Microbiology: Bacteriophage therapy helps treat multi-drug resistant infection in an immunocompromised patient

Bacteriophage therapy is shown to be effective in an immunocompromised patient with a multidrug-resistant Mycobacterium chelonae infection, in conjunction with antibiotics and surgery. The findings, published in Nature Communications, describe the clinical response observed in the first reported successful case of M. chelonae infection treated with bacteriophage therapy.

M. chelonae is commonly associated with skin and soft tissue infections — mostly in individuals with weak immune systems — but is difficult to treat due to extensive antimicrobial resistance. Bacteriophages are able to infect and kill bacterial hosts, but their current clinical use is limited due to complex interactions with the human immune system. Bacteriophage therapy has previously been shown to successfully treat Mycobacterium abscessus infection (which is widely known for extensive antimicrobial resistance), but not for M. chelonae infection.

Jessica Little and colleagues report the treatment of an immunocompromised patient with seronegative arthritis and clinically diagnosed M. chelonae infection with a single bacteriophage, in conjunction with antibiotics and surgery. The authors found that the patient showed an excellent clinical response with their skin lesions showing decreased inflammation and nodularity in the months following treatment, and did not display adverse side effects to the bacteriophage therapy.

The findings suggest that bacteriophages could be a promising therapeutic option for multi-drug resistant infections. Further research is needed to improve our understanding of human immune responses and phage therapy safety (particularly given the clinical burden of infections in immunocompromised individuals), and drug-resistance in mycobacteria.