Wu Nannan, Zhu Tongyu
Shanghai Institute of Phage, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Organ Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China.
Front Microbiol. 2021 Jan 28;12:638094. doi: 10.3389/fmicb.2021.638094. eCollection 2021.
Nosocomial infections (NIs) are hospital-acquired infections which pose a high healthcare burden worldwide. The impact of NIs is further aggravated by the global spread of antimicrobial resistance (AMR). Conventional treatment and disinfection agents are often insufficient to catch up with the increasing AMR and tolerance of the pathogenic bacteria. This has resulted in a need for alternative approaches and raised new interest in therapeutic bacteriophages (phages). In contrast to the limited clinical options available against AMR bacteria, the extreme abundance and biodiversity of phages in nature provides an opportunity to establish an ever-expanding phage library that collectively provides sustained broad-spectrum and poly microbial coverage. Given the specificity of phage-host interactions, phage susceptibility testing can serve as a rapid and cost-effective method for bacterial subtyping. The library can also provide a database for routine monitoring of nosocomial infections as a prelude to preparing ready-to-use phages for patient treatment and environmental sterilization. Despite the remaining obstacles for clinical application of phages, the establishment of phage libraries, pre-stocked phage vials prepared to good manufacturing practice (GMP) standards, and pre-optimized phage screening technology will facilitate efforts to make phages available as modern medicine. This may provide the breakthrough needed to demonstrate the great potential in nosocomial infection management.
医院感染(NIs)是指在医院获得的感染,在全球范围内造成了沉重的医疗负担。抗菌药物耐药性(AMR)的全球传播进一步加剧了医院感染的影响。传统的治疗和消毒剂往往不足以应对日益增加的AMR以及病原菌的耐受性。这导致需要采用替代方法,并引发了对治疗性噬菌体(phages)的新兴趣。与针对AMR细菌的有限临床选择形成对比的是,自然界中噬菌体的极度丰富和生物多样性提供了一个机会,可以建立一个不断扩大的噬菌体文库,该文库共同提供持续的广谱和多微生物覆盖。鉴于噬菌体-宿主相互作用的特异性,噬菌体敏感性测试可作为一种快速且经济高效的细菌分型方法。该文库还可以提供一个数据库,用于医院感染的常规监测,作为为患者治疗和环境消毒准备即用型噬菌体的前奏。尽管噬菌体临床应用仍存在障碍,但建立噬菌体文库、按照良好生产规范(GMP)标准制备的预存噬菌体小瓶以及预先优化的噬菌体筛选技术,将有助于推动噬菌体作为现代药物的应用。这可能提供所需突破,以证明其在医院感染管理中的巨大潜力。