Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Applied Virology Research Center, Biomedicine Technologies Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Virol J. 2024 Aug 19;21(1):191. doi: 10.1186/s12985-024-02450-7.
One of the most common bacteria that cause nosocomial infections is Klebsiella pneumonia (K. pneumoniae), especially in patients who are very sick and admitted to the intensive care unit (ICU). The frequency of multi-drug-resistant Klebsiella pneumoniae (MDRKP) has dramatically increased worldwide in recent decades, posing an urgent threat to public health. The Western world's bacteriophage (phage) studies have been revitalized due to the increasing reports of antimicrobial resistance and the restricted development and discovery of new antibiotics. These factors have also spurred innovation in other scientific domains. The primary agent in phage treatment is an obligately lytic organism (called bacteriophage) that kills the corresponding bacterial host while sparing human cells and lessening the broader effects of antibiotic usage on commensal bacteria. Phage treatment is developing quickly, leading to many clinical studies and instances of life-saving medicinal use. In addition, phage treatment has a few immunological adverse effects and consequences in addition to its usefulness. Since K. pneumoniae antibiotic resistance has made treating multidrug-resistant (MDR) infections challenging, phage therapy (PT) has emerged as a novel therapeutic strategy. The effectiveness of phages has also been investigated in K. pneumoniae biofilms and animal infection models. Compared with antibiotics, PT exhibits numerous advantages, including a particular lysis spectrum, co-evolution with bacteria to avoid the emergence of phage resistance, and a higher abundance and diversity of phage resources than found in antibiotics. Moreover, phages are eliminated in the absence of a host bacterium, which makes them the only therapeutic agent that self-regulates at the sites of infection. Therefore, it is essential to pay attention to the role of PT in treating these infections. This study summarizes the state of knowledge on Klebsiella spp. phages and provides an outlook on the development of phage-based treatments that target K. pneumoniae in clinical trials.
一种最常见的医院感染细菌是肺炎克雷伯菌(K. pneumoniae),尤其是在非常病重并入住重症监护病房(ICU)的患者中。近几十年来,全世界多药耐药肺炎克雷伯菌(MDRKP)的频率急剧增加,对公共卫生构成了紧迫威胁。由于抗微生物药物耐药性的报告越来越多,以及新抗生素的开发和发现受到限制,西方世界的噬菌体(噬菌体)研究重新活跃起来。这些因素也刺激了其他科学领域的创新。噬菌体治疗的主要制剂是一种专性裂解生物(称为噬菌体),它能杀死相应的细菌宿主,而不会杀死人类细胞,并减少抗生素对共生细菌的广泛影响。噬菌体治疗发展迅速,导致许多临床研究和救命药用实例。此外,噬菌体治疗除了有用之外,还有一些免疫不良反应和后果。由于肺炎克雷伯菌的抗生素耐药性使得治疗多重耐药(MDR)感染变得具有挑战性,噬菌体治疗(PT)已成为一种新的治疗策略。噬菌体在肺炎克雷伯菌生物膜和动物感染模型中的有效性也得到了研究。与抗生素相比,PT 具有许多优势,包括特定的裂解谱、与细菌共同进化以避免噬菌体耐药性的出现,以及噬菌体资源的丰度和多样性都高于抗生素。此外,噬菌体在没有宿主细菌的情况下被消除,这使它们成为唯一在感染部位自我调节的治疗剂。因此,关注 PT 在治疗这些感染中的作用至关重要。本研究总结了肺炎克雷伯菌噬菌体的知识现状,并展望了噬菌体在临床试验中针对肺炎克雷伯菌的治疗方法的发展。