Combination of pre-adapted bacteriophage therapy and antibiotics for treatment of fracture-related infection due to pandrug-resistant Klebsiella pneumoniae

A 30-year-old bombing victim with a fracture-related pandrug-resistant Klebsiella pneumoniae infection after long-term (>700 days) antibiotic therapy is treated with a pre-adapted bacteriophage along with meropenem and colistin, followed by ceftazidime/avibactam. This salvage therapy results in o...

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Bibliographic Details
Published in:Nature communications Vol. 13; no. 1; pp. 302 - 14
Main Authors: Eskenazi, Anaïs, Lood, Cédric, Wubbolts, Julia, Hites, Maya, Balarjishvili, Nana, Leshkasheli, Lika, Askilashvili, Lia, Kvachadze, Leila, van Noort, Vera, Wagemans, Jeroen, Jayankura, Marc, Chanishvili, Nina, de Boer, Mark, Nibbering, Peter, Kutateladze, Mzia, Lavigne, Rob, Merabishvili, Maya, Pirnay, Jean-Paul
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 18.01.2022
Nature Publishing Group
Nature Portfolio
Subjects:
631/326/107
631/326/1321
692/699/255/1318
692/700/565
Adult
Anti-Bacterial Agents - therapeutic use
Antibiotics
Azabicyclo Compounds - pharmacology
Azabicyclo Compounds - therapeutic use
Bacteriophages - genetics
Bacteriophages - ultrastructure
Biofilms
Biofilms - drug effects
Ceftazidime
Ceftazidime - pharmacology
Ceftazidime - therapeutic use
Colistin
CpG Islands - genetics
Drug Combinations
Drug Resistance, Microbial - drug effects
Drug Resistance, Microbial - genetics
Drug Resistance, Multiple, Bacterial
Fractures, Bone - complications
Fractures, Bone - diagnostic imaging
Fractures, Bone - microbiology
Genome, Viral
Humanities and Social Sciences
Humans
Infections
Klebsiella
Klebsiella Infections - complications
Klebsiella Infections - diagnostic imaging
Klebsiella Infections - microbiology
Klebsiella Infections - therapy
Klebsiella pneumoniae
Klebsiella pneumoniae - drug effects
Klebsiella pneumoniae - genetics
Klebsiella pneumoniae - isolation & purification
Klebsiella pneumoniae - physiology
Meropenem
Microbial Sensitivity Tests
multidisciplinary
Patients
Phage Therapy
Phages
Polymorphism, Single Nucleotide - genetics
Proteomics
Replicon - genetics
Science
Science (multidisciplinary)
Therapy
ISSN:2041-1723, 2041-1723
Online Access:Get full text
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Summary:A 30-year-old bombing victim with a fracture-related pandrug-resistant Klebsiella pneumoniae infection after long-term (>700 days) antibiotic therapy is treated with a pre-adapted bacteriophage along with meropenem and colistin, followed by ceftazidime/avibactam. This salvage therapy results in objective clinical, microbiological and radiological improvement of the patient’s wounds and overall condition. In support, the bacteriophage and antibiotic combination is highly effective against the patient’s K. pneumoniae strain in vitro, in 7-day mature biofilms and in suspensions. In this case study of a patient with fracture-related pandrug-resistant Klebsiella pneumoniae infection after long-term antibiotic therapy, the authors use a combination therapy of pre-adapted bacteriophage and antibiotics resulting in clinical, microbiological and radiological improvement.
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ISSN:2041-1723
2041-1723
DOI:10.1038/s41467-021-27656-z