Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection

Jessica S. Little (), Rebekah M. Dedrick, Krista G. Freeman, Madison Cristinziano, Bailey E. Smith, Constance A. Benson, Tulip A. Jhaveri, Lindsey R. Baden, Daniel A. Solomon and Graham F. Hatfull
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Jessica S. Little: Division of Infectious Diseases, Brigham and Women’s Hospital
Rebekah M. Dedrick: University of Pittsburgh
Krista G. Freeman: University of Pittsburgh
Madison Cristinziano: University of Pittsburgh
Bailey E. Smith: University of Pittsburgh
Constance A. Benson: University of California San Diego
Tulip A. Jhaveri: Division of Medical Microbiology, Brigham and Women’s Hospital
Lindsey R. Baden: Division of Infectious Diseases, Brigham and Women’s Hospital
Daniel A. Solomon: Division of Infectious Diseases, Brigham and Women’s Hospital
Graham F. Hatfull: University of Pittsburgh

Nature Communications, 2022, vol. 13, issue 1, 1-7

Abstract: Abstract Mycobacterium chelonae is a rare cause of chronic disseminated cutaneous infections in immunocompromised patients. Multidrug-resistant M. chelonae infections present a challenge for treatment, and prolonged antimicrobial courses lead to significant toxicities and further antimicrobial resistance. We report a case of refractory cutaneous disseminated M. chelonae infection in a patient with seronegative arthritis on immunotherapy with tofacitinib that was treated with combination antimicrobial, surgical, and single bacteriophage therapy with excellent clinical response. The patient developed neutralizing antibodies against the bacteriophage but continues to have stable improvement of disease with negative biopsies and no evidence of bacterial resistance to the phage.

Date: 2022
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DOI: 10.1038/s41467-022-29689-4

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