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Evol Med Public Health. 2018 Mar 8;2018(1):60-66. doi: 10.1093/emph/eoy005. eCollection 2018.

Phage treatment of an aortic graft infected with Pseudomonas aeruginosa.

Author information

1
Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA.
2
Program in Microbiology, Yale School of Medicine, New Haven, CT, USA.
3
Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
4
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
5
Section of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.

Abstract

Management of prosthetic vascular graft infections caused by Pseudomonas aeruginosa can be a significant challenge to clinicians. These infections often do not resolve with antibiotic therapy alone due to antibiotic resistance/tolerance by bacteria, poor ability of antibiotics to permeate/reduce biofilms and/or other factors. Bacteriophage OMKO1 binding to efflux pump proteins in P. aeruginosa was consistent with an evolutionary trade-off: wildtype bacteria were killed by phage whereas evolution of phage-resistance led to increased antibiotic sensitivity. However, phage clinical-use has not been demonstrated. Here, we present a case report detailing therapeutic application of phage OMKO1 to treat a chronic P. aeruginosa infection of an aortic Dacron graft with associated aorto-cutaneous fistula. Following a single application of phage OMKO1 and ceftazidime, the infection appeared to resolve with no signs of recurrence.

KEYWORDS:

Pseudomonas aeruginosa; antibiotic resistance; phage therapy; prosthetic vascular graft infection

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