Bacteriophage therapy for human musculoskeletal and skin/soft tissue infections

Metsemakers, Willem‐Jan; Onsea, Jolien; Moriarty, T. Fintan; Pruidze, N.; Nadareishvili, Lia; Dadiani, Mariam; Kutateladze, Mzia

doi:10.1016/j.cmi.2023.01.011

Cited by 12 publications

(6 citation statements)

References 46 publications

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“…As mentioned above, the application of phage therapy has a long history, stretching back over 100 years. Initial records, dating as far back as the 1920s, largely focussed on wound infections, with Staphylococci as the predominant pathogens (31,32). At this time, phages were directly applied to the infected site.…”

Section: General Indications Historical Applications and Indicationsmentioning

confidence: 99%

Bacteriophage therapy in musculoskeletal infections: from basic science to clinical application

Ferry,

Onsea,

Roussel-Gaillard

et al. 2024

EFORT Open Reviews

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The treatment of musculoskeletal infections (MSIs), including periprosthetic joint infection (PJI) and fracture-related infection (FRI), is often complicated by biofilm-related challenges necessitating multiple revision surgeries and incurring substantial costs. The emergence of antimicrobial resistance (AMR) adds to the complexity of the problem, leading to increased morbidity and healthcare expenses. There is an urgent need for novel antibacterial strategies, with the World Health Organization endorsing non-traditional approaches like bacteriophage (phage) therapy. Phage therapy, involving the targeted application of lytic potent phages, shows promise in the treatment of MSIs. Although historical clinical trials and recent case studies present significant milestones in the evolution of phage therapy over the past century, challenges persist, including variability in study designs, administration protocols and phage selection. Efforts to enhance treatment efficacy consist of personalized phage therapy and combination with antibiotics. Future perspectives entail addressing regulatory barriers, standardizing treatment protocols, and conducting high-quality clinical trials to establish phage therapy’s efficacy for the treatment of MSIs. Initiatives like the PHAGEFORCE study and the PHAGEinLYON Clinic programme aim to streamline phage therapy, facilitating personalized treatment approaches and systematic data collection to advance its clinical utility in these challenging infections.

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Section: General Indications Historical Applications and Indicationsmentioning

confidence: 99%

Bacteriophage therapy in musculoskeletal infections: from basic science to clinical application

Ferry,

Onsea,

Roussel-Gaillard

et al. 2024

EFORT Open Reviews

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“…More than 10 clinical trials were in various stages of completion by early 2023 investigating the efficacy of bacteriophage therapy for the treatment of musculoskeletal, skin and soft tissue infections [ 109 ]. Previous trials supported the high safety of phage therapy with varying efficacy arising from delivery mechanisms and phage stability [ 110 ].…”

Section: Therapeutically Relevant Skin-microbiome-derived Compoundsmentioning

confidence: 99%

Bioprospecting the Skin Microbiome: Advances in Therapeutics and Personal Care Products

Nicholas-Haizelden,

Murphy,

Hoptroff

et al. 2023

Microorganisms

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Bioprospecting is the discovery and exploration of biological diversity found within organisms, genetic elements or produced compounds with prospective commercial or therapeutic applications. The human skin is an ecological niche which harbours a rich and compositional diversity microbiome stemming from the multifactorial interactions between the host and microbiota facilitated by exploitable effector compounds. Advances in the understanding of microbial colonisation mechanisms alongside species and strain interactions have revealed a novel chemical and biological understanding which displays applicative potential. Studies elucidating the organismal interfaces and concomitant understanding of the central processes of skin biology have begun to unravel a potential wealth of molecules which can exploited for their proposed functions. A variety of skin-microbiome-derived compounds display prospective therapeutic applications, ranging from antioncogenic agents relevant in skin cancer therapy to treatment strategies for antimicrobial-resistant bacterial and fungal infections. Considerable opportunities have emerged for the translation to personal care products, such as topical agents to mitigate various skin conditions such as acne and eczema. Adjacent compound developments have focused on cosmetic applications such as reducing skin ageing and its associated changes to skin properties and the microbiome. The skin microbiome contains a wealth of prospective compounds with therapeutic and commercial applications; however, considerable work is required for the translation of in vitro findings to relevant in vivo models to ensure translatability.

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“…Phage therapy has been used in the former Soviet Union for S. aureus and streptococcal SSTI and those caused by E. coli and Proteus spp. Examples include furunculosis, hidradenitis suppurativa, osteomyelitis, or infected war wounds [90 ▪ ]. Metsemakers et al [90 ▪ ] have recently published an excellent comprehensive narrative review on bacteriophage therapy for human musculoskeletal infections and SSTI.…”

Section: Introductionmentioning

confidence: 99%

“…The challenge of antimicrobial resistance poses a significant threat to global public health. Many alternative treatments to traditional antibiotics are being developed, including bacteriophage therapy [90 ▪ ].…”

Section: Introductionmentioning

confidence: 99%

“…Examples include furunculosis, hidradenitis suppurativa, osteomyelitis, or infected war wounds [90 ▪ ]. Metsemakers et al [90 ▪ ] have recently published an excellent comprehensive narrative review on bacteriophage therapy for human musculoskeletal infections and SSTI. Phages have been used topically, injected at the site of infection, and administered intravenously, intramuscularly, and even intra-articularly.…”

Section: Introductionmentioning

confidence: 99%

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Current challenges in acute bacterial skin infection management

Burillo,

Pulido-Pérez,

Bouza

2024

Current Opinion in Infectious Diseases

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Purpose of review There are aspects of skin and soft tissue infections (SSTIs) that remain unresolved, such as current numbers, classification criteria, how best to define severity and predict the outcome, what diagnostic tests to perform, what new treatment options are available, or what the duration of antibiotic treatment should be. We have reviewed the literature over the last 18 months to clarify these issues and provide our opinion. Recent findings SSTIs are common and among the top 10 most frequent infections worldwide. They represent a burden on the healthcare system and have a major impact on the quality of life of patients. Regarding classification, the Infectious Diseases Society of America (IDSA) provides a practical guide that distinguishes between uncomplicated and complicated infections, acute and chronic wound infections, and necrotising and nonnecrotizing infections based on skin extension and tissue necrosis. With new microbiological and imaging diagnostic techniques, SSTIs can now be better diagnosed. New PCR techniques are available, and mass spectrometry can be applied to samples collected in liquid transport media. Moreover, new treatment methods such as photodynamic therapy, reactive oxygen, and phages are emerging. SSTI patients can be treated with shorter antibiotic courses if they receive an active drug with good tissue penetration. Antibiotic treatment in necrotizing infections can be shortened to 48 h after the last debridement. Summary SSTIs remain a challenge regarding rapid and accurate diagnosis and clinical management.

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Bacteriophage therapy for human musculoskeletal and skin/soft tissue infections

Cited by 12 publications

References 46 publications

Bacteriophage therapy in musculoskeletal infections: from basic science to clinical application

Bacteriophage therapy in musculoskeletal infections: from basic science to clinical application

Bioprospecting the Skin Microbiome: Advances in Therapeutics and Personal Care Products

Current challenges in acute bacterial skin infection management

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