Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection.
Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection.
复制标题
噬菌体治疗播散性皮肤龟分枝杆菌感染。
DOI：
10.1038/s41467-022-29689-4
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发表时间：
2022-05-03
影响因子：
16.6
通讯作者：
中科院分区：
文献类型：
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作者：
龟分枝杆菌是免疫功能低下患者慢性弥散性皮肤感染的罕见病因。耐多药的龟分枝杆菌感染对治疗提出了挑战，延长的抗菌疗程导致显著的毒性和进一步的抗菌耐药性。我们报告一例难治性皮肤弥散性龟分枝杆菌感染患者，血清阴性关节炎患者接受托法替尼免疫治疗，联合抗菌、手术和单噬菌体治疗，临床反应良好。患者产生了针对噬菌体的中和抗体，但活检呈阴性，疾病持续稳定改善，没有证据表明细菌对噬菌体有耐药性。越来越多的耐多药细菌感染重新引起了人们对噬菌体治疗用途的兴趣。在这里，作者报告了一个皮肤龟分枝杆菌感染的个体，并在噬菌体与抗菌药物联合治疗后疾病的改善。
Mycobacterium chelonae is a rare cause of chronic disseminated cutaneous infections in immunocompromised patients. Multidrug-resistant M. chelonae infections present a challenge for treatment, and prolonged antimicrobial courses lead to significant toxicities and further antimicrobial resistance. We report a case of refractory cutaneous disseminated M. chelonae infection in a patient with seronegative arthritis on immunotherapy with tofacitinib that was treated with combination antimicrobial, surgical, and single bacteriophage therapy with excellent clinical response. The patient developed neutralizing antibodies against the bacteriophage but continues to have stable improvement of disease with negative biopsies and no evidence of bacterial resistance to the phage. Increasing rates of multidrug-resistant bacterial infections has renewed interest in the therapeutic use of phages. Here the authors report an individual with cutaneous M. chelonae infection, and the improvement of disease upon treatment with a bacteriophage in combination with antimicrobial therapy.
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