Bacteriophages for the Treatment of Graft Infections in Cardiovascular Medicine

Antibiotics

Romy Skusa¹  Anja Püschel¹  Justus Gross¹  Eberhard Grambow¹  Juliane Kohlen¹  Sebastian V. Rojas²  Jan Gummert²  Simon Junghans³  Philipp Warnke⁴ 

[1] Department for General, Visceral, Thoracic, Vascular and Transplantation Surgery, Rostock University Medical Center, 18057 Rostock, Germany;Department of Cardio-Thoracic Surgery, Heart and Diabetes Centre NRW, University Hospital of the Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany;G. Pohl-Boskamp GmbH & Co. KG, 25551 Hohenlockstedt, Germany;Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany;

关键词: bacteriophage;    phage;    infection;    prosthesis;    vascular graft;    antimicrobial resistance;   

DOI  :  10.3390/antibiotics10121446

来源: DOAJ

【 摘 要 】

Bacterial infections of vascular grafts represent a major burden in cardiovascular medicine, which is related to an increase in morbidity and mortality. Different factors that are associated with this medical field such as patient frailty, biofilm formation, or immunosuppression negatively influence antibiotic treatment, inhibiting therapy success. Thus, further treatment strategies are required. Bacteriophage antibacterial properties were discovered 100 years ago, but the focus on antibiotics in Western medicine since the mid-20th century slowed the further development of bacteriophage therapy. Therefore, the experience and knowledge gained until then in bacteriophage mechanisms of action, handling, clinical uses, and limitations were largely lost. However, the parallel emergence of antimicrobial resistance and individualized medicine has provoked a radical reassessment of this approach and cardiovascular surgery is one area in which phages may play an important role to cope with this new scenario. In this context, bacteriophages might be applicable for both prophylactic and therapeutic use, serving as a stand-alone therapy or in combination with antibiotics. From another perspective, standardization of phage application is also required. The ideal surgical bacteriophage application method should be less invasive, enabling highly localized concentrations, and limiting bacteriophage distribution to the infection site during a prolonged time lapse. This review describes the latest reports of phage therapy in cardiovascular surgery and discusses options for their use in implant and vascular graft infections.

【 授权许可】

Unknown