Personalized bacteriophage therapy to treat pandrug-resistant spinal Pseudomonas aeruginosa infection

Area of Science:

• Microbiology
• Infectious Diseases
• Biotechnology

Background:

• Bone and joint infections (BJI) are challenging to treat, particularly with rising antimicrobial resistance.
• Lytic bacteriophages (phages) are viruses that specifically infect and kill bacteria, showing potential for treating severe infections, including those involving biofilms.
• Pandrug-resistant bacterial infections pose a significant therapeutic challenge.

Purpose of the Study:

• To report the successful management of a patient with a pandrug-resistant Pseudomonas aeruginosa spinal abscess.
• To evaluate the efficacy of a personalized phage therapy as an adjuvant treatment to surgery and antibiotics.
• To highlight the role of academic collaboration in developing personalized phage cocktails for challenging infections.

Main Methods:

• Surgical intervention for spinal abscess.
• Administration of a personalized phage cocktail, developed through European academic collaboration, in combination with antibiotics.
• Local and intravenous administration of purified phages as adjuvant therapy.
• Management of bacterial persistence and small colony variants.

Main Results:

• The patient with a pandrug-resistant Pseudomonas aeruginosa spinal abscess achieved clinical healing.
• Despite bacterial persistence and the emergence of small colony variants, the adjuvant phage therapy was effective.
• A unique European academic collaboration successfully identified, produced, and administered a personalized phage cocktail.

Conclusions:

• Personalized phage therapy, in conjunction with surgery, can be an effective treatment strategy for pandrug-resistant bone and joint infections.
• Academic collaboration is crucial for developing tailored phage therapies when commercial options are unavailable.
• Phage therapy demonstrates therapeutic potential for complex BJI, even in the presence of bacterial resistance mechanisms.