Phage Therapy in a Burn Patient Colonized with Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> Responsible for Relapsing Ventilator-Associated Pneumonia and Bacteriemia

Abstract

Pseudomonas aeruginosa is one of the main causes of healthcare-associated infection in Europe that increases patient morbidity and mortality. Multi-resistant pathogens are a major public health issue in burn centers. Mortality increases when the initial antibiotic treatment is inappropriate, especially if the patient is infected with P. aeruginosa strains that are resistant to many antibiotics. Phage therapy is an emerging option to treat severe P. aeruginosa infections. It involves using natural viruses called bacteriophages, which have the ability to infect, replicate, and, theoretically, destroy the P. aeruginosa population in an infected patient. We report here the case of a severely burned patient who experienced relapsing ventilator-associated pneumonia associated with skin graft infection and bacteremia due to extensively drug-resistant P. aeruginosa. The patient was successfully treated with personalized nebulized and intravenous phage therapy in combination with immunostimulation (interferon-γ) and last-resort antimicrobial therapy (imipenem-relebactam).

Keywords

• <i>Pseudomonas aeruginosa</i>
• antimicrobial resistance
• phage therapy
• burns
• ICU
• ventilator-associated pneumonia