Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection

Jessica S Little; Rebekah M Dedrick; Krista G Freeman; Madison Cristinziano; Bailey E Smith; Constance A Benson; Tulip A Jhaveri; Lindsey R Baden; Daniel A Solomon; Graham F Hatfull

doi:10.1038/s41467-022-29689-4

Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection

Nat Commun. 2022 May 3;13(1):2313. doi: 10.1038/s41467-022-29689-4.

Authors

Jessica S Little^#^{1

2

3}, Rebekah M Dedrick^#⁴, Krista G Freeman⁴, Madison Cristinziano⁴, Bailey E Smith⁴, Constance A Benson⁵, Tulip A Jhaveri^{6

7}, Lindsey R Baden^{8

9

10}, Daniel A Solomon^{8

9}, Graham F Hatfull⁴

Affiliations

¹ Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA. jlittle@bwh.harvard.edu.
² Harvard Medical School, Boston, MA, USA. jlittle@bwh.harvard.edu.
³ Dana-Farber Cancer Institute, Boston, MA, USA. jlittle@bwh.harvard.edu.
⁴ Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
⁵ Division of Infectious Diseases & Global Public Health, University of California San Diego, San Diego, CA, USA.
⁶ Division of Medical Microbiology, Brigham and Women's Hospital, Boston, MA, USA.
⁷ Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, USA.
⁸ Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
⁹ Harvard Medical School, Boston, MA, USA.
¹⁰ Dana-Farber Cancer Institute, Boston, MA, USA.

^# Contributed equally.

Abstract

Mycobacterium chelonae is a rare cause of chronic disseminated cutaneous infections in immunocompromised patients. Multidrug-resistant M. chelonae infections present a challenge for treatment, and prolonged antimicrobial courses lead to significant toxicities and further antimicrobial resistance. We report a case of refractory cutaneous disseminated M. chelonae infection in a patient with seronegative arthritis on immunotherapy with tofacitinib that was treated with combination antimicrobial, surgical, and single bacteriophage therapy with excellent clinical response. The patient developed neutralizing antibodies against the bacteriophage but continues to have stable improvement of disease with negative biopsies and no evidence of bacterial resistance to the phage.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / therapeutic use
Bacteriophages*
Clarithromycin / therapeutic use
Humans
Mycobacterium Infections, Nontuberculous* / drug therapy
Mycobacterium chelonae*
Skin Diseases, Bacterial*

Substances

Anti-Bacterial Agents
Clarithromycin

Abstract

Publication types

MeSH terms

Substances

Grants and funding