Azevedo Maria Manuel, Pina-Vaz Cidália, Rodrigues Acácio G
Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto.
CINTESIS - Center for Research in Health Technologies and Information Systems, Faculty of Medicine, University of Porto.
J Burn Care Res. 2022 Mar 23;43(2):336-342. doi: 10.1093/jbcr/irab175.
Burn wound infections are often the source of bacteria responsible for systemic infections, including bloodstream infections and pneumonia that ultimately can result in multisystem organ failure and death. Any rapid change in the burn wound appearance or the clinical condition of the burn patient may herald burn wound infection or sepsis. The revival of phage therapy, either in single mode or in combination with conventional antibiotics may represent a valuable alternative, to treat specific bacterial infections such as burn wound infections, including those caused by multidrug-resistant organisms. This systematic review addresses the: 1) general characteristics of bacteriophages; 2) activity of bacteriophages vs conventional antibiotics; 3) activity of bacteriophages against biofilms; 4) bacteriophage administration; and 5) use of bacteriophages in burn wound infections. Although several scientific organizations/societies recognized that phage therapy could be of key value in modern wound care, specific aspects are critical for a burn surgeon and might represent pitfalls discouraging phage therapy adoption in burn wound management; in particular, the unavailability of consensual therapeutic guidelines/regulatory policies and the lack of laboratorial support that might be predictive of its efficacy. The availability of a product/formulation convenient to use, with adequate stability and shelf half-life is also a key condition.
烧伤创面感染往往是导致全身感染的细菌来源，包括血流感染和肺炎，最终可能导致多系统器官衰竭和死亡。烧伤创面外观或烧伤患者临床状况的任何快速变化都可能预示着烧伤创面感染或脓毒症。噬菌体疗法无论是单独使用还是与传统抗生素联合使用，都可能是治疗特定细菌感染（如烧伤创面感染，包括由多重耐药菌引起的感染）的一种有价值的替代方法。本系统综述涉及以下方面：1）噬菌体的一般特征；2）噬菌体与传统抗生素的活性比较；3）噬菌体对生物膜的活性；4）噬菌体的给药方式；5）噬菌体在烧伤创面感染中的应用。尽管一些科学组织/学会认识到噬菌体疗法在现代伤口护理中可能具有关键价值，但对于烧伤外科医生来说，特定方面至关重要，可能成为阻碍在烧伤创面管理中采用噬菌体疗法的陷阱；特别是缺乏共识性的治疗指南/监管政策，以及缺乏可能预测其疗效的实验室支持。此外，拥有方便使用、稳定性良好且货架期半衰期合适的产品/制剂也是一个关键条件。
