Steele Angharad, Stacey Helen J, de Soir Steven, Jones Joshua D
Infection Medicine, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
Edinburgh Medical School, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
Antibiotics (Basel). 2020 Oct 29;9(11):754. doi: 10.3390/antibiotics9110754.
Superficial bacterial infections, such as dermatological, burn wound and chronic wound/ulcer infections, place great human and financial burdens on health systems globally and are often complicated by antibiotic resistance. Bacteriophage (phage) therapy is a promising alternative antimicrobial strategy with a 100-year history of successful application. Here, we report a systematic review of the safety and efficacy of phage therapy for the treatment of superficial bacterial infections. Three electronic databases were systematically searched for articles that reported primary data about human phage therapy for dermatological, burn wound or chronic wound/ulcer infections secondary to commonly causative bacteria. Two authors independently assessed study eligibility and performed data extraction. Of the 27 eligible reports, eight contained data on burn wound infection ( = 156), 12 on chronic wound/ulcer infection ( = 327) and 10 on dermatological infections ( = 1096). Cautionary pooled efficacy estimates from the studies that clearly reported efficacy data showed clinical resolution or improvement in 77.5% ( = 111) of burn wound infections, 86.1% ( = 310) of chronic wound/ulcer infections and 94.14% ( = 734) of dermatological infections. Over half of the reports that commented on safety ( = 8/15), all published in or after 2002, did not express safety concerns. Seven early reports (1929-1987), described adverse effects consistent with the administration of raw phage lysate and co-administered bacterial debris or broth. This review strongly suggests that the use of purified phage to treat superficial bacterial infections can be highly effective and, by various routes of administration, is safe and without adverse effects.
浅表细菌感染，如皮肤病、烧伤创面以及慢性伤口/溃疡感染，给全球卫生系统带来了巨大的人力和经济负担，并且常常因抗生素耐药性而变得复杂。噬菌体疗法是一种有前景的替代抗菌策略，有着100年成功应用的历史。在此，我们报告一项关于噬菌体疗法治疗浅表细菌感染的安全性和有效性的系统评价。系统检索了三个电子数据库，以查找报告关于人类噬菌体疗法治疗由常见致病菌引起的皮肤病、烧伤创面或慢性伤口/溃疡感染的原始数据的文章。两位作者独立评估研究的合格性并进行数据提取。在27篇合格报告中，8篇包含烧伤创面感染的数据（n = 156），12篇包含慢性伤口/溃疡感染的数据（n = 327），10篇包含皮肤病感染的数据（n = 1096）。明确报告了疗效数据的研究得出的谨慎合并疗效估计显示，77.5%（n = 111）的烧伤创面感染、86.1%（n = 310）的慢性伤口/溃疡感染以及94.14%（n = 734）的皮肤病感染实现了临床缓解或改善。超过一半对安全性发表评论的报告（n = 8/15），均发表于2002年或之后，未表达出安全担忧。七篇早期报告（1929 - 1987年）描述了与给予未纯化的噬菌体裂解物以及共同给予细菌碎片或肉汤相关的不良反应。本综述强烈表明，使用纯化噬菌体治疗浅表细菌感染可能非常有效，并且通过各种给药途径都是安全且无不良反应的。
