Bacteriophage therapy for periprosthetic joint infections: Current limitations and research needed to advance this therapeutic

Doub, James B.; Urish, Ken

doi:10.1002/jor.25432

Cited by 6 publications

(6 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Establishing bacteriophages libraries, using bacteriophages mixtures, and modifications of certain bacteriophages using genetic engineering to overcome the narrow host range [34]. For best implementation in managing PJI, Doub et al suggested that more research should be done to identify bacteriophages with the best PJI curing capabilities, to identify the best administration route and duration of BT in cases having PJI, and more studying of the pharmacokinetic properties of bacteriophages [13].…”

Section: Discussionmentioning

confidence: 99%

The promising role of bacteriophage therapy in managing total hip and knee arthroplasty related periprosthetic joint infection, a systematic review

Khalifa

Hussien

2023

J. exp. orthop.

View full text Add to dashboard Cite

Purpose Total hip and knee arthroplasty periprosthetic joint infection (PJI) poses a management dilemma owing to the emergence of resistant organisms. A promising option is Bacteriophage therapy (BT) was used as an adjuvant for PJI management, aiming at treating resistant infections, decreasing morbidity, and mortality. The current review aimed to demonstrate the role and safety of using BT as an adjuvant to treat PJIs. Methods A systematic search was performed through four databases (Embase, PubMed, Web of Science, and Scopus) up to March 2022, according to the predetermined inclusion and exclusion criteria. Results Our systematic review included 11 case reports of 13 patients in which 14 joints (11 TKAs and three THAs) were treated. The patients’ average age was 73.7 years, underwent an average of 4.5 previous surgeries. The most common organism was the Staphylococcus aureus species. All patients underwent surgical debridement; for the 13 patients, eight received a cocktail, and five received monophage therapy. All patients received postoperative suppressive antibiotic therapy. After an average follow-up of 14.5 months, all patients had satisfactory outcomes. No recurrence of infection in any patient. Transaminitis complicating BT was developed in three patients, needed stoppage in only one, and the condition was reversible and non-life-threatening. Conclusion BT is a safe and potentially effective adjuvant therapy for treating resistant and relapsing PJIs. However, further investigations are needed to clarify some BT-related issues to create effective and reproducible therapeutics. Furthermore, new ethical regulations should be implemented to facilitate its widespread use.

show abstract

Section: Discussionmentioning

confidence: 99%

The promising role of bacteriophage therapy in managing total hip and knee arthroplasty related periprosthetic joint infection, a systematic review

Khalifa

Hussien

2023

J. exp. orthop.

View full text Add to dashboard Cite

show abstract

“…Yet bacteriophage therapies are not like conventional antibiotics, rather bacteriophage therapeutics can have a very narrow spectrum of activity to only certain strains of a bacterial species [8] . Therefore, we had to ensure no other pathogens were present besides E. faecalis given his past polymicrobial infection.…”

Section: Discussionmentioning

confidence: 99%

Salphage: Salvage bacteriophage therapy for a chronic Enterococcus faecalis prosthetic joint infection

Doub

Johnson

2023

IDCases

Self Cite

View full text Add to dashboard Cite

“…This adds additional niduses of antibiotic tolerant bacteria beyond traditional biofilms that can predispose PJI patients to be at risk for recurrence. Consequently, to devise effective and reproducible bacteriophage protocols for the treatment of PJI, the activity of bacteriophages in SF is paramount to understand 16 . Therefore, the aims of this study were to (1) assess the activity of a clinically used bacteriophage in SF and in preventing SF induced aggregate formation as well as (2) evaluate if a bacteriophage can eradicate bacteria in preformed SF induced aggregates.…”

Section: Introductionmentioning

confidence: 99%

Do bacteriophages have activity in synovial fluid and against synovial fluid induced bacterial aggregates?

Yu,

Doub,

Mao

et al. 2023

Journal Orthopaedic Research

Self Cite

View full text Add to dashboard Cite

Bacteriophage therapy is a promising adjuvant therapy for the treatment of periprosthetic joint infections. However, there is a paucity of knowledge about the activity of bacteriophages in synovial fluid. Therefore, this study evaluated the activity of a clinically used bacteriophage in synovial fluid as well as the ability of that bacteriophage to prevent the formation of and eradicate bacteria in synovial fluid induced aggregates. The results of this study reinforce that synovial fluid induced aggregates form rapidly in numerous synovial fluid concentrations. More importantly, there was a statistically significant reduction in bacteriophage activity in synovial fluid compared to tryptic soy broth (p< 0.05) and the bacteriophage could not prevent the formation synovial fluid induced aggregates. Also the bacteriophage could not significantly reduce the amount of bacteria in the synovial fluid induced aggregates when compared to controls, and this was not secondary to resistance. Rather the reduced activity seems to be caused by bacteriophages being hindered in the ability to attach to bacterial receptors. We hypothesize this occurred because the viscosity of synovial fluid slowed bacteriophage interactions with planktonic bacteria and the synovial fluid polymers obstructed the bacteriophage attachment receptors thereby preventing attachment to bacteria in the aggregates. These findings have clinical ramifications, supporting the use of bacteriophage therapy as an adjunct to surgical interventions and not in isolation, at the nascent stage. While these findings show a shortcoming of bacteriophage therapy in periprosthetic joint infections, the knowledge gained should spearhead further research to ultimately devise effective and reproducible bacteriophage therapeutics.This article is protected by copyright. All rights reserved.

show abstract

Bacteriophage therapy for periprosthetic joint infections: Current limitations and research needed to advance this therapeutic

Cited by 6 publications

References 51 publications

The promising role of bacteriophage therapy in managing total hip and knee arthroplasty related periprosthetic joint infection, a systematic review

The promising role of bacteriophage therapy in managing total hip and knee arthroplasty related periprosthetic joint infection, a systematic review

Salphage: Salvage bacteriophage therapy for a chronic Enterococcus faecalis prosthetic joint infection

Do bacteriophages have activity in synovial fluid and against synovial fluid induced bacterial aggregates?

Contact Info

Product

Resources

About