First Successful Use of Phages for Treating Antibiotic-Resistant Lung Infection

Denver National Jewish Health and University of Pittsburgh’s researchers published the premier attempt to treat antibiotic-resistant mycobacterial lung infection using phages in Cell journal, the breakthrough helped a young cystic fibrosis patient to receive life-saving lung transplant.

Cystic fibrosis is an inheritable disorder that brings severe lung damages, leading to repeated bacterial infections, and can cause respiratory failure. In this case, the patient displayed a rapid lung function decline following persistent mycobacterial infection, and various treatments proved unsuccessful. This treatment published on May 13 focuses on antibiotic-resistant Mycobacterium abscessus, a hostile, multidrug-resistant and highly variable nontuberculous mycobacterial (NTM) infection. 

The patient had been refused transplants due to the mycobacterial infection, which can spread from the lungs to other areas, particularly in transplant recipients who are on immunosuppressive medications. Lead researcher Dr. Jerry Nick and his team at National Jewish Health then developed phages as a treatment option. 

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Combating Antibiotic-Resistant Bacteria with Phages

Antibiotic resistance occurs when bacteria evolve and stop responding to medicines, making infections harder to treat and increasing the risk of spread, severe illness, and death. As a result of resistance, antibiotics and antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. For acute infections that are resistant to multiple antibiotics, treatment with phages is increasingly considered due to its specificity and effectiveness.

The team genetically engineered two mycobacteriophages (Mycobacterium-specific bacteriophages) to improve their neutralizing ability and were selected for their specificity and effectiveness on the patient’s sample. They observed a general decline in M. abscessus diversity and no increased resistance to phage or antibiotics, which is great news for both the patient and the novel therapeutic. Later, the patient received lung transplantation on day 379, and examination of the explanted lung did not detect lingering M. abscessus, this study demonstrated to be a success. 

“This research can serve as a roadmap for future use of phages to treat patients with severe Mycobacterium abscessus lung infection and to save lives,” said Dr. Nick.

Beside this National Jewish Health research, two other promising phage trials on severe dermal mycobacterial infection have been reported by co-author Dr. Graham Hatfull’s team at the University of Pittsburgh.

Author

Fujie Tham