Non-tuberculous mycobacteria (NTM) cause chronic pulmonary infections in individuals with cystic fibrosis, and antibiotic-resistant NTM (for example, Mycobacterium abscessus) is widespread. The use of phages to treat drug-resistant bacterial infections is a potential alternative strategy. Dedrick et al. report the use of a three-phage cocktail in the treatment of disseminated drug-resistant M. abscessus. After an uncomplicated bilateral lung transplant in a 15-year-old patient with cystic fibrosis, the patient was diagnosed with a disseminated drug-resistant M. abscessus subsp. massiliense infection, necessitating an alternative treatment strategy. The authors used screening, genome engineering and forward genetics to develop a cocktail of three lytic phage derivatives that efficiently kill the infectious M. abscessus strain. Intravenous administration of the cocktail was well-tolerated and resulted in clinical improvements — sternal wound closure, improved liver function and substantial resolution of infected skin lesions.
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Dedrick, R. M. et al. Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus. Nat. Med. https://doi.org/10.1038/s41591-019-0437-z (2019)
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York, A. A phage cocktail for drug-resistant mycobacteria. Nat Rev Microbiol 17, 399 (2019). https://doi.org/10.1038/s41579-019-0216-3
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DOI: https://doi.org/10.1038/s41579-019-0216-3