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一例尽管接受噬菌体治疗但仍持续存在腹腔内感染的病例。

A Case of Persistent Intra-Abdominal Infection Despite Bacteriophage Therapy.

作者信息

Cullen Grace D, Salazar Keiko Christine, Terwilliger Austen Lee, Aslam Saima, Clark Justin R, Maresso Anthony W, Bollyky Paul L, Aronson Jenny R

机构信息

The Department of Internal Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

出版信息

Phage (New Rochelle). 2024 Sep 16;5(3):120-125. doi: 10.1089/phage.2023.0034. eCollection 2024 Sep.

Abstract

Multidrug resistant infections are a challenge in the health care setting and a cause of patient morbidity and mortality. Bacteriophages (phages) are viruses that target and kill bacteria and have been used in patients to treat bacterial infections. We present a case of disseminated infection, with pulmonary, intra-abdominal and bloodstream involvement. The patient was treated with a combination of antibiotics and personalized phage therapy, administered daily for 12 days both intravenously as well as intra-abdominal drains. Phage therapy was well-tolerated, the patient cleared from their bloodstream and their intra-abdominal abscesses were stable or decreased in size. However, the intra-abdominal fluid cultures remained positive for . Unfortunately, the patient passed away 2 months after completion of phage therapy due to multiorgan failure. These data highlight the difficulty of treating critically ill patients and clearing complex, biofilm mediated infections, even with phages. More information is needed regarding the optimal treatment protocols for phage therapy in complex multifocal infections.

摘要

多重耐药感染是医疗环境中的一项挑战,也是患者发病和死亡的一个原因。噬菌体是靶向并杀死细菌的病毒,已用于患者治疗细菌感染。我们报告一例播散性感染病例,累及肺部、腹腔内和血液。该患者接受了抗生素和个性化噬菌体疗法的联合治疗,静脉内和腹腔引流管每日给药,持续12天。噬菌体疗法耐受性良好,患者血液中感染清除,腹腔内脓肿稳定或缩小。然而,腹腔积液培养物仍对……呈阳性。不幸的是,患者在噬菌体治疗完成2个月后因多器官衰竭去世。这些数据凸显了治疗重症患者以及清除复杂的、生物膜介导的感染的困难,即使使用噬菌体也是如此。对于复杂多灶性感染中噬菌体疗法的最佳治疗方案,还需要更多信息。

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