Table 1.
Data collection, after reading the full texts of the selected articles.
| Author(s)/ Reference |
Country | Year of Publication | Multidrug-Resistant Bacteria | Site or Type of Infection | Patients (Number/Gender/ Age) |
Comorbidities/ Medical History | Adverse Effects | Effect of the Treatment |
|---|---|---|---|---|---|---|---|---|
| Ooi, M.L. et al. [37] |
Australia | 2019 | Staphylococcus aureus | Recalcitrant chronic rhinosinusitis caused by a biofilm | 9/4 men, 5 women/ 18–70 years of age |
Endoscopic sinus surgery | Diarrhea, epistaxis, oropharyngeal pain, cough, rhinalgia, and low blood bicarbonate level | Positive treatment effect: 2 patients were cured and the others showed reduced bacterial growth |
| Schooley, R.T. et al. [25] |
U.S. | 2017 | Acinetobacter baumannii | Pancreatic pseudocyst infection | 1/male/68 years of age | Diabetic, necrotizing pancreatitis | Not reported | Positive treatment effect: patient showed continuous clinical improvement, woke up from coma, showed renal improvement, and was extubated |
| Jault, P. et al. [23] |
France–Belgium | 2018 | Pseudomonas aeruginosa- Escherichia coli | Infection of wounds from burns on the skin | 12/men and women/ over 18 years of age |
Hospitalized patients, treated for burns in a burn unit | No adverse effects related to PT were observed | No/insufficient treatment effect owing to the administration of a very low treatment dose |
| Law, N. et al. [34] |
U.S. | 2019 | Pseudomonas aeruginosa | Respiratory tract infection | 1/woman/26 years of age | Patient with cystic fibrosis, persistent respiratory failure, and renal failure | No adverse effects related to PT were observed | Positive treatment effect: pneumonia clinically resolved, baseline renal function was restored, and fever disappeared |
| Aslam, S. et al. [19] |
U.S. | 2019 | Pseudomonas aeruginosa-Burkholderia dolosa-Mycobacterium abscessus | Lower respiratory tract infections | 3/1 man, 2 women/ 67, 28, and 57 years of age |
Lung transplantation and progressive kidney failure | Intravenous and nebulized formulations of bacteriophages were well tolerated without adverse effects attributed to bacteriophage administration | A positive effect of the treatment was observed in two of the three patients (one male and female, each aged 67 years) as they did not develop further infection with Pseudomonas aeruginosa, and their respiratory status markedly improved. The 28-year-old patient died. However, this was not attributed to PT, but rather to a sequence of events that led to multi-organ failure, most plausibly attributable to postsplenectomy complications and liver disease. Hence, a verdict on the treatment was not possible. |
| Nir-Paz, R. et al. [35] |
U.S. | 2019 | Acinetobacter baumannii-Klebsiella pneumoniae | Left tibial infection following trauma | 1/male/42 years of age | Grade IIIA bilateral open fractures of the lower extremities: left bicondylar tibial plateau fracture with compartment syndrome and right distal femoral fracture | No adverse effects associated with PT were observed | Positive treatment effect, with healing of the graft and elimination of subtle chronic bone pain in the left leg. During a follow-up period of 8 months after treatment, no Ab- or Kp-positive cultures were obtained from any site. |
| Tkhilaisshvili, T. et al. [33] |
Germany | 2019 | Pseudomonas aeruginosa- Staphylococcus epidermidis | Chronic recurrent periprosthetic infection of the knee and chronic osteomyelitis of the femur | 1/woman/ 80 years of age |
Metabolic syndrome (type II diabetes mellitus and obesity) and chronic renal failure | No adverse effects related to PT were observed | Positive treatment effect. The patient did not report pain in the right knee; the soft tissue at the surgical site did not show complications; and mobility was satisfactory. All periprosthetic tissue samples collected intraoperatively resulted in negative cultures. |
| Corbellino, M. et al. [28] |
Italy | 2019 | Klebsiella pneumoniae | Infections of the gastrointestinal and urinary tracts | 1/male/57 years of age | Crohn’s disease, obstructive nephrolithiasis, right nephrectomy and radical cystectomy, and stage III chronic renal failure | No adverse effects related to PT were observed | Positive treatment effect. Long-lasting multi-site colonization by an MDR Kp strain in a patient with a single kidney, a cutaneous ureterostomy, and an indwelling ureteral stent resolved after a 3-week course of PT. |
| Duplessis, C. et al. [36] |
U.S. | 2017 | Pseudomonas aeruginosa | Recalcitrant infection after ASD/VSD closures | 1/male (child)/2 years of age | DiGeorge syndrome and complex congenital heart disease, including a type B interrupted aortic arch, posterior misalignment of a ventricular septal defect (VSD), sub-aortic stenosis, bicuspid aortic valve, and secundum atrial septal defect | Decompensation owing to anaphylaxis, which was subsequently attributed to progressive heart failure, although the release of endotoxins as a contributing factor could not be ruled out | Clinical improvement was seen after treatment for several days with PT; however, the patient decompensated and developed severe arrhythmias and cardiac and septic shocks. This turbulent worsening was attributed to the progressive accumulation of undrained fluids, a history of influenza infection, and end-stage heart failure. Finally, the child passed away. |
