病例报告:分析菌体治疗失败的病人的病例报告
Lucia Blasco1,2, Inmaculada López-Hernández3,4,5,6, Miguel Rodríguez-Fernández7
1Translational and Multidisciplinary Microbiology (MicroTM)-Biomedical Research Institute (INIBIC), University of A Coruña (UDC), A Coruña, Spain.
Frontiers in medicine
|June 5, 2023
概括
该案例研究表明,Pseudomonas aeruginosa对菌体治疗产生了耐药性,导致新的血液感染. 在治疗后观察到细菌的基因组变化,影响其对抗生素的敏感性.
科学领域:
- 医学微生物学 医学微生物学
- 基因组学就是基因组学.
- 传染性疾病 传染性疾病
背景情况:
- 假体血管移植感染由于多药耐药性病原体带来了重大挑战.
- Pseudomonas aeruginosa 是与医疗相关的感染的常见原因,经常表现出抗菌素耐药性.
研究的目的:
- 报告一个临床病例的多药耐药性Pseudomonas aeruginosa假体血管移植感染治疗菌体治疗.
- 在菌体治疗后调查P. aeruginosa的基因组和表型变化.
主要方法:
- 一个用菌体尾酒 (PT07,14/01,PNM) 和ceftazidime-avibactam治疗的患者的病例报告.
- 在菌体治疗前后对P. aeruginosa分离物的微生物学分析和全基因组测序.
- 现型研究包括最小抑制度 (MIC) 确定和生物膜生产试验.
主要成果:
- 最初用菌体和塞夫塔齐迪姆-阿维巴克坦治疗后,出现了一种新的P. aeruginosa血流感染,感染的是易受感染的菌株.
- 基因组分析揭示了克隆关系,但在分离后的菌体治疗中显著的基因组变化.
- 现型变化包括生物膜产量增加,菌体耐药性的发展以及对某些抗生素的易感性改变.
结论:
- 菌体治疗虽然可能有效,但可以驱动 Pseudomonas aeruginosa 的基因组变化,从而导致耐药性.
- 监测细菌基因组和表型演变在假体血管移植感染的菌体治疗期间至关重要.
- 需要进一步的研究来了解菌体耐药性的机制,并优化组合疗法.
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