Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Feb 26:11:631585.
doi: 10.3389/fcimb.2021.631585. eCollection 2021.

Clinical Experience of Personalized Phage Therapy Against Carbapenem-Resistant Acinetobacter baumannii Lung Infection in a Patient With Chronic Obstructive Pulmonary Disease

Xin Tan  1 , Huaisheng Chen  2 , Min Zhang  3   4 , Ying Zhao  5 , Yichun Jiang  2 , Xueyan Liu  2 , Wei Huang  3   4 , Yingfei Ma  1
Affiliations
Case Reports

Clinical Experience of Personalized Phage Therapy Against Carbapenem-Resistant Acinetobacter baumannii Lung Infection in a Patient With Chronic Obstructive Pulmonary Disease

Xin Tan et al. Front Cell Infect Microbiol. .

Abstract

Overuse of antibiotics in clinical medicine has contributed to the global spread of multidrug-resistant bacterial pathogens, including Acinetobacter baumannii. We present a case of an 88-year-old Chinese man who developed hospital-acquired pneumonia caused by carbapenem-resistant A. baumannii (CRAB). A personalized lytic pathogen-specific single-phage preparation was nebulized to the patient continuously for 16 days in combination with tigecycline and polymyxin E. The treatment was well tolerated and resulted in clearance of the pathogen and clinical improvement of the patient's lung function.

Keywords: carbapenem-resistant Acinetobacter baumannii; endotoxin; lung infection; personalized phage therapy; phage.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patient clinical data in phage therapy. (A) Timeline of bronchoalveolar lavage fluid (BALF) cultures, drug, and phage administration. BALF samples were collected as indicated (*), positive cultures of carbapenem-resistant A. baumannii (CRAB) have been marked (★). The timeline shows the administration of antibiotics and phage preparation, and the administration of drugs is indicated (day 0 indicates the time when phage therapy was initiated). Iv, intravenous; neb, nebulization. (B) Administrated phage titers and phage titers in BALF detected by plaque assays following the phage therapy. Left Y-axis represents the administrated phage titers and right Y-axis represents the phage titers in BALF. (C) Chest X-rays results on -1st day, 14th and 42nd day of phage treatment, respectively.
Figure 2
Figure 2
Characterization of phage Ab_SZ3. (A) Transmission electron micrographs of the phage. Scale bar represents 100 nm. (B) Genome map of the phage. The color of the ORFs refers to five modules: phage structure, blue; host lysis, red; DNA packaging, light blue; DNA replication, green; and hypothetical proteins, black. GC content, purple.
Figure 3
Figure 3
Patient’s clinical examination (A) and inflammatory factor profile (B). No major alterations were observed (day 0 indicates the time when phage therapy was initiated). MBP, Mean blood pressure; WBC, white blood cells; PCT, procalcitonin; hs-CRP, high-sensitivity C-reactive protein. Normal ranges are presented between dotted lines in temperature, heart rate, MBP, and WBC; normal ranges are below the dotted line for PCT, hsCRP, and Il-6.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Aziz R. K., Bartels D., Best A. A., DeJongh M., Disz T., Edwards R. A., et al. . (2008). The RAST Server: rapid annotations using subsystems technology. BMC Genomics 9, 75. - PMC - PubMed
    1. Bachrach U., Friedmann A. (1971). Practical procedures for the purification of bacterial viruses. Appl. Microbiol. 22 (4), 706–715. - PMC - PubMed
    1. Bonilla N., Rojas M. I., Netto Flores Cruz G., Hung S. H., Rohwer F., Barr J. J. (2016). Phage on tap-a quick and efficient protocol for the preparation of bacteriophage laboratory stocks. PeerJ. 4, e2261. - PMC - PubMed
    1. Chen L., Yuan S., Liu Q., Mai G., Yang J., Deng D., et al. . (2018). In Vitro Design and Evaluation of Phage Cocktails Against Aeromonas salmonicida. Front. Microbiol. 9, 1476. - PMC - PubMed
    1. Chen L., Liu Q., Fan J., Yan T., Zhang H., Yang J., et al. . (2020). Characterization and Genomic Analysis of ValSw3-3, a New Siphoviridae Bacteriophage Infecting Vibrio alginolyticus. J. Virol. 94 (10), e00066–e00020. - PMC - PubMed

Publication types