Phage therapy for bone and joint infections: A comprehensive exploration of challenges, dynamics, and therapeutic prospects

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES Journal of global antimicrobial resistance Pub Date : 2024-08-19 DOI:10.1016/j.jgar.2024.07.007
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Abstract

Objectives

Bone and joint infections (BJI) pose formidable challenges in orthopaedics due to antibiotic resistance and the complexities of biofilm, complicating treatment. This comprehensive exploration addresses the intricate challenges posed by BJI and highlights the significant role of phage therapy as a non-antibiotic strategy.

Methods

BJI, which encompass prosthetic joint infections, osteomyelitis, and purulent arthritis, are exacerbated by biofilm formation on bone and implant surfaces, hindering treatment efficacy. Gram-negative bacterial infections, characterized by elevated antibiotic resistance, further contribute to the clinical challenge. Amidst this therapeutic challenge, phage therapy emerges as a potential strategy, showing unique characteristics such as strict host specificity and biofilm disruption capabilities.

Results

The review unveils the dynamics of phages, including their origins, lifecycle outcomes, and genomic characteristics. Animal studies, in vitro investigations, and clinical research provide compelling evidence of the efficacy of phages in treating Staphylococcus aureus infections, particularly in osteomyelitis cases. Phage lysins exhibit biofilm-disrupting capabilities, offering a meaningful method for addressing BJI. Recent statistical analyses reveal high clinical relief rates and a favourable safety profile for phage therapy.

Conclusions

Despite its promise, phage therapy encounters limitations, including a narrow host range and potential immunogenicity. The comprehensive analysis navigates these challenges and charts the future of phage therapy, emphasizing standardization, pharmacokinetics, and global collaboration. Anticipated strides in phage engineering and combination therapy hold promise for combating antibiotic-resistant BJI.

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骨与关节感染的噬菌体疗法:全面探讨挑战、动态和治疗前景。
由于抗生素耐药性和生物膜的复杂性,骨与关节感染(BJI)给骨科带来了严峻的挑战,使治疗变得更加复杂。本研究全面探讨了骨与关节感染所带来的复杂挑战,并强调了噬菌体疗法作为一种非抗生素策略的重要作用。BJI 包括假体关节感染、骨髓炎和化脓性关节炎,骨和植入物表面生物膜的形成加剧了 BJI,阻碍了治疗效果。以抗生素耐药性增强为特征的革兰氏阴性细菌感染进一步加剧了临床挑战。在这一治疗挑战中,噬菌体疗法作为一种潜在策略应运而生,它具有严格的宿主特异性和生物膜破坏能力等独特特性。本综述揭示了噬菌体的动态变化,包括其起源、生命周期结果和基因组特征。动物研究、体外调查和临床研究为噬菌体治疗金黄色葡萄球菌感染,尤其是骨髓炎病例的疗效提供了令人信服的证据。噬菌体溶菌素具有破坏生物膜的能力,为治疗北京和睦家医院感染提供了一种有意义的方法。最近的统计分析显示,噬菌体疗法的临床缓解率高,安全性好。尽管噬菌体疗法大有可为,但它也存在局限性,包括宿主范围狭窄和潜在的免疫原性。本报告全面分析了这些挑战,并描绘了噬菌体疗法的未来,强调了标准化、药代动力学和全球合作。噬菌体工程和联合疗法有望取得长足进步,为抗击抗生素耐药北京pk10助赢带来希望。
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来源期刊
Journal of global antimicrobial resistance
Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
8.70
自引率
2.20%
发文量
285
审稿时长
34 weeks
期刊介绍: The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.
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