| Qin, J. et al. [24] |
China | 2021 | Klebsiella pneumoniae | Multifocal urinary tract infections | 1/male/66 years of age | The patient’s cancerous bladder was partially resected | No adverse effects related to PT were observed | Negative treatment effect. The phage cocktail did not work. It is believed that the heterogeneous bacteria that colonized the renal pelvis could not be effectively eliminated because the phages could not reach them. |
| Tan, X. et al. [26] |
China | 2021 | Acinetobacter baumannii | Lung infection | 1/male/86 years of age | Exacerbation of chronic obstructive pulmonary disease and type II diabetes | No adverse effects related to PT were observed | Positive treatment effect, with elimination of the pathogen and clinical improvement of the patient’s lung function |
| Hoyle, N. et al. [29] |
Georgia | 2018 | Achromobacter xylosoxidans | Chronic lung infection | 1/female/ 17 years of age |
Cystic fibrosis | No adverse effects related to PT were observed | Positive treatment effect; dyspnea resolved and cough was reduced. Lung function: FEV1 increased. |
| Leitner, L. et al. [38] |
Georgia | 2018 | Enterococcus spp. Escherichia coli, Streptococcus spp. | Urinary tract infection | 28/men/ over 18 years of age |
Transurethral resection of the prostate (TURP), with complicated or recurrent uncomplicated UTI without signs of systemic infection | No adverse effects related to PT were observed | Positive effect of treatment in 60% of patients, with normalization of urine cultures |
| Cano, E.J. et al. [30] |
U.S. | 2020 | Klebsiella pneumoniae | Knee joint prosthesis infection | 1/male/62 years of age | Diabetes mellitus, obesity, total knee arthroplasty, multiple bacterial infections | No adverse effects related to PT were observed | Positive treatment effect. The patient showed improvement and remained asymptomatic 34 weeks after completing the treatment, in addition to showing improvement of erythema, swelling, pain, range of motion, and function of his right lower extremity. |
| Gupta, P. et al. [44] |
Varanasi, India | 2019 | Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa | Infection of chronic wounds (ulcers) that do not heal | 20/12–60 years of age | Not reported | No adverse effects related to PT were observed | Positive treatment effect in 7 patients who completely healed; the others showed significant improvement in terms of wound healing |
| Lebeaux, D. et al. [45] |
Paris, France | 2021 | Achromobacter xylosoxidans | Persistent lung infection | 1/male/12 years of age | Cystic fibrosis and double lung transplantation | No adverse effects related to PT were observed | Positive effect. Respiratory condition gradually improved, and the bacterial load decreased. |
| Nadareishvili, L. et al. [40] |
Georgia | 2020 | Staphylococcus aureus | Osteomyelitis of the sternum and parasternal abscess | 1/male/74 years of age | Coronary artery graft, type II diabetes mellitus, high blood pressure | Not reported | Positive treatment effect. The diameter of the wound decreased and the purulent fistula closed. |
| Staphylococcus aureus | Chronic osteomyelitis of the right tibia | 1/female/ 60 years of age |
Type II diabetes mellitus | Not reported | Positive treatment effect with complete wound closure | |||
| Burkholderia cepacia, S. aureus, and Enterococcus faecalis | Osteomyelitis with foot ulcer | 1/male/69 years of age | Type II diabetes mellitus | Not reported | Positive treatment effect. The patient improved and the ulcer healed. | |||
| Pseudomonas aeruginosa, then by Staphylococcus aureus and Serratia Marcescens | Laryngeal (post-surgical) infection | 1/male/68 years of age | Removal of the larynx due to carcinoma | Not reported | Positive treatment effect. The patient improved and infection was completely cured. | |||
| Patel, D.R. et al. [46] |
India | 2019 | Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Proteus species, Citrobacter freundii, Morganella morganii, Acinetobacter baumannii | Chronic wound infection of the skin | 48/34 men, 14 women/12–70 years of age | 27 diabetics, 8 with high blood pressure, 2 with tuberculosis, and 10 with amputations | Not reported | Positive treatment effect in 39 patients who were completely cured; 2 patients died |
| Fadlallah, A. et al. [31] |
Georgia | 2015 | Staphylococcus aureus | Eye infection/bacterial keratitis | 1/female/65 years of age | Postoperative corneal abscess of the left eye and interstitial keratitis after craniotomy for acoustic neurinoma | No adverse effects related to PT were observed | Positive treatment effects, with stabilization of ocular signs and negative eye and nasal cultures |
