Refractory Pseudomonas Bacteremia in a 2-Year-Old Sterilized by Bacteriophage Therapy

Duplessis, Christopher; Biswas, Biswajit; Hanisch, Benjamin; Perkins, Matthew J.; Henry, Matthew; Quiñónes, Javier; Wolfe, David M.; Estrella, Luis A.; Hamilton, Theron

doi:10.1093/jpids/pix056

Cited by 97 publications

(73 citation statements)

References 13 publications

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“…What is now needed are efficacy data for these phage cocktails. As large, formal trials require a substantial financial investment, PT has frequently been documented by case reports and case-series (Letkiewicz et al, 2009;Fish et al, 2016;Górski et al, 2016;Duplessis et al, 2017;Jennes et al, 2017;Schooley et al, 2017). A small, uncontrolled case-study suggests treatment potential with the Eliava staphylococcal monophage product for infected diabetic toe ulcers (Fish et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Metagenome analysis of Russian and Georgian Pyophage cocktails and a placebo‐controlled safety trial of single phage versus phage cocktail in healthy Staphylococcus aureus carriers

McCallin

Sarker

Sultana

et al. 2018

Environmental Microbiology

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Bacteriophage therapy is a commonly used treatment for Staphylococcus aureus infections in countries of the former Soviet Union, using both single phages and phage cocktails. The scarce data available on Eastern phage cocktails prompted an investigation into commercially-available Pyophage cocktails from two different manufacturers used to treat skin and wound infections. Comparison of the metagenomic composition of two Pyophage products from Georgia and Russia revealed substantial differences in phage-types targeting Escherichia, Enterococcus, Salmonella, Pseudomonas aeruginosa and Proteus, therefore indicating multiple strategies for composing phage cocktails against these bacterial pathogens. Closely-related Kayvirus-like Myoviruses were, however, a shared component against S. aureus within all products, except for the inclusion of a secondary S. aureus Podovirus in one Microgen cocktail. Metagenomic analysis also revealed the presence of several probable prophage sequences but detected no genetic safety risks in terms of virulence factors or antibiotic resistance genes. The safety of broad-spectrum cocktails was tested by comparing the effects of nasal and oral exposure to Eliava Pyophage, a monospecies counterpart and placebo in healthy human carriers of S. aureus. The lack of adverse effects in any treatment groups supports the clinical safety of S. aureus phages administered as a single phage or as phage cocktail.

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Section: Discussionmentioning

confidence: 99%

Metagenome analysis of Russian and Georgian Pyophage cocktails and a placebo‐controlled safety trial of single phage versus phage cocktail in healthy Staphylococcus aureus carriers

McCallin

Sarker

Sultana

et al. 2018

Environmental Microbiology

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“…Such cocktails showed promise in Phase I/II clinical studies against P. aeruginosa- mediated chronic otitis [123]. Recent anecdotal reports suggest efficacy in humans against MDR P. aeruginosa and A. baumannii [124, 125]. …”

Section: Contemporary Treatment Strategies For Gram-negative Vapmentioning

confidence: 99%

Resistance Trends and Treatment Options in Gram-Negative Ventilator-Associated Pneumonia

Rhodes

Cruce

O’Donnell

et al. 2018

Curr Infect Dis Rep

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Rapid identification technologies and phenotypic methods, new therapeutic strategies, and novel treatment paradigms have evolved in an attempt to improve treatment outcomes for VAP; however, clinical data supporting alternative treatment strategies and adjunctive therapies remain sparse. Importantly, new classes of antimicrobials, novel virulence factor inhibitors, and beta-lactam/beta-lactamase inhibitor combinations are currently in development. Conscientious stewardship of new and emerging therapeutic agents will be needed to ensure they remain effective well into the future.

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“…Secondly, adverse host responses, such as shock, reported by early phage researchers (MacNeal, 1941 ) are likely due to the lack of purification of these initial preparations: current best practice involves extensive purification to ensure exclusion of bacterial components and endotoxins (Bonilla et al, 2016 ). The current state of bacteriophage preparation for IV use, however, has been refined significantly and has allowed successful IV administration and infection eradication as reported by numerous case studies in the US in the last year (Duplessis et al, 2017 ; Jennes et al, 2017 ; Schooley et al, 2017 ). Similarly, the effect of cell lysis and ensuing response to cell debris has been raised, however, this should be considered no different to the effects of bactericidal IV antibiotics which are regularly prescribed (Speck and Smithyman, 2016 ).…”

Section: Route Of Administration and Transfermentioning

confidence: 99%

Applications for Bacteriophage Therapy during Pregnancy and the Perinatal Period

2018

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Pregnant women and their unborn children are a population that is particularly vulnerable to bacterial infection. Physiological changes that occur during pregnancy affect the way women respond to such infections and the options that clinicians have for treatment. Antibiotics are still considered the best option for active infections and a suitable prophylaxis for prevention of potential infections, such as vaginal/rectal Streptococcus agalactiae colonization prior to birth. The effect of such antibiotic use on the developing fetus, however, is still largely unknown. Recent research has suggested that the fetal gut microbiota plays a critical role in fetal immunologic programming. Hence, even minor alterations in this microbiota may have potentially significant downstream effects. An ideal antibacterial therapeutic for administration during pregnancy would be one that is highly specific for its target, leaving the surrounding microbiota intact. This review first provides a basic overview of the challenges a clinician faces when administering therapeutics to a pregnant patient and then goes on to explore common bacterial infections in pregnancy, use of antibiotics for treatment/prevention of such infections and the consequences of such treatment for the mother and infant. With this background established, the review then explores the potential for use of bacteriophage (phage) therapy as an alternative to antibiotics during the antenatal period. Many previous reviews have highlighted the revitalization of and potential for phage therapy for treatment of a range of bacterial infections, particularly in the context of the increasing threat of widespread antibiotic resistance. However, information on the potential for the use of phage therapeutics in pregnancy is lacking. This review aims to provide a thorough overview of studies of this nature and discuss the feasibility of bacteriophage use during pregnancy to treat and/or prevent bacterial infections.

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Refractory Pseudomonas Bacteremia in a 2-Year-Old Sterilized by Bacteriophage Therapy

Cited by 97 publications

References 13 publications

Metagenome analysis of Russian and Georgian Pyophage cocktails and a placebo‐controlled safety trial of single phage versus phage cocktail in healthy Staphylococcus aureus carriers

Metagenome analysis of Russian and Georgian Pyophage cocktails and a placebo‐controlled safety trial of single phage versus phage cocktail in healthy Staphylococcus aureus carriers

Resistance Trends and Treatment Options in Gram-Negative Ventilator-Associated Pneumonia

Applications for Bacteriophage Therapy during Pregnancy and the Perinatal Period

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