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Personalized bacteriophage therapy outcomes for 100 consecutive cases: a multicentre, multinational, retrospective
Jean-Paul Pirnay1,2, Sarah Djebara3, Griet Steurs4
1Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium. jean-paul.pirnay@mil.be.
Nature Microbiology
|June 4, 2024
Summary
Personalized bacteriophage therapy (BT) showed significant clinical improvement in 77.2% of difficult-to-treat infections. Combining BT with antibiotics improved bacterial eradication rates, suggesting its potential in clinical trials.
Area of Science:
- Microbiology
- Infectious Diseases
- Therapeutics
Background:
- Randomized controlled trials of non-personalized bacteriophage products have yielded disappointing results.
- Personalized bacteriophage therapy (BT) has shown promise in real-world cases for treating difficult infections.
Purpose of the Study:
- To analyze the outcomes of personalized bacteriophage therapy in 100 consecutive cases of difficult-to-treat infections.
- To assess the general efficacy and identify factors influencing positive clinical outcomes in personalized BT.
Main Methods:
- Retrospective observational analysis of 100 personalized BT cases across 35 hospitals in 12 countries (2008-2022).
- Involved individualized bacteriophage selection and sometimes pre-adaptation against causative bacterial pathogens.
- Regression analysis was performed to identify functional relationships and predictors of success.
Main Results:
- Clinical improvement was observed in 77.2% of infections, with bacterial eradication in 61.3%.
- Concomitant antibiotic use significantly increased eradication probability (OR=0.3).
- Bacteriophage resistance, antibiotic re-sensitization, reduced virulence, and immune neutralization were observed in subsets of patients.
Conclusions:
- Personalized bacteriophage therapy, particularly in combination with antibiotics, demonstrates efficacy in treating difficult-to-treat infections.
- The findings support the potential of personalized BT and can guide the design of future controlled clinical trials.
- Further research is warranted to optimize BT strategies and address challenges like bacteriophage resistance and immune neutralization.
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