Development and Use of Personalized Bacteriophage-Based Therapeutic Cocktails To Treat a Patient with a Disseminated Resistant Acinetobacter baumannii Infection

Abstract

Widespread antibiotic use in clinical medicine and the livestock industry has contributed to the global spread of multidrug-resistant (MDR) bacterial pathogens, including Acinetobacter baumannii. We report on a method used to produce a personalized bacteriophage-based therapeutic treatment for a 68-year-old diabetic patient with necrotizing pancreatitis complicated by an MDR A. baumannii infection. Despite multiple antibiotic courses and efforts at percutaneous drainage of a pancreatic pseudocyst, the patient deteriorated over a 4-month period. In the absence of effective antibiotics, two laboratories identified nine different bacteriophages with lytic activity for an A. baumannii isolate from the patient. Administration of these bacteriophages intravenously and percutaneously into the abscess cavities was associated with reversal of the patient's downward clinical trajectory, clearance of the A. baumannii infection, and a return to health. The outcome of this case suggests that the methods described here for the production of bacteriophage therapeutics could be applied to similar cases and that more concerted efforts to investigate the use of therapeutic bacteriophages for MDR bacterial infections are warranted.

Therapeutic bacteriophages as a rescue treatment for drug‐resistant infections – anin vivostudies overview

“…As a result of this treatment, the A. baumannii infection was resolved and the patient recovered. As suggested by this case report, management followed the right regimen, may be used in similar cases (Schooley et al ).…”

A century of bacteriophage research and applications: impacts on biotechnology, health, ecology and the economy!

“…Also deliberate administration of E. coli phages or Staphylococcus phage preparations had generally no major adverse effects on human volunteers. Recently intravenous phage administration was shown to be effective against a bacteremic episode in a patient at the military hospital Queen Astrid in Brussels, Belgium and other similar cases have been recently described . A very first and successful phage therapy treatment, orally administered as a Shigella ‐bacteriophage culture, was performed by d'Herelle at the Hôpital des Enfants‐Malades in Paris in August 1919 on five children suffering dysentery.…”

Resistance Trends and Treatment Options in Gram-Negative Ventilator-Associated Pneumonia

“…Such cocktails showed promise in Phase I/II clinical studies against P. aeruginosa- mediated chronic otitis [123]. Recent anecdotal reports suggest efficacy in humans against MDR P. aeruginosa and A. baumannii [124, 125]. …”