Pre-optimized phage therapy on secondary Acinetobacter baumannii infection in four critical COVID-19 patients

Emerg Microbes Infect. 2021 Dec;10(1):612-618. doi: 10.1080/22221751.2021.1902754.

Abstract

Phage therapy is recognized as a promising alternative to antibiotics in treating pulmonary bacterial infections, however, its use has not been reported for treating secondary bacterial infections during virus pandemics such as coronavirus disease 2019 (COVID-19). We enrolled 4 patients hospitalized with critical COVID-19 and pulmonary carbapenem-resistant Acinetobacter baumannii (CRAB) infections to compassionate phage therapy (at 2 successive doses of 109 plaque-forming unit phages). All patients in our COVID-19-specific intensive care unit (ICU) with CRAB positive in bronchoalveolar lavage fluid or sputum samples were eligible for study inclusion if antibiotic treatment failed to eradicate their CRAB infections. While phage susceptibility testing revealed an identical profile of CRAB strains from these patients, treatment with a pre-optimized 2-phage cocktail was associated with reduced CRAB burdens. Our results suggest the potential of phages on rapid responses to secondary CRAB outbreak in COVID-19 patients.

Keywords: COVID-19; Phage therapy; carbapenem-resistant Acinetobacter baumannii; nosocomial infections.

Publication types

  • Case Reports

MeSH terms

  • Acinetobacter Infections / etiology*
  • Acinetobacter Infections / microbiology
  • Acinetobacter Infections / therapy*
  • Acinetobacter baumannii / physiology
  • Acinetobacter baumannii / virology*
  • Aged
  • Aged, 80 and over
  • Bacteriophages / physiology*
  • COVID-19 / complications*
  • COVID-19 / virology
  • Coinfection / microbiology
  • Coinfection / therapy*
  • Female
  • Humans
  • Male
  • Phage Therapy*
  • Podoviridae / physiology*
  • SARS-CoV-2 / physiology

Grants and funding

This work was supported by National Major Science and Technology Projects of China [grant number 2020ZX09201001-005-003]; Shanghai Municipal Science and Technology Commission [grant number 20Y11900300]; Shanghai Public Health Clinical Center [grant number RCJJ2019-06,SJTNY].