RESUMEN
A 30-year-old bombing victim with a fracture-related pandrug-resistant Klebsiella pneumoniae infection after long-term (>700 days) antibiotic therapy is treated with a pre-adapted bacteriophage along with meropenem and colistin, followed by ceftazidime/avibactam. This salvage therapy results in objective clinical, microbiological and radiological improvement of the patient's wounds and overall condition. In support, the bacteriophage and antibiotic combination is highly effective against the patient's K. pneumoniae strain in vitro, in 7-day mature biofilms and in suspensions.
Asunto(s)
Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana Múltiple , Fracturas Óseas/microbiología , Infecciones por Klebsiella/microbiología , Infecciones por Klebsiella/terapia , Klebsiella pneumoniae/fisiología , Terapia de Fagos , Adulto , Compuestos de Azabiciclo/farmacología , Compuestos de Azabiciclo/uso terapéutico , Bacteriófagos/genética , Bacteriófagos/ultraestructura , Biopelículas/efectos de los fármacos , Ceftazidima/farmacología , Ceftazidima/uso terapéutico , Islas de CpG/genética , Combinación de Medicamentos , Farmacorresistencia Microbiana/efectos de los fármacos , Farmacorresistencia Microbiana/genética , Fracturas Óseas/complicaciones , Fracturas Óseas/diagnóstico por imagen , Genoma Viral , Humanos , Infecciones por Klebsiella/complicaciones , Infecciones por Klebsiella/diagnóstico por imagen , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Polimorfismo de Nucleótido Simple/genética , Proteómica , Replicón/genéticaRESUMEN
In recent decades the increase in antibiotic-resistant bacterial strains has become a serious threat to the treatment of infectious diseases. Drug resistance of Staphylococcus aureus has become a major problem in hospitals of many countries, including developed ones. Today the interest in alternative remedies to antibiotics, including bacteriophage treatment, is gaining new ground. Here, we describe the staphylococcal bacteriophage Sb-1 - a key component of therapeutic phage preparation that was successfully used against staphylococcal infections during many years in the Former Soviet Union. This phage still reveals a high spectrum of lytic activity in vitro against freshly isolated, genetically different clinical samples (including methicillin-resistant S. aureus) obtained from the local hospitals, as well as the clinics from different geographical areas. The sequence analyses of phage genome showed absence of bacterial virulence genes. A case report describes a promising clinical response after phage application in patient with cystic fibrosis and indicates the efficacy of usage of Sb-1 phage against various staphylococcal infections.