Non-active antibiotic and bacteriophage synergism to successfully treat recurrent urinary tract infection caused by extensively drug-resistant <i>Klebsiella pneumoniae</i>
Juan Bao, Nannan Wu, Yigang Zeng, Liguang Chen, Linlin Li, Lan Yang, Yiyuan Zhang, Mingquan Guo, Lisha Li, Jie Li, Demeng Tan, Mengjun Cheng, Jingmin Gu, Jinghong Qin, Jiazhen Liu, Shiru Li, Guangqiang Pan, Xin Jin, Bangxin Yao, Xiaokui Guo, Tongyu Zhu, Shuai Le
Abstract
We report a case of a 63-year-old female patient who developed a recurrent urinary tract infection (UTI) with extensively drug-resistant Klebsiella pneumoniae (ERKp). In the initial two rounds of phage therapy, phage resistant mutants developed within days. Although ERKp strains were completely resistant to sulfamethoxazole-trimethoprim, the combination of sulfamethoxazole-trimethoprim with the phage cocktail inhibited the emergence of phage resistant mutant in vitro, and the UTI of patient was successfully cured by this combination. Thus, we propose that non-active antibiotic and bacteriophage synergism (NABS) might be an alternative strategy in personalized phage therapy.