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

Nat Commun. 2022 Jan 18;13(1):302. doi: 10.1038/s41467-021-27656-z.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Azabicyclo Compounds / pharmacology
  • Azabicyclo Compounds / therapeutic use
  • Bacteriophages / genetics
  • Bacteriophages / ultrastructure
  • Biofilms / drug effects
  • Ceftazidime / pharmacology
  • Ceftazidime / therapeutic use
  • 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
  • Humans
  • Klebsiella Infections / complications
  • Klebsiella Infections / diagnostic imaging
  • Klebsiella Infections / microbiology*
  • Klebsiella Infections / therapy*
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification
  • Klebsiella pneumoniae / physiology*
  • Microbial Sensitivity Tests
  • Phage Therapy*
  • Polymorphism, Single Nucleotide / genetics
  • Proteomics
  • Replicon / genetics

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • Drug Combinations
  • avibactam, ceftazidime drug combination
  • Ceftazidime