Successful use of a phage endolysin for treatment of chronic pelvic pain syndrome/chronic bacterial prostatitis

Frontiers in Medicine

Medicine

Stanislav Šutovský¹  Michal Kajsik²  Peter Sabaka³  Rafał Płoski⁴  Malgorzata Rydzanicz⁴  Roy H. Stevens⁵  Hongming Zhang⁵ 

[1] 1st Department of Neurology, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia;Department of Bacteriology, Comenius University Science Park, Bratislava, Slovakia;Department of Molecular Biology, Comenius University Faculty of Natural Sciences, Bratislava, Slovakia;Department of Infectiology and Geographical Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia;Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland;Laboratory of Oral Infectious Diseases, Kornberg School of Dentistry, Temple University, Philadelphia, PA, United States;

关键词: chronic bacterial prostatitis;    bacteriophage;    endolysin therapy;    antibiotic resistance;    Enterococcus faecalis;   

DOI  :  10.3389/fmed.2023.1238147

 received in 2023-06-10, accepted in 2023-07-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

Chronic prostatitis (CP) is a common inflammatory condition of the prostate that is estimated to effect 2%–10% of the world’s male population. It can manifest as perineal, suprapubic, or lower back pain and urinary symptoms occurring with either recurrent bacterial infection [chronic bacterial prostatitis (CBP)] or in the absence of evidence of bacterial infection [chronic pelvic pain syndrome (CPPS)]. Here, in the case of a 39 years-old CBP patient, we report the first successful use of a bacteriophage-derived muralytic enzyme (endolysin) to treat and resolve the disease. Bacteriological analysis of the patient’s prostatic secretion and semen samples revealed a chronic Enterococcus faecalis prostate infection, supporting a diagnosis of CBP. The patient’s E. faecalis strain was resistant to several antibiotics and developed resistance to others during the course of treatment. Previous treatment with multiple courses of antibiotics, bacteriophages, probiotics, and immunologic stimulation had failed to achieve long term eradication of the infection or lasting mitigation of the symptoms. A cloned endolysin gene, encoded by E. faecalis bacteriophage ϕEf11, was expressed, and the resulting gene product was purified to electrophoretic homogeneity. A seven-day course of treatment with the endolysin resulted in the elimination of the E. faecalis infection to below culturally detectable levels, and the abatement of symptoms to near normal levels. Furthermore, during the endolysin treatment, the patient experienced no untoward reactions. The present report demonstrates the effectiveness of an endolysin as a novel modality in managing a recalcitrant infection that could not be controlled by conventional antibiotic therapy.

【 授权许可】

Unknown   
Copyright © 2023 Stevens, Zhang, Kajsik, Płoski, Rydzanicz, Sabaka and Šutovský.