Engineered Phage Therapy for Mycobacterial Infection

Nontuberculous mycobacterial infections are common in patients with cystic fibrosis and can be persistent despite appropriate antimicrobial therapy. This occurred in a 15-year-old boy infected with Mycobacterium abscessus massiliense prior to a bilateral lung transplant. After transplantation, he developed pulmonary, sternal, hepatic, and cutaneous infection with the same organism despite continued antimicrobial therapy.

Three phages specific to the patient's infecting organism were identified. Two of these were genetically engineered to have lytic activity. All three were combined into a single three-phage cocktail that was infused intravenously every 12 hours for 32 weeks. In addition, topical therapy was applied to visible cutaneous lesio…