Background

Respiratory infections caused by Staphylococcus aureus and Pseudomonas aeruginosa are a major concern for cystic fibrosis (CF) patients due to increasing antibiotic resistance. Bacteriophages, which are viruses that selectively target and kill bacteria, are being studied as an alternative treatment for these infections.

This systematic review evaluates the safety and effectiveness of bacteriophages for the treatment of CF-related infections caused by S. aureus and/or P. aeruginosa.

We conducted a search for original, published articles in the English language up to March 2023. Studies that administered bacteriophages via intravenous, nebulised, inhaled, or intranasal routes were included, with no comparators required. In vitro and in vivo studies were eligible for inclusion, and only animal in vivo studies that utilised a CF transmembrane conductance regulator (CFTR) animal model were included.

Bacteriophage treatment resulted in a decrease in bacterial load in both humans and animals infected with P. aeruginosa. Complete eradication of P. aeruginosa was only observed in one human subject. Additionally, there was a reduction in biofilm, improvement in resistance profile, and reduced pulmonary exacerbations in individual case reports. Evidence suggests that bacteriophage therapy may be a promising treatment option for CF-related infections caused by P. aeruginosa and S. aureus. However, larger and more robust trials are needed to establish its safety and efficacy and create necessary evidence for global legislative frameworks.

中文翻译：

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使用噬菌体治疗囊性纤维化中金黄色葡萄球菌和铜绿假单胞菌感染的系统评价

背景

由于抗生素耐药性不断增加，金黄色葡萄球菌和铜绿假单胞菌引起的呼吸道感染是囊性纤维化 (CF) 患者的主要担忧。噬菌体是一种选择性靶向并杀死细菌的病毒，目前正在研究作为这些感染的替代治疗方法。

本系统综述评估了噬菌体治疗由金黄色葡萄球菌和/或铜绿假单胞菌引起的 CF 相关感染的安全性和有效性。

我们对截至 2023 年 3 月为止发表的英文原创文章进行了检索。其中包括通过静脉内、雾化、吸入或鼻内途径施用噬菌体的研究，不需要比较器。体外和体内研究符合纳入条件，并且仅纳入利用 CF 跨膜电导调节器 (CFTR) 动物模型的动物体内研究。

噬菌体治疗导致感染铜绿假单胞菌的人和动物的细菌负荷减少。仅在一名人类受试者中观察到铜绿假单胞菌完全根除。此外，个别病例报告中生物膜减少，耐药性改善，肺部病情恶化减少。有证据表明，噬菌体疗法可能是治疗由铜绿假单胞菌和金黄色葡萄球菌引起的 CF 相关感染的一种有前途的治疗选择。然而，需要更大规模、更强有力的试验来确定其安全性和有效性，并为全球立法框架创造必要的证据。