Case Report: Arthroscopic “Debridement Antibiotics and Implant Retention” With Local Injection of Personalized Phage Therapy to Salvage a Relapsing Pseudomonas Aeruginosa Prosthetic Knee Infection

52Citations
Citations of this article
93Readers
Mendeley users who have this article in their library.
Get full text

Abstract

Bacteriophages are viruses that specifically target bacteria. They are considered to have a high potential in patients with prosthetic joint infection (PJI), as they have a synergistic anti-biofilm activity with antibiotics. We report here the case of an 88-year-old man (63 kg) with relapsing Pseudomonas aeruginosa prosthetic knee infection. The patient had severe alteration of the general status and was bedridden with congestive heart failure. As prosthesis explantation and/or exchange was not feasible, we proposed to this patient the use of phage therapy to try to control the disease in accordance with the local ethics committee and the French National Agency for Medicines and Health Products Safety (ANSM). Three phages, targeting P. aeruginosa, were selected based on their lytic activity on the patient's strain (phagogram). Hospital pharmacist mixed extemporaneously the active phages (initial concentration 1 ml of 1 × 1010 PFU/ml for each phage) to obtain a cocktail of phages in a suspension form (final dilution 1 × 109 PFU/ml for both phages). Conventional arthroscopy was performed and 30 cc of the magistral preparation was injected through the arthroscope (PhagoDAIR procedure). The patient received intravenous ceftazidime and then oral ciprofloxacin as suppressive antimicrobial therapy. Under this treatment, the patient rapidly improved with disappearance of signs of heart failure and pain of the left knee. During the follow-up of 1 year, the local status of the left knee was normal, and its motion and walking were unpainful. The present case suggests that the PhagoDAIR procedure by arthroscopy has the potential to be used as salvage therapy for patients with P. aeruginosa relapsing PJI, in combination with suppressive antimicrobial therapy. A Phase II clinical study deserves to be performed to confirm this hypothesis.

References Powered by Scopus

Diagnosis and management of prosthetic joint infection: Clinical practice guidelines by the infectious diseases Society of America

2188Citations
N/AReaders
Get full text

Efficacy and tolerability of a cocktail of bacteriophages to treat burn wounds infected by Pseudomonas aeruginosa (PhagoBurn): a randomised, controlled, double-blind phase 1/2 trial

614Citations
N/AReaders
Get full text

One hundred and twelve infected arthroplasties treated with 'DAIR' (debridement, antibiotics and implant retention): Antibiotic duration and outcome

334Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Considerations for the Use of Phage Therapy in Clinical Practice

216Citations
N/AReaders
Get full text

Personalized bacteriophage therapy to treat pandrug-resistant spinal Pseudomonas aeruginosa infection

69Citations
N/AReaders
Get full text

Antibiotic Therapy for Prosthetic Joint Infections: An Overview

62Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Ferry, T., Kolenda, C., Batailler, C., Gaillard, R., Gustave, C. A., Lustig, S., … Laurent, F. (2021). Case Report: Arthroscopic “Debridement Antibiotics and Implant Retention” With Local Injection of Personalized Phage Therapy to Salvage a Relapsing Pseudomonas Aeruginosa Prosthetic Knee Infection. Frontiers in Medicine, 8. https://doi.org/10.3389/fmed.2021.569159

Readers over time

‘21‘22‘23‘24‘25010203040

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 27

69%

Researcher 7

18%

Professor / Associate Prof. 3

8%

Lecturer / Post doc 2

5%

Readers' Discipline

Tooltip

Biochemistry, Genetics and Molecular Bi... 13

39%

Medicine and Dentistry 10

30%

Pharmacology, Toxicology and Pharmaceut... 5

15%

Agricultural and Biological Sciences 5

15%

Save time finding and organizing research with Mendeley

Sign up for free
0