Non-active antibiotic and bacteriophage synergism to successfully treat recurrent urinary tract infection caused by extensively drug-resistant Klebsiella pneumoniae

Emerg Microbes Infect. 2020 Dec;9(1):771-774. doi: 10.1080/22221751.2020.1747950.

Abstract

We report a case of a 63-year-old female patient who developed a recurrent urinary tract infection (UTI) with extensively drug-resistant Klebsiella pneumoniae (ERKp). In the initial two rounds of phage therapy, phage resistant mutants developed within days. Although ERKp strains were completely resistant to sulfamethoxazole-trimethoprim, the combination of sulfamethoxazole-trimethoprim with the phage cocktail inhibited the emergence of phage resistant mutant in vitro, and the UTI of patient was successfully cured by this combination. Thus, we propose that non-active antibiotic and bacteriophage synergism (NABS) might be an alternative strategy in personalized phage therapy.

Keywords: Bacteriophage; antibiotic resistance; phage therapy; urinary tract infection.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Humans
  • Klebsiella Infections / therapy*
  • Klebsiella pneumoniae
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mutation
  • Phage Therapy*
  • Recurrence
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / therapy*

Substances

  • Anti-Bacterial Agents

Grants and funding

This study was supported by Shanghai Public Health Clinical Center (SIP project: SJTNY), Shanghai Municipal Key Clinical Specialty (No. shslczdzk01102), National Natural Science Foundation of China (NSFC, 31870167 to SL), Shanghai Municipal Health Commission Scientific Research Project (No. 20194Y0061), and National Science and Technology Major Project (No. 2020ZX09201001).