Phage Therapy in Traumatology: A Review on Perspectives for Treating Acute Wounds and Post-Surgical Complications
DOI:
https://doi.org/10.15407/microbiolj86.05.117Keywords:
pathogenic microbiota, bacteriophages, phage therapy, bacterial complications, purulent wounds, gunshot and mine-explosive injuries, antibiotic resistanceAbstract
Full-scale hostilities in Ukraine led to an unprecedented number of victims with serious injuries, including gunshot wounds, broken bones, and mine-explosive injuries. Wound infections are one of the main causes of non-combat losses of personnel. A prerequisite for the development of a wound infection, among other things, is high microbial contamination of combat wounds. Major bacteria causing such infections are staphylococci (Staphylococcus aureus, S. epidermidis), streptococci (Streptococcus pyogenes, St. agalictiae), enterococci (Enterococcus faecalis), gram-negative bacteria (Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii), anaerobic bacteria (Clostridium perfringens, Bacterioides spp.), etc. Modern data indicate a change in the current species composition of causative agents of wound infections, an increase both in the polyresistance of the microbiota to antibacterial drugs and in the frequency of biofilm formation protecting pathogenic microorganisms from antimicrobial therapy and the patient’s immune response. Such purulent bacterial infections require new approaches to therapy. Taking into account the large number of combat injuries in Ukraine, the use of bacteriophages as specific agents for the biological control of pathogenic microbiota is of particular importance. In view of the nature of injuries, phage preparations intended for the treatment of purulent-surgical infections of wound and burn surfaces are considered the most promising and in demand today. This review summarizes modern data on the use of phage preparations in clinics and in orthopedics and traumatology in particular. Issues of the delivery of phages to the focus of infection, their effective dose, duration of therapy, and the possibility of combining it with antibiotic therapy are discussed. Information about phage therapy programs that have already been implemented in some countries is presented. The advantages and disadvantages of the use of bacteriophages for personalized therapy of severe patients are highlighted, and the prospects for further research are indicated.
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