Development and Use of Personalized Bacteriophage-Based Therapeutic Cocktails To Treat a Patient with a Disseminated Resistant Acinetobacter baumannii Infection
Development and Use of Personalized Bacteriophage-Based Therapeutic Cocktails To Treat a Patient with a Disseminated Resistant Acinetobacter baumannii Infection
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DOI：
10.1128/aac.00954-17
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发表时间：
2017-10-01
影响因子：
4.9
通讯作者：
Hamilton, Theron
中科院分区：
文献类型：
--
作者：
Schooley, Robert T.;Biswas, Biswajit;Hamilton, Theron
抗生素在临床医学和畜牧业中的广泛使用促进了多重耐药(MDR)细菌病原体的全球传播，包括鲍曼不动杆菌。我们报告了一种方法，用于产生一种个性化的基于噬菌体的治疗方法，用于治疗68岁的糖尿病坏死性胰腺炎合并多药耐药菌感染。尽管多次抗生素疗程和努力经皮引流胰腺假性囊肿，患者的病情在4个月内恶化。在缺乏有效抗生素的情况下，两个实验室鉴定出九种不同的噬菌体对患者的鲍曼不动杆菌分离物具有裂解活性。将这些噬菌体静脉和经皮注射到脓肿腔内与患者向下的临床轨迹逆转、鲍氏不动杆菌感染清除和恢复健康有关。这一案例的结果表明，这里描述的生产噬菌体治疗药物的方法可以适用于类似的病例，需要做出更多协调一致的努力，调查治疗MDR细菌感染的治疗噬菌体的使用。
Widespread antibiotic use in clinical medicine and the livestock industry has contributed to the global spread of multidrug-resistant (MDR) bacterial pathogens, including Acinetobacter baumannii. We report on a method used to produce a personalized bacteriophage-based therapeutic treatment for a 68-year-old diabetic patient with necrotizing pancreatitis complicated by an MDR A. bournannii infection. Despite multiple antibiotic courses and efforts at percutaneous drainage of a pancreatic pseudocyst, the patient deteriorated over a 4-month period. In the absence of effective antibiotics, two laboratories identified nine different bacteriophages with lytic activity for an A. baumannii isolate from the patient. Administration of these bacteriophages intravenously and percutaneously into the abscess cavities was associated with reversal of the patient's downward clinical trajectory, clearance of the A. baurnannii infection, and a return to health. The outcome of this case suggests that the methods described here for the production of bacteriophage therapeutics could be applied to similar cases and that more concerted efforts to investigate the use of therapeutic bacteriophages for MDR bacterial infections are warranted.