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Antimicrob Agents Chemother. 2017 Sep 22;61(10). pii: e00954-17. doi: 10.1128/AAC.00954-17. Print 2017 Oct.

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

Author information

1
Department of Medicine, University of California, San Diego, La Jolla, California, USA rschooley@ucsd.edu.
2
Biological Defense Research Directorate, Naval Medical Research Center, Frederick, Maryland, USA.
3
Henry M. Jackson Foundation, Bethesda, Maryland, USA.
4
Department of Animal Science, Texas A&M University, College Station, Texas, USA.
5
Center for Phage Technology, Texas A&M AgriLife Research and Texas A&M University, College Station, Texas, USA.
6
Department of Biochemistry and Biophysics, Texas A&M University, College Station, Texas, USA.
7
Department of Biology, San Diego State University, San Diego, California, USA.
8
Monash University, School of Biological Sciences, Melbourne, Australia.
9
Department of Medicine, University of California, San Diego, La Jolla, California, USA.
10
Department of Pathology, University of California, San Diego, La Jolla, California, USA.
11
Department of Pediatrics, University of California, San Diego, La Jolla, California, USA.
12
Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA.
13
National Biodefense Analysis and Countermeasures Center, Frederick, Maryland, USA.
14
Department of Radiology, University of California, San Diego, La Jolla, California, USA.
15
Advanced Surgical Imaging Program, Department of Regenerative Medicine, Naval Medical Research Center, Silver Spring, Maryland, USA.
16
AmpliPhi Biosciences, San Diego, California, USA.

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.

KEYWORDS:

Acinetobacter; bacteriophage therapy; multidrug resistance

PMID:
28807909
PMCID:
PMC5610518
DOI:
10.1128/AAC.00954-17
[Indexed for MEDLINE]
Free PMC Article

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