Table 1.
Baseline characteristics, treatments, and outcomes of the patients*.
| Patient 1 | Patient 2 | Patient 3 | Patient 4 | |||
|---|---|---|---|---|---|---|
| Characteristics at baseline | ||||||
| Age-year | 62 | 64 | 81 | 78 | ||
| SARS-CoV-2 status (RNA, Antibodies)a | (Negative, Positive) | (Negative, Positive) | (Negative, Positive) | (Negative, Positive) | ||
| CRAB infections (days after admission to ICU) | Respiratory tract (18) | Respiratory tract (21) | Wound (34)b | Respiratory tract (40) | Respiratory tract (18) | |
| Days before phage therapy | 11 | 38 | 1 | 6 | 50 | |
| CRAB detected samples | Sputum, BALF | Sputum, BALF | Secretion | Sputum, BALF | Sputum, BALF, Urine | |
| Coexisting infections | Candida albicans | Candida albicans, Ralstonia mannitolilytica | ND | Candida albicans, Candida glabrata | Candida albicans, CSKP, Sphingomonas paucimobilis | |
| Antibiotic and life-support treatment | ||||||
| Principal antibiotics (Susceptibility) | CFP/SUL (S/I) | CFP/SUL (S/I), TGC (S), LEV (S/I) |
MPM (R), CFP/SUL (S/I) | TGC (S), IPM (R), CFP/SUL (S/I) | ||
| Life-support status | MV, ECMO | MV, ECMO | MV, ECMO, CRRT | MV | ||
| Phage therapy | ||||||
| Therapeutic phages | 1ɸ | 2ɸ | 2ɸ | 2ɸ | 2ɸ | 2ɸ |
| Administrated route | Inhalation | Inhalation | Inhalation | Wet compress | Inhalation | Inhalation |
| Primary indicators | ||||||
| Semi-quantitative CRAB (24 h before, after)c | (4+, 2+) | (4+, 2+) | (3+, 2+) | (4+, Negative) | (4+, Negative) | (4+, 2+) |
| Phage resistance of evolved CRAB | Yes | Yes | Yes | NA | NA | Yes |
| Adverse event | fever, IL-6&IL-8 storm | ND | ND | ND | ND | ND |
| Outcome | Discharged from hospital Day 30 |
Discharged from hospital Day 9 |
Died Day 10 | Discharged from ICU Day 7, Died Day 40 | ||
*SARS-CoV-2, Severe acute respiratory syndrome coronavirus-2; CRAB, Carbapenem-resistant Acinetobacter baumanni; ICU, Intensive care unit; BALF, Bronchoalveolar lavage fluid; ND, Not detectable; CSKP, Carbapenem-resistant Klebsiella Pneumoniae; CFP/SUL, Cefoperazone-sulbactam; TGC, Tigecycline; LEV, Levofloxacin; MPM, Meropenem; IPM, Imipenem; S, Susceptible; R, Resistant; I, Intermediate; MV, Mechanical ventilation; ECMO, Extracorporeal membrane oxygenation; CRRT, Continuous Renal Replacement Therapy; 1ɸ, ɸ124; 2ɸ, ɸ124+ɸ121; NA, Not applicable.
SARS-CoV-2 RNA status in throat swab and IgG/IgM status in serum.
Wound infection on the jugular intubation site of ECMO.
Semi-quantitative burden of bacteria was measured by streak-plate method.