Assessment of the microbiome during bacteriophage therapy in combination with systemic antibiotics to treat a case of staphylococcal device infection
Andre Mu,
Daniel McDonald,
Alan K. Jarmusch,
Cameron Martino,
Caitriona Brennan,
Mackenzie Bryant,
Gregory C. Humphrey,
Julia Toronczak,
Tara Schwartz,
Dominic Nguyen,
Gail Ackermann,
Anthony D’Onofrio,
Steffanie A. Strathdee,
Robert T. Schooley,
Pieter C. Dorrestein,
Rob Knight,
Saima Aslam
Affiliations
Andre Mu
Doherty Applied Microbial Genomics, Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, University of Melbourne
Daniel McDonald
Department of Pediatrics, University of California San Diego
Alan K. Jarmusch
Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego
Cameron Martino
Department of Pediatrics, University of California San Diego
Caitriona Brennan
Department of Pediatrics, University of California San Diego
Mackenzie Bryant
Department of Pediatrics, University of California San Diego
Gregory C. Humphrey
Department of Pediatrics, University of California San Diego
Julia Toronczak
Department of Pediatrics, University of California San Diego
Tara Schwartz
Department of Pediatrics, University of California San Diego
Dominic Nguyen
Department of Pediatrics, University of California San Diego
Gail Ackermann
Department of Pediatrics, University of California San Diego
Anthony D’Onofrio
Antimicrobial Discovery Center, Department of Biology, Northeastern University
Steffanie A. Strathdee
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego
Robert T. Schooley
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego
Pieter C. Dorrestein
Department of Pediatrics, University of California San Diego
Rob Knight
Department of Pediatrics, University of California San Diego
Saima Aslam
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego
Abstract Background Infectious bacterial diseases exhibiting increasing resistance to antibiotics are a serious global health issue. Bacteriophage therapy is an anti-microbial alternative to treat patients with serious bacterial infections. However, the impacts to the host microbiome in response to clinical use of phage therapy are not well understood. Results Our paper demonstrates a largely unchanged microbiota profile during 4 weeks of phage therapy when added to systemic antibiotics in a single patient with Staphylococcus aureus device infection. Metabolomic analyses suggest potential indirect cascading ecological impacts to the host (skin) microbiome. We did not detect genomes of the three phages used to treat the patient in metagenomic samples taken from saliva, stool, and skin; however, phages were detected using endpoint-PCR in patient serum. Conclusion Results from our proof-of-principal study supports the use of bacteriophages as a microbiome-sparing approach to treat bacterial infections. Video abstract
