• #Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection | Nature Communications
    https://www.nature.com/articles/s41467-022-29689-4

    We report a case of refractory cutaneous disseminated M. chelonae infection in a patient with seronegative arthritis on immunotherapy with tofacitinib that was treated with combination antimicrobial, surgical, and single bacteriophage therapy with excellent clinical response. The patient developed neutralizing antibodies against the bacteriophage but continues to have stable improvement of disease with negative biopsies and no evidence of bacterial resistance to the phage.

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    Bacteriophage therapy using a cocktail of multiple phage isolates has been recently successfully used for the treatment of resistant bacterial infections including multidrug-resistant nontuberculous mycobacterial infections in conjunction with traditional antibiotic therapy. Widespread use of bacteriophage therapy is limited by logistic and regulatory challenges as well as the development of bacterial resistance or neutralizing antibodies that may reduce host response to the bacteriophage.

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    To our knowledge, this is the first case of a human M. chelonae infection treated with a bacteriophage, and the first case of bacteriophage treatment with a single phage for a mycobacterial infection. Bacteriophage therapy is a promising therapeutic option for multi-drug resistant infections, though improved understanding of safety, the factors driving the development of bacterial resistance, and the clinical significance of antibody-mediated phage neutralization is vital to advance this therapeutic option for patients.