Osteomyelitis

Osteomyelitis is a bone infection supported by pathogenic bacteria or, less commonly, by fungi or clostridia. It is distinguished in:

• Acute osteomyelitis
• Chronic osteomyelitis

Phage therapy has been successfully applied for the treatment of bone infections, as reported in the following scientific publications:

• Biofilms in Periprosthetic Joint Infections: A Review of Diagnostic Modalities, Current Treatments, and Future Directions. Shoji MM, Chen AF. J Knee Surg. 2020 Feb;33(2):119-131. doi: 10.1055/s-0040-1701214. Epub 2020 Jan 14. link
• Evaluation of the activity of a combination of three bacteriophages alone or in association with antibiotics on Staphylococcus aureus embedded in biofilm or internalised in osteoblasts. Kolenda C, Josse J, Medina M, Fevre C, Lustig S, Ferry T, Laurent F. Antimicrob Agents Chemother. 2019 Dec 23. pii: AAC.02231-19. link
• Successful Treatment of Antibiotic-resistant, Poly-microbial Bone Infection With Bacteriophages and Antibiotics Combination. Nir-Paz R, Gelman D, Khouri A, Sisson BM, Fackler J, Alkalay-Oren S, Khalifa L, Rimon A, Yerushalmy O, Bader R, Amit S, Coppenhagen-Glazer S, Henry M, Quinones J, Malagon F, Biswas B, Moses AE, Merril G, Schooley RT, Brownstein MJ, Weil YA, Hazan R. Clin Infect Dis. 2019 Nov 13;69(11):2015-2018. link
• Resolving Digital Staphylococcal Osteomyelitis Using Bacteriophage-A Case Report. Fish R, Kutter E, Bryan D, Wheat G, Kuhl S. Antibiotics (Basel). 2018 Oct 2;7(4). pii: E87. link

Skin infections

The skin is an effective barrier against bacterial infections. Although many bacteria come into contact with or reside on the skin surface, they are normally unable to cause an infection. When a bacterial skin infection occurs, the extent varies from small spots to the entire body surface. Severity also varies from harmless to life-threatening infections.

Phage therapy has been successfully applied for the treatment of skin infections (e.g. diabetic foot; vascular ulcers; stump; bedsores, etc.), as reported in the following scientific publications:

• Compassionate Use of Bacteriophage Therapy for Foot Ulcer Treatment as an Effective Step for Moving Toward Clinical Trials. Fish R, Kutter E, Wheat G, Blasdel B, Kutateladze M, Kuhl S. Methods Mol Biol. 2018;1693:159-170. link
• Bacteriophage Treatment of Infected Diabetic Foot Ulcers. Morozova VV, Kozlova YN, Ganichev DA, Tikunova NV. Methods Mol Biol. 2018;1693:151-158. link
• Bacteriophage therapy and diabetic foot ulcer]. Morinet F. Pathol Biol (Paris). 2013 Apr;61(2):37. link

Infection associated with joint prostheses

Joint prosthesis infections are an uncommon complication of orthopedic surgery. The bacteria involved in this infectious process are numerous, but the main ones are staphylococci, Pseudomonas aeruginosa, Cutibacterium spp. They are distinguished in:

• acute infections (within one month of placing the prosthesis)
• chronic infections (from the second month onwards)

Phage therapy has been successfully applied for the treatment of joint-associated infections, as reported in the following scientific publications:

• Biofilms in Periprosthetic Joint Infections: A Review of Diagnostic Modalities, Current Treatments, and Future Directions. Shoji MM, Chen AF. J Knee Surg. 2020 Feb;33(2):119-131. link
• Bacteriophage Application for Difficult-to-treat Musculoskeletal Infections: Development of a Standardized Multidisciplinary Treatment Protocol. Onsea J, Soentjens P, Djebara S, Merabishvili M, Depypere M, Spriet I, De Munter P, Debaveye Y, Nijs S, Vanderschot P, Wagemans J, Pirnay JP, Lavigne R, Metsemakers WJ. Viruses. 2019 Sep 23;11(10). pii: E891. link
• Salvage Debridement, Antibiotics and Implant Retention ("DAIR") With Local Injection of a Selected Cocktail of Bacteriophages: Is It an Option for an Elderly Patient With Relapsing Staphylococcus aureus Prosthetic-Joint Infection? Ferry T, Leboucher G, Fevre C, Herry Y, Conrad A, Josse J, Batailler C, Chidiac C, Medina M, Lustig S, Laurent F; Lyon BJI Study Group. Open Forum Infect Dis. 2018 Oct 24;5(11):ofy269. link

Ear infection

Otitis is an acute or chronic inflammation of the ear. Three forms of ear infections can be distinguished according to which part of the ear is affected:

• Outer ear infection
• Middle ear infection
• Inner ear infection (or labyrinthitis)

The pathogens most frequently involved in this infection are Staphylococcus aureus and Pseudomonas aeruginosa. Here are some scientific publications that demonstrate the success of phage therapy in otitis:

