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噬菌体治疗播散性皮肤龟分枝杆菌感染。

Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection.

机构信息

Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

Nat Commun. 2022 May 3;13(1):2313. doi: 10.1038/s41467-022-29689-4.


DOI:10.1038/s41467-022-29689-4
PMID:35504908
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9064978/
Abstract

Mycobacterium chelonae is a rare cause of chronic disseminated cutaneous infections in immunocompromised patients. Multidrug-resistant M. chelonae infections present a challenge for treatment, and prolonged antimicrobial courses lead to significant toxicities and further antimicrobial resistance. We report a case of refractory cutaneous disseminated M. chelonae infection in a patient with seronegative arthritis on immunotherapy with tofacitinib that was treated with combination antimicrobial, surgical, and single bacteriophage therapy with excellent clinical response. The patient developed neutralizing antibodies against the bacteriophage but continues to have stable improvement of disease with negative biopsies and no evidence of bacterial resistance to the phage.

摘要

龟分枝杆菌是免疫功能低下患者慢性播散性皮肤感染的罕见病因。耐多药龟分枝杆菌感染给治疗带来了挑战,延长抗菌疗程会导致严重的毒性和进一步的抗菌耐药性。我们报告了一例接受托法替尼免疫治疗的血清阴性关节炎患者发生难治性播散性皮肤龟分枝杆菌感染的病例,该患者采用联合抗菌药物、手术和单噬菌体治疗,取得了极好的临床疗效。该患者产生了针对噬菌体的中和抗体,但仍持续改善疾病,活检阴性,无噬菌体耐药证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89a/9064978/e91fd3ae0cb9/41467_2022_29689_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89a/9064978/041d9e3273bb/41467_2022_29689_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89a/9064978/db84e41525de/41467_2022_29689_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89a/9064978/e91fd3ae0cb9/41467_2022_29689_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89a/9064978/041d9e3273bb/41467_2022_29689_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89a/9064978/db84e41525de/41467_2022_29689_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89a/9064978/e91fd3ae0cb9/41467_2022_29689_Fig3_HTML.jpg

相似文献

[1]
Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection.

Nat Commun. 2022-5-3

[2]
Rapid development of resistance to clarithromycin following monotherapy for disseminated Mycobacterium chelonae infection in a heart transplant patient.

Clin Infect Dis. 1995-2

[3]
Induction therapy with linezolid/clarithromycin combination for Mycobacterium chelonae skin infections in immunocompromised hosts.

J Eur Acad Dermatol Venereol. 2016-1

[4]
Clinical trial of clarithromycin for cutaneous (disseminated) infection due to Mycobacterium chelonae.

Ann Intern Med. 1993-9-15

[5]
Case of disseminated cutaneous Mycobacterium chelonae infection mimicking cutaneous vasculitis.

J Dermatol. 2014-5

[6]
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[7]
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J Infect Chemother. 2015-9

[8]
Development of resistance to clarithromycin after treatment of cutaneous Mycobacterium chelonae infection.

J Am Acad Dermatol. 1997-3

[9]
Disseminated cutaneous Mycobacterium chelonae infection in an immunocompetent host.

Clin Exp Dermatol. 2010-4

[10]
Mycobacterium chelonae (M. chelonae subspecies chelonae): report of a patient with a sporotrichoid presentation who was successfully treated with clarithromycin and ciprofloxacin.

Clin Infect Dis. 1994-6

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本文引用的文献

[1]
Application of Bacteriophages for Mycobacterial Infections, from Diagnosis to Treatment.

Microorganisms. 2021-11-16

[2]
Phage Therapy for Antibiotic-Resistant Bacterial Infections.

Annu Rev Med. 2022-1-27

[3]
Potent antibody-mediated neutralization limits bacteriophage treatment of a pulmonary Mycobacterium abscessus infection.

Nat Med. 2021-8

[4]
Investigation of two cases of Mycobacterium chelonae infection in haemato-oncology patients using whole-genome sequencing and a potential link to the hospital water supply.

J Hosp Infect. 2021-8

[5]
Mycobacterium abscessus Strain Morphotype Determines Phage Susceptibility, the Repertoire of Therapeutically Useful Phages, and Phage Resistance.

mBio. 2021-3-30

[6]
Successful adjunctive use of bacteriophage therapy for treatment of multidrug-resistant Pseudomonas aeruginosa infection in a cystic fibrosis patient.

Infection. 2019-5-17

[7]
Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus.

Nat Med. 2019-5-8

[8]
Phage Therapy in the Postantibiotic Era.

Clin Microbiol Rev. 2019-1-16

[9]
Bacteriophage therapy as an alternative treatment for human infections. A comprehensive review.

Int J Antimicrob Agents. 2018-9-17

[10]
Ibrutinib Therapy and Skin and Soft Tissue Infection.

Open Forum Infect Dis. 2018-7-18

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