to a revitalization of bacteriophage (phage) studies in the Western world. Phage therapy mainly utilizes obligately lytic phages to kill their respective bacterial hosts, while leaving human cells intact and reducing the broader impact on commensal bacteria that often results from antibiotic use. Phage therapy is rapidly evolving and has resulted in cases of life-saving therapeutic use and multiple clinical trials. However, one of the biggest challenges this antibiotic alternative faces relates to regulations and policy surrounding clinical use and implementation beyond compassionate cases. This review discusses the multi-drug resistant Gram-negative pathogens of highest critical priority and summarizes the current state-of-the-art in phage therapy targeting these organisms. It also examines phage therapy in humans in general and the approaches different countries have taken to introduce it into clinical practice and policy. We aim to highlight the rapidly advancing field of phage therapy and the challenges that lie ahead as the world shifts away from complete reliance on antibiotics.
越来越多的关于抗生素耐药性的报告以及新抗生素发现和开发的有限性，推动了其他研究领域的创新，并在西方世界重新激发了噬菌体（phage）研究的活力。噬菌体治疗主要利用专性裂解噬菌体来杀死其各自的细菌宿主，同时使人体细胞保持完整，并减少抗生素使用通常对共生细菌造成的广泛影响。噬菌体治疗正在迅速发展，并已导致了一些救命治疗用途和多项临床试验。然而，这种抗生素替代品面临的最大挑战之一涉及围绕同情治疗案例之外的临床使用和实施的法规和政策。本文综述了高度优先的多重耐药革兰氏阴性病原体，并总结了针对这些生物体的噬菌体治疗的最新技术状态。它还考察了一般情况下的噬菌体治疗在人类中的应用，以及不同国家为将其引入临床实践和政策所采取的方法。我们的目的是强调噬菌体治疗这一快速发展的领域，以及随着世界逐渐摆脱对抗生素的完全依赖而面临的挑战。