| Jennes, S. et al. [41] |
Belgium | 2017 | Pseudomonas aeruginosa | Acute kidney infection after injury | 1/male/61 years of age | Peritonitis owing to Enterobacter cloacae and severe abdominal sepsis with disseminated intravascular coagulation secondary to strangulated diaphragmatic hernia. The patient had a prolonged hospital stay complicated by peripheral gangrene of his extremities, which resulted in the amputation of the lower limbs and the development of large necrotic pressure ulcers. | No adverse effects related to PT were observed | Positive treatment effects; blood cultures were negative, CRP levels decreased, and fever disappeared. Kidney function recovered within a few days. However, the patient died after 4 months from a sudden refractory cardiac arrest in the hospital due to Klebsiella pneumoniae. |
| Kuipers, S. et al. [42] |
Holland | 2020 | Klebsiella pneumoniae | Recurrent urinary tract infection | 1/male/58 years of age | Kidney transplant | No adverse effects related to PT were observed | Positive treatment effects. The symptoms of urethritis quickly disappeared. |
| Onsea, S. et al. [43] |
Belgium | 2019 | P. aeruginosa and S. epidermidis | Chronic osteomyelitis of the pelvis | Patient 1 | Isolated fibrous tumor in the left pelvic region | Not reported | Positive treatment effects. C-reactive protein and white blood cell levels returned to normal. |
| P. aeruginosa and S. epidermidis | Non-union of distal femur | Patient 2 | Polytrauma after aggression, with open segmental fractures of the right femur | Not reported | Positive treatment effects. The levels of C-reactive protein and white blood cells returned to normal. Infection-free. | |||
| S. agalactiae and S. aureus | Postoperative problems of the femur wound | Patient 3 | Polytrauma after the collapse of a building, with crush injuries of the upper right leg and complex fractures of the femur | Not reported | Positive treatment effects. C-reactive protein and white blood cell levels returned to normal. | |||
| E. faecalis | Infection of the surgical site with abscess formation and evolution to osteomyelitis of the femur | Patient 4 | Polytrauma after traffic accident, with fracture of the femur | Local redness and pain | Positive treatment effects. C-reactive protein and white blood cell levels returned to normal. | |||
| Wu, N. et al. [27] |
Shanghai, China | 2021 | Acinetobacter baumannii | Respiratory tract infection acquired in the hospital | 1/male/62 years of age | Critical condition due to COVID-19 (RNA-negative) and co-infection with Candida albicans and Ralstonia mannitolilytica | Cytokine storm and fever 4 h after 1Ф phage administration | Positive treatment effects. Clinical improvement, discharged from the hospital on day 30. |
| Respiratory tract and intubation wound infections acquired in the hospital | 1/male/64 years of age | Critical condition due to COVID-19 (RNA-negative) | No adverse effects related to PT were observed | Positive treatment effects. Clinical improvement and discharge from the hospital on day 9. | ||||
| Respiratory tract infection acquired in the hospital | 1/male/81 years of age | Critical condition due to COVID-19 (RNA-negative) and co-infection with Candida albicans and Candida glabrata | No adverse effects related to PT were observed | Positive treatment effects. The infection was eliminated; however, patient died on day 10 owing to respiratory failure caused by infection with Klebsiella pneumoniae. | ||||
| Respiratory tract and bladder infections acquired in the hospital | 1/male/78 years of age | Critical status due to COVID-19 (RNA-negative) and co-infection with Candida albicans, Klebsiella pneumoniae resistant to carbapenems, and Sphingomonas paucimobilis | No adverse effects related to PT were observed | Positive treatment effect with improvement, patient was discharged from the ICU on day 7; however, he died on day 40 owing to respiratory failure | ||||
| Bao, J. et al. [22] |
Shanghai, China | 2020 | Klebsiella pneumoniae | Recurrent urinary tract infection | 1/female/63 years of age | Type II diabetes and hypertension | No adverse effects related to PT were observed | Positive treatment effect. The infection was completely eradicated. |
| Rose, T. et al. [39] |
Brussels, Belgium | 2014 | Pseudomonas aeruginosa and Staphylococcus aureus | Burn infection | 9/4 men, 5 women/ 27–88 years of age |
Not reported | No adverse effects related to PT were observed | Negative treatment effect. Low bacterial load, almost unchanged. |
| Rubalskii, E. et al. [32] |
Germany | 2020 | Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli | Patients had infections associated with immunosuppression after organ transplantation or had infections of vascular grafts, implanted medical devices, and surgical wounds | 8/7 men, 1 woman | Not reported | No adverse effects related to PT were observed | Positive effect of treatment in 7 patients who are completely cured; the other showed a significant improvement in terms of decreased bacterial load |