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

Abstract

<i>Pseudomonas aeruginosa</i> 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 <i>P. aeruginosa</i> strains that are resistant to many antibiotics. Phage therapy is an emerging option to treat severe <i>P. aeruginosa</i> infections. It involves using natural viruses called bacteriophages, which have the ability to infect, replicate, and, theoretically, destroy the <i>P. aeruginosa</i> 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 <i>P. aeruginosa</i>. 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).