title: Experimental phage therapy of burn wound infection: difficult first steps.
abstract: Antibiotic resistance has become a major public health problem and the antibiotics pipeline is running dry. Bacteriophages (phages) may offer an 'innovative' means of infection treatment, which can be combined or alternated with antibiotic therapy and may enhance our abilities to treat bacterial infections successfully. Today, in the Queen Astrid Military Hospital, phage therapy is increasingly considered as part of a salvage therapy for patients in therapeutic dead end, particularly those with multidrug resistant infections. We describe the application of a well-defined and quality controlled phage cocktail, active against Pseudomonas aeruginosa and Staphylococcus aureus, on colonized burn wounds within a modest clinical trial (nine patients, 10 applications), which was approved by a leading Belgian Medical Ethical Committee. No adverse events, clinical abnormalities or changes in laboratory test results that could be related to the application of phages were observed. Unfortunately, this very prudent 'clinical trial' did not allow for an adequate evaluation of the efficacy of the phage cocktail. Nevertheless, this first 'baby step' revealed several pitfalls and lessons for future experimental phage therapy and helped overcome the psychological hurdles that existed to the use of viruses in the treatment of patients in our burn unit.
authors.affiliation: Burn Wound Center, Queen Astrid Military Hospital Bruynstraat 1, B-1120 Brussel, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rose
authors.affiliation: Laboratory for Molecular and Cellular Technology, Burn Wound Center, Queen Astrid Military Hospital Bruynstraat 1, B-1120 Brussel, Belgium.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Verbeken
authors.affiliation: Laboratory for Molecular and Cellular Technology, Burn Wound Center, Queen Astrid Military Hospital Bruynstraat 1, B-1120 Brussel, Belgium.
authors.forename: Daniel De
authors.initials: DD
authors.lastname: Vos
authors.affiliation: Laboratory for Molecular and Cellular Technology, Burn Wound Center, Queen Astrid Military Hospital Bruynstraat 1, B-1120 Brussel, Belgium ; Eliava Institute of Bacteriophage, Microbiology and Virology 3, Gotua street, Tbilisi 0160, Georgia ; Laboratory of Bacteriology Research, University of Ghent De Pintelaan 185, B-9000 Gent, Belgium.
authors.forename: Maya
authors.initials: M
authors.lastname: Merabishvili
authors.affiliation: Laboratory of Bacteriology Research, University of Ghent De Pintelaan 185, B-9000 Gent, Belgium.
authors.forename: Mario
authors.initials: M
authors.lastname: Vaneechoutte
authors.affiliation: Laboratory of Gene Technology, Katholieke Universiteit Leuven Kasteelpark Arenberg 21, B-3001 Leuven, Belgium.
authors.forename: Rob
authors.initials: R
authors.lastname: Lavigne
authors.affiliation: Burn Wound Center, Queen Astrid Military Hospital Bruynstraat 1, B-1120 Brussel, Belgium.
authors.forename: Serge
authors.initials: S
authors.lastname: Jennes
authors.affiliation: Department of Physiology, Vrije Universiteit Brussel Laerbeeklaan 101, B-1090 Brussel, Belgium.
authors.forename: Martin
authors.initials: M
authors.lastname: Zizi
authors.affiliation: Burn Wound Center, Queen Astrid Military Hospital Bruynstraat 1, B-1120 Brussel, Belgium.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Pirnay
keywords: Phage therapy; Pseudomonas aeruginosa; Staphylococcus aureus; antibiotic resistance; burn wound; infection