Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester Minnesota, USA.
Department of Infectious and Tropical Diseases, Hospital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
Clin Infect Dis. 2023 Nov 2;77(Suppl 5):S407-S415. doi: 10.1093/cid/ciad533.
Solutions for bone and joint infection (BJI) are needed where conventional treatments are inadequate. Bacteriophages (phages) are naturally occurring viruses that infect bacteria and have been harnessed for refractory bone and joint infections (BJI) in many case reports. Here we examine the safety and efficacy of English-language published cases of BJI since 2010 with phage therapy. From 33 reported cases of BJI treated with phage therapy, 29 (87%) achieved microbiological or clinical success, 2 (5.9%) relapsed with the same organisms, and 2 (5.9%) with a different organism. Of these 4 relapses, all but 1 had eventual clinical resolution with additional surgery or phage treatments. Eight out of 33 cases (24%) reported mild, transient adverse events with no serious events reported. Further work is needed to understand the true efficacy of phages and the role of phages in BJI. Opportunities lay ahead for thoughtfully designed clinical trials adapted to individualized therapies.
需要寻找解决骨和关节感染（BJI）的方法，因为常规治疗方法并不适用。噬菌体（phages）是一种天然存在的病毒，能够感染细菌，在许多病例报告中，噬菌体已被用于治疗难治性骨和关节感染（BJI）。在这里，我们研究了自 2010 年以来使用噬菌体疗法治疗 BJI 的英文文献中报道的病例的安全性和疗效。在接受噬菌体治疗的 33 例 BJI 患者中，29 例（87%）达到了微生物学或临床成功，2 例（5.9%）复发且病原体相同，2 例（5.9%）复发但病原体不同。在这 4 例复发中，除 1 例外，所有病例最终都通过额外的手术或噬菌体治疗获得了临床缓解。33 例中有 8 例（24%）报告了轻度、短暂的不良事件，但没有报告严重事件。需要进一步的研究来了解噬菌体的真正疗效以及噬菌体在 BJI 中的作用。有机会通过精心设计的临床试验来适应个体化治疗。
