The potential utility of phage therapy in the treatment of periprosthetic infection caused by multidrug-resistant pathogens: a review

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Abstract

Background. One of the main and most costly problems in large joint arthroplasty associated with socially significant losses is periprosthetic infection. Of particular importance is periprosthetic joint infection (PJI) caused by antibiotic-resistant pathogens and followed by the worst treatment results. Currently, when antibiotic-resistant pathogens are spreading rapidly, particularly in health facilities, researchers are constantly looking for alternative treatments for severe cases of PJI. Phage therapy can be one of these methods.

The aim of the review was to analyse the application of personalized bacteriophages in the management of periprosthetic infection caused by multidrug-resistant pathogens during arthroplasty of large joints of the lower extremities.

Methods. A 20-year literature search (2003-2023) was performed in the eLIBRARY, PubMed, Google Scholar, and Scopus electronic databases.

Results. During the search, 1.482 publications meeting the objectives of this review were found. Taking into account the inclusion/non-inclusion criteria adopted by the authors, the review included 12 studies describing 45 cases of the use of bacteriophages in the management of hip and knee PJI caused by multidrug-resistant pathogens. The infection was eradicated without recurrence in 42 cases (89.4%), recurrence was recorded only in 5 cases (10.6%).

Conclusions. The analysis of the literature confirms that a combination therapy of personalized phages and antibiotics as adjuvant therapy is safe and effective. Bacteriophage treatment is a promising direction in the fight against resistant pathogens of periprosthetic infection. Its combination with antibiotics seems to be the most promising, as it can significantly increase the effectiveness of therapy for infections caused by multidrug-resistant pathogens due to the synergy of these drug classes.

About the authors

Taalaibek U. Sheraliev

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Author for correspondence.
Email: sheraliev.taalai@mail.ru
ORCID iD: 0000-0002-7261-2730
SPIN-code: 8092-9687
Россия, Novosibirsk

Alexander G. Samokhin

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Email: motorist@inbox.ru
ORCID iD: 0000-0001-5599-3925

Cand. Sci. (Med.)

Россия, Novosibirsk

Baikozho R. Tashtanov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Email: b.tashtanov95@gmail.com
ORCID iD: 0000-0002-8553-9712
Россия, Novosibirsk

Andrey A. Korytkin

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Email: andrey.korytkin@gmail.com
ORCID iD: 0000-0001-9231-5891

Cand. Sci. (Med.)

Россия, Novosibirsk

Vitaliy V. Pavlov

Tsivyan Novosibirsk Research Institute of Traumatology and Orthopaedics

Email: pavlovdoc@mail.ru
ORCID iD: 0000-0002-8997-7330

Dr. Sci. (Med.)

Россия, Novosibirsk

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