BRIEF COMMUNICATION
Early clinical experience of bacteriophage therapy in 3 lung transplant recipients

https://doi.org/10.1111/ajt.15503Get rights and content
Under a Creative Commons license
open archive

Bacteriophage therapy (BT) uses bacteriophages to treat pathogenic bacteria and is an emerging strategy against multidrug-resistant (MDR) infections. Experience in solid organ transplant is limited. We describe BT in 3 lung transplant recipients (LTR) with life-threatening MDR infections caused by Pseudomonas aeruginosa (n = 2) and Burkholderia dolosa (n = 1). For each patient, lytic bacteriophages were selected against their bacterial isolates. BT was administered for variable durations under emergency Investigational New Drug applications and with patient informed consent. Safety was assessed using clinical/laboratory parameters and observed clinical improvements described, as appropriate. All patients received concurrent antibiotics. Two ventilator-dependent LTR with large airway complications and refractory MDR P. aeruginosa pneumonia received BT. Both responded clinically and were discharged from the hospital off ventilator support. A third patient had recurrent B. dolosa infection following transplant. Following BT initiation, consolidative opacities improved and ventilator weaning was begun. However, infection relapsed on BT and the patient died. No BT-related adverse events were identified in the 3 cases. BT was well tolerated and associated with clinical improvement in LTRs with MDR bacterial infection not responsive to antibiotics alone. BT may be a viable adjunct to antibiotics for patients with MDR infections.

KEYWORDS

antibiotic drug resistance
antibiotic: antibacterial
clinical research/practice
infection and infectious agents – bacterial
infectious disease
lung disease: infectious
lung transplantation/pulmonology
translational research/science

Abbreviations

BAL
bronchoalveolar lavage
BT
bacteriophage therapy
CF
cystic fibrosis
FDA
Food and Drug Administration
IV
intravenous
LTRs
lung transplant recipients
MDR
multidrug-resistant
PFU
plaque-forming units

Cited by (0)

Saima Aslam and Andrew M. Courtwright share first authorship