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Case Report

Bacteriophage Therapy for Critical Infections Related to Cardiothoracic Surgery

1
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany
2
Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, 30625 Hannover, Germany
3
Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, 30625 Hannover, Germany
4
G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Moscow 125212, Russia
5
German Center for Lung Research (DZL), 30625 Hannover, Germany
6
Clinical Research Group (KFO 311), German Research Foundation, 30625 Hannover, Germany
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Received: 31 March 2020 / Revised: 27 April 2020 / Accepted: 28 April 2020 / Published: 5 May 2020
(1) Objective: Bacterial resistance to conventional antibiotic therapy is an increasingly significant worldwide challenge to human health. The objective is to evaluate whether bacteriophage therapy could complement or be a viable alternative to conventional antibiotic therapy in critical cases of bacterial infection related to cardiothoracic surgery. (2) Methods: Since September 2015, eight patients with multi-drug resistant or especially recalcitrant Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli infections were treated with bacteriophage preparations as a therapy of last resort according to Article 37 of the Declaration of Helsinki. Patients had infections associated with immunosuppression after organ transplantation or had infections of vascular grafts, implanted medical devices, and surgical wounds. Individualized phage preparations were administered locally, orally, or via inhalation for different durations depending on the case. All patients remained on conventional antibiotics during bacteriophage treatment. (3) Results: Patients ranged in age from 13 to 66 years old (average 48.5 ± 16.7) with seven males and one female. Eradication of target bacteria was reached in seven of eight patients. No severe adverse side effects were observed. (4) Conclusions: Phage therapy can effectively treat bacterial infections related to cardiothoracic surgery when conventional antibiotic therapy fails. View Full-Text
Keywords: phage therapy; bacterial infection; cardiothoracic surgery; implant-associated infection; transplant-associated infection; surgical site infection phage therapy; bacterial infection; cardiothoracic surgery; implant-associated infection; transplant-associated infection; surgical site infection
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MDPI and ACS Style

Rubalskii, E.; Ruemke, S.; Salmoukas, C.; Boyle, E.C.; Warnecke, G.; Tudorache, I.; Shrestha, M.; Schmitto, J.D.; Martens, A.; Rojas, S.V.; Ziesing, S.; Bochkareva, S.; Kuehn, C.; Haverich, A. Bacteriophage Therapy for Critical Infections Related to Cardiothoracic Surgery. Antibiotics 2020, 9, 232. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9050232

AMA Style

Rubalskii E, Ruemke S, Salmoukas C, Boyle EC, Warnecke G, Tudorache I, Shrestha M, Schmitto JD, Martens A, Rojas SV, Ziesing S, Bochkareva S, Kuehn C, Haverich A. Bacteriophage Therapy for Critical Infections Related to Cardiothoracic Surgery. Antibiotics. 2020; 9(5):232. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9050232

Chicago/Turabian Style

Rubalskii, Evgenii, Stefan Ruemke, Christina Salmoukas, Erin C. Boyle, Gregor Warnecke, Igor Tudorache, Malakh Shrestha, Jan D. Schmitto, Andreas Martens, Sebastian V. Rojas, Stefan Ziesing, Svetlana Bochkareva, Christian Kuehn, and Axel Haverich. 2020. "Bacteriophage Therapy for Critical Infections Related to Cardiothoracic Surgery" Antibiotics 9, no. 5: 232. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9050232

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