Benefits of Aerosolized Phages for the Treatment of Pneumonia Due to Methicillin-Resistant Staphylococcus aureus: An Experimental Study in Rats. (1st March 2021)

• Record Type: Journal Article
• Authors: Prazak, Josef; Valente, Luca G; Iten, Manuela; Federer, Lea; Grandgirard, Denis; Soto, Sara; Resch, Gregory; Leib, Stephen L; Jakob, Stephan M; Haenggi, Matthias; Cameron, David R; Que, Yok-Ai
• Is Part Of: Journal of infectious diseases. Volume 225:Number 8(2022)
• Page Start: 1452
• Page End: 1459
• Publication Date: 2021-03-01
• Subjects: antibiotic resistance -- inhalative -- nosocomial infections -- phage therapy -- ventilator-associated pneumonia; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiab112
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: The optimal method for delivering phages in the context of ventilator-associated pneumonia (VAP) is unknown. In the current study, we assessed the utility of aerosolized phages (aerophages) for experimental methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Methods: Rats were ventilated for 4 hours before induction of pneumonia. Animals received one of the following: (1) aerophages; (2) intravenous (IV) phages; (3) a combination of IV and aerophages; (4) IV linezolid; or (5) a combination of IV linezolid and aerophages. Phages were administered at 2, 12, 24, 48, and 72 hours, and linezolid was administered at 2, 12, 24, 36, 48, 60, and 72 hours. The primary outcome was survival at 96 hours. Secondary outcomes were bacterial and phage counts in tissues and histopathological scoring of the lungs. Results: Aerophages and IV phages each rescued 50% of animals from severe MRSA pneumonia ( P < .01 compared with placebo controls). The combination of aerophages and IV phages rescued 91% of animals, which was higher than either monotherapy ( P < .05). Standard-of-care antibiotic linezolid rescued 38% of animals. However, linezolid and aerophages did not synergize in this setting (55% survival). Conclusions: Aerosolized phage therapy showed potential for the treatment of MRSA pneumonia in an experimental animal model and warrants further investigation for application in humans. Abstract : Nebulized bacteriophages (aerophages) showed promise for the treatment of pneumonia due to MRSA; aerophages reduced bacterial loads and lung damage, and when combined with systemically applied phages, they rescued >90% of animals from lethal infection. Graphical Abstract: