Concept of individualized medicine based on personalized phage therapy for intensive care unit patients suffering from healthcare‑associated infections

Authors / Institutions

Andrey V. Aleshkin / G.N.Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Federal Supervision Service for Consumer Rights Protection and People’s Welfare, Moscow, Russian Federation

Andrei S. Shkoda / L.A.Vorokhobov Municipal Clinical Hospital No 67 of the Moscow Health Department, Moscow, Russian Federation

Svetlana S. Bochkareva / G.N.Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Federal Supervision Service for Consumer Rights Protection and People’s Welfare, Moscow, Russian Federation

Olga N. Ershova / N.N.Burdenko Neurosurgery Research Institute, Moscow, Russian Federation

Sergei D. Mitrokhin / L.A.Vorokhobov Municipal Clinical Hospital No 67 of the Moscow Health Department, Moscow, Russian Federation

Irina A. Kiseleva / G.N.Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Federal Supervision Service for Consumer Rights Protection and People’s Welfare, Moscow, Russian Federation

E.R.Zul'karneev / G.N.Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Federal Supervision Service for Consumer Rights Protection and People’s Welfare, Moscow, Russian Federation

Evgenii O. Rubalskii / G.N.Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Federal Supervision Service for Consumer Rights Protection and People’s Welfare, Moscow, Russian Federation / Astrakhan State Medical University, Astrakhan, Russian Federation

Lidiya I. Novikova / G.N.Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology, Federal Supervision Service for Consumer Rights Protection and People’s Welfare, Moscow, Russian Federation

O.E.Orlova / L.A.Vorokhobov Municipal Clinical Hospital No 67 of the Moscow Health Department, Moscow, Russian Federation

M.G.Shvydkaya / L.A.Vorokhobov Municipal Clinical Hospital No 67 of the Moscow Health Department, Moscow, Russian Federation

A.N.Kalakutskaya / L.A.Vorokhobov Municipal Clinical Hospital No 67 of the Moscow Health Department, Moscow, Russian Federation

M.V.Zeigarnik / N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation / «Nutrition and Health» Medical Center, Moscow, Russian Federation

Karaulov A. Viktorovich / I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation

Effectiveness of serially produced bacteriophages is high in case of intestinal and respiratory infections caused by communityacquired antimicrobial resistant (AMR) pathogens. However, mass-produced phages don’t consider the rapid changes in circulating strains causing HAIs, the formation of anti-phage immunity, phage pharmacokinetics, etc. We have developed an algorithm of personalized phage therapy for ICU patients suffering from HAIs which increases the efficiency of phage therapy by 30 per cent. It consists of three consecutive stages: 1. Determination of sensitivity of target bacterium to bacteriophage preparation; 2. Determination by enzyme-linked immunosorbent assay (ELISA) of IgG-antibodies in the patients’ sera active against the phages used; 3. Selection of pharmaceutical form and administration route based on the preliminary phage pharmacokinetics study. Sound and safe update of phage compositions, used against HAI-pathogens, requires the creation of an up-to-date collection of pheno- and genotypically characterized bacteriophages that expect to be included into ready-to-use pharmaceutical forms on the first demand of the hospital.

Key words: HAIs, AMR, ICU, bacteriophages, personalized phage therapy.

For citation: Aleshkin A.V., Shkoda A.S., Bochkareva S.S., Ershova O.N., Mitrokhin S.D., Kiseleva I.A., Zul’karneev E.R., Rubal’skiy E.O., Novikova L.I., Orlova O.E., Shvydkaya M.G., Kalakuttskaya A.N., Zeigarnik M.V., Karaulov A.V. Concept of individualized medicine based on personalized phage therapy for intensive care unit patients suffering from healthcare-associated infections. Infekc. bolezni (Infectious diseases). 2017; 15(4): 49–54.
DOI: 10.20953/1729-9225-2017-4-49-54