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Case Report

A Case of Phage Therapy against Pandrug-Resistant Achromobacter xylosoxidans in a 12-Year-Old Lung-Transplanted Cystic Fibrosis Patient

1
Université de Paris, F-75006 Paris, France
2
Service de Microbiologie, Unité Mobile d’Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
3
Laboratory Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, B-1120 Brussels, Belgium
4
Laboratory Bacteriology Research, Faculty of Medicine & Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Gent, Belgium
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Service de Pharmacie, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris Centre Université-Paris, 20 rue Leblanc, 75015 Paris, France
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Lipides, Systèmes Analytiques et Biologiques, Université Paris-Saclay, 92296 Châtenay-Malabry, France
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CHU Lille, Institut de Pharmacie, F-59000 Lille, France
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ULR7365—GRITA—Groupe de Recherche Sur Les Formes Injectables et Les Technologies Associées, Universit Lille, F-59000 Lille, France
9
Research Center Health & Water Technology, University College Ghent, Keramiekstraat 80, B-9000 Gent, Belgium
10
Service d’Anesthésie-Réanimation, Hôpital Européen Georges Pompidou, 75015 Paris, France
11
Pediatric Pulmonology and Allergy Unit, Hôpital Jeanne de Flandre, University Lille, CHU Lille, F-59000 Lille, France
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Service de Microbiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
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Unité d'Hygiène Hospitalière, Service de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France
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Leibniz Institute DSMZ—German Collection of Microorganisms and Cell Cultures GmbH, Inhoffenstraße 7B, 38124 Braunschweig, Germany
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Service de Réanimation Médico-Chirurgicale, Centre Hospitalier René Dubos, 95300 Pontoise, France
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Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Gent, Belgium
*
Author to whom correspondence should be addressed.
Academic Editors: Mikael Skurnik and Dann Turner
Viruses 2021, 13(1), 60; https://doi.org/10.3390/v13010060
Received: 29 November 2020 / Revised: 29 December 2020 / Accepted: 30 December 2020 / Published: 5 January 2021
(This article belongs to the Special Issue State-of-the-Art Phage Therapy Development in Europe)
Bacteriophages are a promising therapeutic strategy among cystic fibrosis and lung-transplanted patients, considering the high frequency of colonization/infection caused by pandrug-resistant bacteria. However, little clinical data are available regarding the use of phages for infections with Achromobacter xylosoxidans. A 12-year-old lung-transplanted cystic fibrosis patient received two rounds of phage therapy because of persistent lung infection with pandrug-resistant A. xylosoxidans. Clinical tolerance was perfect, but initial bronchoalveolar lavage (BAL) still grew A. xylosoxidans. The patient’s respiratory condition slowly improved and oxygen therapy was stopped. Low-grade airway colonization by A. xylosoxidans persisted for months before samples turned negative. No re-colonisation occurred more than two years after phage therapy was performed and imipenem treatment was stopped. Whole genome sequencing indicated that the eight A. xylosoxidans isolates, collected during phage therapy, belonged to four delineated strains, whereby one had a stop mutation in a gene for a phage receptor. The dynamics of lung colonisation were documented by means of strain-specific qPCRs on different BALs. We report the first case of phage therapy for A. xylosoxidans lung infection in a lung-transplanted patient. The dynamics of airway colonization was more complex than deduced from bacterial culture, involving phage susceptible as well as phage resistant strains. View Full-Text
Keywords: cystic fibrosis; lung transplantation; antibiotic resistance; Achromobacter xylosoxidans; bacteriophage therapy cystic fibrosis; lung transplantation; antibiotic resistance; Achromobacter xylosoxidans; bacteriophage therapy
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MDPI and ACS Style

Lebeaux, D.; Merabishvili, M.; Caudron, E.; Lannoy, D.; Van Simaey, L.; Duyvejonck, H.; Guillemain, R.; Thumerelle, C.; Podglajen, I.; Compain, F.; Kassis, N.; Mainardi, J.-L.; Wittmann, J.; Rohde, C.; Pirnay, J.-P.; Dufour, N.; Vermeulen, S.; Gansemans, Y.; Van Nieuwerburgh, F.; Vaneechoutte, M. A Case of Phage Therapy against Pandrug-Resistant Achromobacter xylosoxidans in a 12-Year-Old Lung-Transplanted Cystic Fibrosis Patient. Viruses 2021, 13, 60. https://doi.org/10.3390/v13010060

AMA Style

Lebeaux D, Merabishvili M, Caudron E, Lannoy D, Van Simaey L, Duyvejonck H, Guillemain R, Thumerelle C, Podglajen I, Compain F, Kassis N, Mainardi J-L, Wittmann J, Rohde C, Pirnay J-P, Dufour N, Vermeulen S, Gansemans Y, Van Nieuwerburgh F, Vaneechoutte M. A Case of Phage Therapy against Pandrug-Resistant Achromobacter xylosoxidans in a 12-Year-Old Lung-Transplanted Cystic Fibrosis Patient. Viruses. 2021; 13(1):60. https://doi.org/10.3390/v13010060

Chicago/Turabian Style

Lebeaux, David, Maia Merabishvili, Eric Caudron, Damien Lannoy, Leen Van Simaey, Hans Duyvejonck, Romain Guillemain, Caroline Thumerelle, Isabelle Podglajen, Fabrice Compain, Najiby Kassis, Jean-Luc Mainardi, Johannes Wittmann, Christine Rohde, Jean-Paul Pirnay, Nicolas Dufour, Stefan Vermeulen, Yannick Gansemans, Filip Van Nieuwerburgh, and Mario Vaneechoutte. 2021. "A Case of Phage Therapy against Pandrug-Resistant Achromobacter xylosoxidans in a 12-Year-Old Lung-Transplanted Cystic Fibrosis Patient" Viruses 13, no. 1: 60. https://doi.org/10.3390/v13010060

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