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Early clinical experience of bacteriophage therapy in 3 lung transplant recipients
Author(s) -
Aslam Saima,
Courtwright Andrew M.,
Koval Christine,
Lehman Susan M.,
Morales Sandra,
Furr CarrieLynn Langlais,
Rosas Francisco,
Brownstein Michael J.,
Fackler Joseph R.,
Sisson Brittany M.,
Biswas Biswajit,
Henry Matthew,
Luu Truong,
Bivens Brittany N.,
Hamilton Theron,
Duplessis Christopher,
Logan Cathy,
Law Nancy,
Yung Gordon,
Turowski Jason,
Anesi Judith,
Strathdee Steffanie A.,
Schooley Robert T.
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15503
Subject(s) - medicine , pseudomonas aeruginosa , lytic cycle , antibiotics , phage therapy , multiple drug resistance , adverse effect , bacteriophage , intensive care medicine , microbiology and biotechnology , immunology , virus , bacteria , biology , biochemistry , genetics , escherichia coli , gene
Bacteriophage therapy ( BT ) uses bacteriophages to treat pathogenic bacteria and is an emerging strategy against multidrug‐resistant ( MDR ) infections. Experience in solid organ transplant is limited. We describe BT in 3 lung transplant recipients ( LTR ) with life‐threatening MDR infections caused by Pseudomonas aeruginosa (n = 2) and Burkholderia dolosa (n = 1). For each patient, lytic bacteriophages were selected against their bacterial isolates. BT was administered for variable durations under emergency Investigational New Drug applications and with patient informed consent. Safety was assessed using clinical/laboratory parameters and observed clinical improvements described, as appropriate. All patients received concurrent antibiotics. Two ventilator‐dependent LTR with large airway complications and refractory MDR P. aeruginosa pneumonia received BT . Both responded clinically and were discharged from the hospital off ventilator support. A third patient had recurrent B. dolosa infection following transplant. Following BT initiation, consolidative opacities improved and ventilator weaning was begun. However, infection relapsed on BT and the patient died. No BT ‐related adverse events were identified in the 3 cases. BT was well tolerated and associated with clinical improvement in LTR s with MDR bacterial infection not responsive to antibiotics alone. BT may be a viable adjunct to antibiotics for patients with MDR infections.