Rubalskii Evgenii, Ruemke Stefan, Salmoukas Christina, Boyle Erin C, Warnecke Gregor, Tudorache Igor, Shrestha Malakh, Schmitto Jan D, Martens Andreas, Rojas Sebastian V, Ziesing Stefan, Bochkareva Svetlana, Kuehn Christian, Haverich Axel
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany.
Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, 30625 Hannover, Germany.
Antibiotics (Basel). 2020 May 5;9(5):232. doi: 10.3390/antibiotics9050232.
(1) Objective: Bacterial resistance to conventional antibiotic therapy is an increasingly significant worldwide challenge to human health. The objective is to evaluate whether bacteriophage therapy could complement or be a viable alternative to conventional antibiotic therapy in critical cases of bacterial infection related to cardiothoracic surgery. (2) Methods: Since September 2015, eight patients with multi-drug resistant or especially recalcitrant , , , , and infections were treated with bacteriophage preparations as a therapy of last resort according to Article 37 of the Declaration of Helsinki. Patients had infections associated with immunosuppression after organ transplantation or had infections of vascular grafts, implanted medical devices, and surgical wounds. Individualized phage preparations were administered locally, orally, or via inhalation for different durations depending on the case. All patients remained on conventional antibiotics during bacteriophage treatment. (3) Results: Patients ranged in age from 13 to 66 years old (average 48.5 ± 16.7) with seven males and one female. Eradication of target bacteria was reached in seven of eight patients. No severe adverse side effects were observed. (4) Conclusions: Phage therapy can effectively treat bacterial infections related to cardiothoracic surgery when conventional antibiotic therapy fails.
(1) 目的：细菌对传统抗生素治疗产生耐药性，这在全球范围内对人类健康构成了日益严峻的挑战。本研究旨在评估在心胸外科相关的严重细菌感染病例中，噬菌体疗法是否可以补充或替代传统抗生素治疗。(2) 方法：自2015年9月起，根据《赫尔辛基宣言》第37条，对8例耐多药或特别难治的、、、、和感染患者，使用噬菌体制剂作为最后手段进行治疗。这些患者在器官移植后出现与免疫抑制相关的感染，或患有血管移植物、植入式医疗器械和手术伤口感染。根据具体情况，将个体化的噬菌体制剂局部、口服或通过吸入方式给药，持续不同时间。在噬菌体治疗期间，所有患者均继续使用传统抗生素。(3) 结果：患者年龄在13至66岁之间（平均48.5±16.7），男性7例，女性1例。8例患者中有7例实现了目标细菌的清除。未观察到严重的不良副作用。(4) 结论：当传统抗生素治疗无效时，噬菌体疗法可有效治疗心胸外科相关的细菌感染。
