Do bacteriophages have a role in treating multidrug-resistant periprosthetic joint infection (PJI)?

Authors: Tristan Ferry, Antonio Pellegrini, Sébastien Lustig, Frédéric Laurent, Gilles Leboucher, Claudio Legnani, Vittorio Macchi, Silvia Gianola

RESPONSE: Unknown. Although some preclinical and clinical studies have demonstrated a good safety profile as well as promising therapeutic effects using bacteriophages for treating bone and joint infections, further clinical research using bacteriophage therapy in patients with multidrug-resistant PJI is required.
There are known obstacles to bacteriophage therapy, including the fact that bacteriophages are neutralized in serum and relevant pathogens contain Clustered Regularly Interspaced Short Palindromic Repeats – associated protein-9 nuclease (CRISPR/cas9) immunity against bacteriophage. Phages are usually bacterial strain-specific; thus, a cocktail of different bacteriophage lineages may be necessary to effectively treat biofilm-mediated infections.

LEVEL OF EVIDENCE: Consensus

DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)

B13