Related Experiment Video
Updated: Aug 5, 2026
Phage Therapy Application to Counteract Pseudomonas aeruginosa Infection in Cystic Fibrosis Zebrafish Embryos
Published on: May 12, 2020
Personalized Phage Therapy in an ICU Patient with Polymicrobial Pulmonary Infections: a case from a single-arm trial
Yongxin Shi1, Jie Li2, Qian Yang3
1Department of Critical Care Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China.
Abstract:
Ventilator-associated infections (VAIs) caused by multidrug-resistant (MDR) pathogens poses a significant challenge in intensive care units (ICUs). Phage therapy has emerged as a promising alternative for VAIs, though its efficacy depends on multiple factors. We report a 40-year-old male ICU patient with sequential pulmonary infections of MDR Acinetobacter baumannii, Klebsiella pneumoniae, and Stenotrophomonas maltophilia. Seven rounds of tailored phage therapy-targeting single or dual pathogens-were administered adjunctive to antibiotics. A. baumannii was complete eradication, but K. pneumoniae and S. maltophilia showed cyclical clearance and recurrence due to strain replacement and phage resistance. Phage therapy correlated with reduced bacterial load, fever, procalcitonin, and IL-6 levels, alongside improved pulmonary inflammation, while white blood cell counts and C-reactive protein showed limited response. No severe adverse events occurred. Dynamic shifts in dominant pathogens aligned with clinical progression, with phage therapy providing transient control, extending the window for intervention and reducing high-level antibiotic use. After six months, the patient was weaned from ventilation and discharged. This case underscores the complexity of VAI management and highlights the potential of personalized phage therapy to mitigate MDR infections and minimize antibiotic reliance. This case was enrolled in a single arm trial (ChiCTR2000036801).
Insights
Phage therapy offers a promising approach for ventilator-associated infections (VAIs) caused by multidrug-resistant (MDR) pathogens. This case study shows personalized phage therapy provided transient control, reduced antibiotic use, and aided patient recovery.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Background:
- Ventilator-associated infections (VAIs) caused by multidrug-resistant (MDR) pathogens present a significant challenge in intensive care units (ICUs).
- Phage therapy is an emerging alternative for VAIs, but its effectiveness is influenced by various factors.
Purpose of the Study:
- To report on the efficacy of tailored phage therapy as an adjunctive treatment for sequential MDR pulmonary infections in an ICU patient.
- To evaluate the impact of phage therapy on clinical outcomes, inflammatory markers, and pathogen dynamics.
Main Methods:
- A case report of a 40-year-old male ICU patient with sequential MDR Acinetobacter baumannii, Klebsiella pneumoniae, and Stenotrophomonas maltophilia pulmonary infections.
- Seven rounds of personalized phage therapy, targeting single or dual pathogens, administered alongside antibiotics.
- Monitoring of bacterial load, clinical symptoms, inflammatory markers (procalcitonin, IL-6, WBC, CRP), and pathogen susceptibility to phages.
Main Results:
- Complete eradication of Acinetobacter baumannii was achieved.
- Klebsiella pneumoniae and Stenotrophomonas maltophilia exhibited cyclical clearance and recurrence, attributed to strain replacement and phage resistance.
- Phage therapy correlated with reduced bacterial load, fever, procalcitonin, and IL-6 levels, and improved pulmonary inflammation.
- Limited response observed in white blood cell counts and C-reactive protein levels.
- No severe adverse events were reported.
Conclusions:
- Personalized phage therapy demonstrated transient control of MDR pathogens, extended intervention windows, and reduced reliance on high-level antibiotics.
- Dynamic shifts in dominant pathogens influenced treatment outcomes, highlighting the complexity of VAI management.
- The patient was successfully weaned from ventilation and discharged after six months, indicating the potential of phage therapy in mitigating MDR infections.
