摘要
目的由于多重耐药细菌的不断出现,噬菌体疗法再次出现在公众的视野里,笔者着重介绍噬菌体疗法在临床上用于多种多重耐药细菌性肺炎的现状,以期为噬菌体应用于肺部感染提供文献证据。方法采用关键词“噬菌体”或“噬菌体疗法”或“噬菌体裂解酶”或“工程噬菌体”和“肺炎”在知网和pubmed网站进行文献检索,并将检索到的病例报告按照病原分类进行介绍。结果用于治疗肺炎的噬菌体疗法随机对照试验(randomized controlled trial,RCT)临床研究尚无公开报道,但噬菌体在铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌和鲍曼不动杆菌感染性肺炎的治疗中取得了较好的疗效,且仅有一例不良反应报告。同时,笔者探讨了噬菌体疗法目前面临的细菌耐药、自身的安全性或免疫系统对其疗效的影响等困难及噬菌体裂解酶和工程噬菌体两种噬菌体疗法的最新发展方向。结论噬菌体在治疗呼吸道感染,特别是那些由多重耐药细菌引起的感染方面还是具有应用前景。未来会有更多的体内研究来回答噬菌体衍生物或是工程噬菌体治疗的有效性和安全性。
OBJECTIVE To review the latest progress of phage therapy in clinical application of multiple multidrug-resistant bacterial pneumonia,in order to provide documentary evidence for the application of phage in pulmonary infection.METHODS The keywords“phage”or“phage therapy”or“phage endolysin”or“engineered phage”and“pneumonia”were used in literature search on CNKI and pubmed,and the retrieved case reports were reviewed according to pathogen classification.RESULTS Clinical studies on randomized controlled trial(RCT)of phage therapy for the treatment of pneumonia had not been publicly reported,but phage had achieved good efficacy in the treatment of pneumonia infected by Pseudomonas aeruginosa,Staphylococcus aureus,Klebsiella pneumoniae and Acinetobacter baumannii,and only one adverse reaction had been reported.At the same time,this paper discussed the current difficulties of bacteriophage therapy,such as bacterial resistance,its own safety or the influence of immune system on its efficacy,and the latest development direction of phage endolysin and engineered phage therapy.CONCLUSION Bacteriophages have a promising future in the treatment of respiratory infections,especially those caused by multidrug-resistant bacteria.In the future,more in vivo studies may be needed to answer questions about the efficacy and safety of phage derivatives or engineered phage therapy.
作者
付涵宇
曹玲
甘霖
袁静
FU Hanyu;CAO Ling;GAN Lin;YUAN Jing(Department of Pulmonology,The Affiliated Children's Hospital,Capital Institute of Pediatrics,Beijing 100020,China;Department of Bacteriology,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中国药学杂志》
CAS
CSCD
北大核心
2024年第6期549-554,共6页
Chinese Pharmaceutical Journal
关键词
噬菌体
多重耐药菌
噬菌体裂解酶
工程噬菌体
肺炎
bacteriophage
multidrug resistance bacteria
bacteriophage lysin
engineered phage
pneumonia
