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严重细菌感染的噬菌体疗法现状

Current status of bacteriophage therapy for severe bacterial infections.

作者信息

Sawa Teiji, Moriyama Kiyoshi, Kinoshita Mao

机构信息

University Hospital, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji-Agaru, Kamigyo, Kyoto, 602-8566, Japan.

Department of Anesthesiology, School of Medicine, Kyorin University, Mitaka, Japan.

出版信息

J Intensive Care. 2024 Nov 1;12(1):44. doi: 10.1186/s40560-024-00759-7.

Abstract

The increase in the incidence of antibiotic-resistant bacteria poses a global public health threat. According to a 2019 WHO report, approximately 1.27 million deaths were attributed to antibiotic-resistant bacteria, with many cases linked to specific bacterial species, such as drug-resistant Pseudomonas aeruginosa and Staphylococcus aureus. By 2050, the number of deaths caused by these bacteria is predicted to surpass that caused by cancer. In response to this serious situation, phage therapy, an alternative to antibiotic treatment, has gained attention. Phage therapy involves the use of viruses that target specific bacteria to treat infections. This method has proven effective in multiple clinical cases, particularly for patients with severe infections caused by multidrug-resistant bacteria. For example, there are reports of patients with systemic infections caused by multidrug-resistant Acinetobacter who recovered following phage administration and patients infected with panresistant Pseudomonas aeruginosa who were cured by phage therapy. A key feature of phage therapy is its high specificity. Phages infect only specific bacteria and eliminate them. However, this specificity can also be a disadvantage, as careful selection of the appropriate phage for the target bacteria is needed. Additionally, bacteria can develop resistance to phages, potentially reducing treatment effectiveness over time. Efforts are underway to select, combine, and improve phages to address these challenges. In Belgium, a national phage bank has been established, and in the United States, the University of California, San Diego, has founded Innovative Phage Applications and Therapeutics (IPATH), marking significant progress toward the clinical application of phage therapy in the country. As a result, phage therapy is emerging as a component of personalized medicine, offering a new treatment option against antibiotic-resistant bacteria. The clinical application of phage therapy is particularly important in life-saving treatments for patients with severe bacterial infections, and its use in conjunction with antibiotics could enhance therapeutic outcomes. Continued research and development of this therapy could provide hope for many more patients in the future.

摘要

抗生素耐药细菌发病率的上升对全球公共卫生构成威胁。根据世界卫生组织2019年的一份报告,约127万人的死亡归因于抗生素耐药细菌,许多病例与特定细菌种类有关,如耐药铜绿假单胞菌和金黄色葡萄球菌。预计到2050年,这些细菌导致的死亡人数将超过癌症造成的死亡人数。针对这种严峻形势,噬菌体疗法作为抗生素治疗的替代方法受到了关注。噬菌体疗法涉及使用靶向特定细菌的病毒来治疗感染。这种方法在多个临床病例中已被证明有效,特别是对于由多重耐药细菌引起的严重感染患者。例如,有报告称,多重耐药不动杆菌引起全身感染的患者在接受噬菌体治疗后康复,以及全耐药铜绿假单胞菌感染的患者通过噬菌体疗法治愈。噬菌体疗法的一个关键特征是其高度特异性。噬菌体仅感染特定细菌并将其消灭。然而,这种特异性也可能是一个缺点,因为需要仔细选择针对目标细菌的合适噬菌体。此外,细菌可能对噬菌体产生耐药性,随着时间的推移可能会降低治疗效果。目前正在努力筛选、组合和改进噬菌体以应对这些挑战。在比利时,已经建立了一个国家噬菌体库,在美国,加利福尼亚大学圣地亚哥分校成立了创新噬菌体应用与治疗中心(IPATH),标志着该国在噬菌体疗法临床应用方面取得了重大进展。因此,噬菌体疗法正在成为个性化医疗的一个组成部分,为对抗抗生素耐药细菌提供了一种新的治疗选择。噬菌体疗法的临床应用在挽救严重细菌感染患者生命的治疗中尤为重要,并且将其与抗生素联合使用可以提高治疗效果。对这种疗法的持续研发可能会在未来为更多患者带来希望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab1c/11529433/a93df1498d25/40560_2024_759_Fig1_HTML.jpg

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