Bacteriophage Therapy of Chronic Nonhealing Wound: Clinical Study

Abstract

Background: A chronic wound usually results due to halt in the inflammatory phase of wound healing. Bacterial infections and biofilm formation are considered to be the basic cause of it. Chronic wounds significantly impair the quality of life. Antibiotics are now failing due to biofilm formation emergence of drug-resistant bacteria. Objective: This study aims to see the effect of bacteriophage therapy in chronic nonhealing wound infected with the following bacteria: Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Subject: Patients with chronic nonhealing wound not responding to conventional local debridement and antibiotic therapy were included in the study. The age of patients ranged between 12 and 60 years. Method: A total of 20 patients selected and tissue biopsies and wound swabs were taken for isolation of the bacteria. After confirmation of organism, a cocktail of customized bacteriophages was topically applied over the wound on alternate days till the wound surface became microbiologically sterile. Mean bacterial count and clinical assessment were done and compared at the time of presentation and after 3 and 5 doses of application. Results: A significant improvement was observed in the wound healing, and there were no signs of infection clinically and microbiologically after 3 to 5 doses of topical bacteriophage therapy. Seven patients achieved complete healing on day21 during follow up while in others healthy margins and healthy granulation tissue were observed. Conclusion: Topical bacteriophage application may be quite effective therapy for the treatment of chronic nonhealing wounds.

Phage-Antibiotic Combination Treatments: Antagonistic Impacts of Antibiotics on the Pharmacodynamics of Phage Therapy?

“…Phages have been employed clinically to treat bacterial infections for roughly one-hundred years [1,2], and many of these efforts seem to have been successful, e.g., such as in terms of treatment of chronic infections [3,4], wound infections [4][5][6], or lung-associated infections [7][8][9][10]. This 'phage therapy' furthermore has been proven to be efficacious in at least one modern efficacy (phase I/II) clinical trial [11], and recently there have been several well publicized phage therapy case-study successes [12][13][14]; see also [4,9,10,[15][16][17]. Phages also can be effective against bacterial biofilms, e.g., [18][19][20][21], as well as against persister cells [22,23], though phages do not necessarily actively kill bacteria while these cells are still in the low-growth persister state [24].…”

“…Section 4.1.2, phages tested individually: ϕ29, SP50, or SP82 4. Section 4.1.5, antibiotics tested individually: clofazimine, colistin, dapsone, ethambutol, isoniazid, rifampin, or streptomycin 5.…”

Bacteriophages for Chronic Wound Treatment: From Traditional to Novel Delivery Systems

“…The effect of phage therapy was tested on 20 patients (aged between 12 and 60 years) with chronic nonhealing wounds (>six weeks) that did not respond to conventional local debridement and antibiotic treatment [134]. These wounds presented E. coli, S. aureus, and P. aeruginosa and 3 to 5 doses of the phage therapy led to complete healing or to healthy margins and healthy granulation tissue in the wounds.…”

Isolation, Characterization, and Comparison of Efficiencies of Bacteriophages to Reduce Planktonic and Biofilm-Associated Staphylococcus aureus

“…Increasing reports on the prospective use of bacteriophages against S. aureus in various clinical manifestations has come to light in recent years. [4][5][6] Phage activity is often determined by routine test dilution method, plaque assay, or culture lysis method. 7 All these methods are well established and use actively growing cells that are often freely dispersed in the culture media.…”