Personalized bacteriophage therapy to treat pandrug-resistant spinal Pseudomonas aeruginosa infection
Bone and joint infections (BJI) are one of the most difficult-to-treat bacterial infection,
especially in the era of antimicrobial resistance. Lytic bacteriophages (phages for short) are
natural viruses that can selectively target and kill bacteria. They are considered to have a high
therapeutic potential for the treatment of severe bacterial infections and especially BJI, as
they also target biofilms. Here we report on the management of a patient with a pandrugresistant
Pseudomonas aeruginosa spinal abscess who was treated with surgery and a personalized
combination of phage therapy that was added to antibiotics. As the infecting P.
aeruginosa strain was resistant to the phages developed by private companies that were
contacted, we set up a unique European academic collaboration to find, produce and
administer a personalized phage cocktail to the patient in due time. After two surgeries,
despite bacterial persistence with expression of small colony variants, the patient healed with
local and intravenous injections of purified phages as adjuvant therapy.