• A controlled clinical trial of a therapeutic bacteriophage preparation in chronic otitis due to antibiotic-resistant Pseudomonas aeruginosa; a preliminary report of efficacy. Wright A, Hawkins CH, Anggård EE, Harper DR. Clin Otolaryngol. 2009 Aug;34(4):349-57. link
• Use of bacteriophages in the treatment of Pseudomonas aeruginosa infections. Soothill J. Expert Rev Anti Infect Ther. 2013 Sep;11(9):909-15. link

Chronic sinusitis

Sinusitis is inflammation of the paranasal sinuses due to viral, bacterial or fungal infections or allergic reactions. Symptoms include nasal obstruction and congestion, purulent rhinorrhea, and facial pain or pressure. Here are some scientific publications that demonstrate the success of phage therapy in bacterial sinusitis:

• Safety and Tolerability of Bacteriophage Therapy for Chronic Rhinosinusitis Due to Staphylococcus aureus. Ooi ML, Drilling AJ, Morales S, Fong S, Moraitis S, Macias-Valle L, Vreugde S, Psaltis AJ, Wormald PJ. JAMA Otolaryngol Head Neck Surg. 2019 Jun 20. link
• Long-Term Safety of Topical Bacteriophage Application to the Frontal Sinus Region. Drilling AJ, Ooi ML, Miljkovic D, James C, Speck P, Vreugde S, Clark J, Wormald PJ. Front Cell Infect Microbiol. 2017 Feb 24;7:49. link

Prostatitis

Prostate infections play a major role among the most common male ailments. These infectious processes affect the prostate, an organ responsible for the synthesis of prostate fluid, therefore used for reproductive function. Some articles related to the treatment of bacterial prostatitis through the use of phages are reported below:

• Phage Therapy in Prostatitis: Recent Prospects. Górski A, Jończyk-Matysiak E, Łusiak-Szelachowska M, Międzybrodzki R, Weber-Dąbrowska B, Borysowski J, Letkiewicz S, Bagińska N, Sfanos KS. Front Microbiol. 2018 Jun 29;9:1434. link
• Eradication of Enterococcus faecalis by phage therapy in chronic bacterial prostatitis--case report. Letkiewicz S, Miedzybrodzki R, Fortuna W, Weber-Dabrowska B, Górski A. Folia Microbiol (Praha). 2009 Sep;54(5):457-61. link

Chronic cystitis/genitourinary tract infections

Bacterial urinary tract infections can affect the urethra, prostate, bladder or kidneys. Symptoms may be absent or include urination frequency, urgency, dysuria, lower abdominal pain and flank pain. Systemic symptoms and even sepsis may be present in case of kidney infection. Below are the articles on phage therapy for the treatment of urinary infections:

• Bacteriophages for treating urinary tract infections in patients undergoing transurethral resection of the prostate: a randomized, placebo-controlled, double-blind clinical trial. Leitner L, Sybesma W, Chanishvili N, Goderdzishvili M, Chkhotua A, Ujmajuridze A, Schneider MP, Sartori A, Mehnert U, Bachmann LM, Kessler TM. BMC Urol. 2017 Sep 26;17(1):90. link
• Managing urinary tract infections through phage therapy: a novel approach. Malik S, Sidhu PK, Rana JS, Nehra K. Folia Microbiol (Praha). 2019 Sep 7. link
• Adapted Bacteriophages for Treating Urinary Tract Infections. Ujmajuridze A, Chanishvili N, Goderdzishvili M, Leitner L, Mehnert U, Chkhotua A, Kessler TM, Sybesma W. Front Microbiol. 2018 Aug 7;9:1832. link

Chronic bronchitis and pneumonia

Bacterial pneumonia is the infection of the pulmonary alveoli sustained by the action of a bacterium and are the most feared forms of pneumonia, as they can give rise to life-threatening complications. Here are some articles on the treatment of bacterial polonites using phages:

• Successful adjunctive use of bacteriophage therapy for treatment of multidrug-resistant Pseudomonas aeruginosa infection in a cystic fibrosis patient. Law N, Logan C, Yung G, Furr CL, Lehman SM, Morales S, Rosas F, Gaidamaka A, Bilinsky I, Grint P, Schooley RT, Aslam S. Infection. 2019 Aug;47(4):665-668. link
• Bacteriophage Therapy of Ventilator-associated Pneumonia and Empyema Caused by Pseudomonas aeruginosa. Maddocks S, Fabijan AP, Ho J, Lin RCY, Ben Zakour NL, Dugan C, Kliman I, Branston S, Morales S, Iredell JR. Am J Respir Crit Care Med. 2019 Nov 1;200(9):1179-1181. link
• Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus. Dedrick RM, Guerrero-Bustamante CA, Garlena RA, Russell DA, Ford K, Harris K, Gilmour KC, Soothill J, Jacobs-Sera D, Schooley RT, Hatfull GF, Spencer H. Nat Med. 2019 May;25(5):730-733. link