Related Experiment Video

Updated: Aug 6, 2026

Characterizing Multidrug Efflux Systems in Acinetobacter baumannii Using an Efflux-Deficient Bacterial Strain and a Single-Copy Gene Expression System
05:06

Characterizing Multidrug Efflux Systems in Acinetobacter baumannii Using an Efflux-Deficient Bacterial Strain and a Single-Copy Gene Expression System

Published on: January 5, 2024

Phage-antibiotic synergy attenuates Acinetobacter baumannii resistance in refractory pneumonia: a precision

Lei Zhang1,2, Kexin Yan3, Pengli Xu1

  • 1National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Southern University of Science and Technology, Shenzhen, China.

Frontiers in Cellular and Infection Microbiology
|July 24, 2026
PubMed

Insights

Phage-antibiotic therapy effectively treated extensively drug-resistant Acinetobacter baumannii pneumonia in a critically ill patient. This combination strategy reduced pathogen load and resistance genes, offering a promising approach for severe bacterial infections.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Genomics

Background:

  • Extensively drug-resistant (XDR) Acinetobacter baumannii pneumonia presents a critical challenge with high mortality and limited treatment options.
  • Bacteriophage therapy is a potential alternative for drug-resistant infections, but clinical applications are often empirical.

Purpose of the Study:

  • To report a systematically planned phage-antibiotic combination strategy for a patient with refractory XDR A. baumannii pneumonia.
  • To evaluate the efficacy and safety of this precision therapy in a critically ill patient.

Main Methods:

  • Isolated a virulent bacteriophage targeting the patient's A. baumannii strain.
  • Conducted in vitro time-kill assays to assess phage-antibiotic synergy.
  • Administered nebulized phage therapy combined with intravenous antibiotics (fosfomycin, amikacin, polymyxin B).
  • Utilized longitudinal metagenomic sequencing to analyze pathogen abundance and antimicrobial resistance genes (ARGs) in lung samples.

Main Results:

  • Phage monotherapy showed limited efficacy, while phage-antibiotic therapy achieved synergistic bacterial inhibition in vitro.
  • The patient showed clinical improvement, including normalization of PaCO2, clearance of A. baumannii sputum cultures, and reduced inflammatory markers.
  • No treatment-related toxicity was observed.
  • Metagenomic sequencing revealed a significant reduction in pathogen abundance and A. baumannii-associated ARGs in the lung.

Conclusions:

  • Precision phage-antibiotic therapy demonstrated significant clinical efficacy and safety in treating refractory XDR A. baumannii pneumonia.
  • This combination approach offers a promising strategy for managing severe, multidrug-resistant bacterial infections.
  • Further research into phage-antibiotic synergy is warranted for recalcitrant infections.
Keywords:
Acinetobacter baumanniiantibioticsantimicrobial resistance genesbacteriophageextensive drug resistance

More Related Videos

Phage Therapy Application to Counteract Pseudomonas aeruginosa Infection in Cystic Fibrosis Zebrafish Embryos11:20

Phage Therapy Application to Counteract Pseudomonas aeruginosa Infection in Cystic Fibrosis Zebrafish Embryos

Published on: May 12, 2020

Related Concept Videos

Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Gene Regulation in Microbial Communities: Quorum Sensing01:28

Gene Regulation in Microbial Communities: Quorum Sensing

Quorum sensing is a mechanism of bacterial communication that enables coordinated gene expression in response to changes in population density. This facilitates collective behaviors that enhance survival, resource acquisition, and ecological adaptation. This process relies on small signaling molecules called autoinducers that accumulate as bacterial populations grow. When a critical threshold concentration of autoinducers is reached, bacterial cells collectively modify gene expression,...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Atypical Pneumonia01:14

Atypical Pneumonia

Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...
Development of Antibiotic Resistance01:30

Development of Antibiotic Resistance

Antibiotic resistance is a major public health concern that arises when bacteria evolve mechanisms to withstand the effects of antibiotic treatments. This resistance can be intrinsic, acquired through genetic mutations, or transferred between bacteria via horizontal gene transfer. The development of antibiotic resistance poses significant challenges in treating bacterial infections and necessitates ongoing research to develop new therapeutic strategies.Intrinsic resistance occurs when bacterial...