Patients who have undergone cardiac surgery are at very high risk of infectious complications, which can be fatal. Infections associated with transplants and implanted devices often become chronic. The bacteria that cause them tend to form biofilms and are therefore relatively resistant to antibiotics. An additional risk factor for severe infectious complications in patients following heart or lung transplantation is the use of immunosuppressive drugs. Given the rapid spread of antibiotic-resistant strains worldwide, the search for alternative methods of combating bacterial infections is urgent. Bacteriophages are increasingly being used to treat biofilm-forming and/or antibiotic-resistant infections in various fields of medicine—internal medicine, cardiology, pulmonology, orthopedics, otolaryngology, and dermatology.

In May 2020, an article* was published in the journal Antibiotics describing the experience of using bacteriophage preparations to treat eight patients with multidrug-resistant Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli infections after transplantation or implantation of cardiac devices.

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The patients ranged in age from 13 to 66 years; there were seven men and one woman. The pathogen was isolated from each patient, and specific phages were selected. Phage preparations were administered topically, orally, or by inhalation, depending on the lesions. Phages were administered topically in combination with fibrin glue, which consists of fibrinogen and thrombin and has good adhesive and hemostatic properties. The duration of phage therapy was determined individually. Phage therapy was administered in conjunction with traditional antibiotic therapy (which alone did not eliminate the pathogen).

Eradication of target bacteria was achieved in 7 of 8 participants.

No significant side effects were observed during phage therapy.

The authors of the article note that phage therapy may be effective in treating bacterial infections in cardiac surgery patients that are resistant to traditional antibiotic therapy.

* Rubalskii E, Ruemke S, Salmoukas Ch et al. Bacteriophage Therapy for Critical Infections Related to Cardiothoracic Surgery. Antibiotics 2020, 9(5), 232; https://doi.org/10.3390/antibiotics9050232