Adjunctive phage therapy improves antibiotic treatment of ventilator-associated-pneumonia with Pseudomonas aeruginosa

Abstract Bacterial multidrug resistance poses an urgent challenge for the treatment of critically ill patients developing ventilator-associated pneumonia (VAP). Phage therapy, a potential alternative when conventional antibiotics fail, has been unsuccessful in first clinical trials when used alone....

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Main Authors: Chantal Weissfuss, Jingjing Li, Ulrike Behrendt, Karen Hoffmann, Magdalena Bürkle, Chunjiang Tan, Gopinath Krishnamoorthy, Imke H. E. Korf, Christine Rohde, Baptiste Gaborieau, Laurent Debarbieux, Jean-Damien Ricard, Martin Witzenrath, Matthias Felten, Geraldine Nouailles
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-59806-y
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author Chantal Weissfuss
Jingjing Li
Ulrike Behrendt
Karen Hoffmann
Magdalena Bürkle
Chunjiang Tan
Gopinath Krishnamoorthy
Imke H. E. Korf
Christine Rohde
Baptiste Gaborieau
Laurent Debarbieux
Jean-Damien Ricard
Martin Witzenrath
Matthias Felten
Geraldine Nouailles
author_facet Chantal Weissfuss
Jingjing Li
Ulrike Behrendt
Karen Hoffmann
Magdalena Bürkle
Chunjiang Tan
Gopinath Krishnamoorthy
Imke H. E. Korf
Christine Rohde
Baptiste Gaborieau
Laurent Debarbieux
Jean-Damien Ricard
Martin Witzenrath
Matthias Felten
Geraldine Nouailles
author_sort Chantal Weissfuss
collection DOAJ
description Abstract Bacterial multidrug resistance poses an urgent challenge for the treatment of critically ill patients developing ventilator-associated pneumonia (VAP). Phage therapy, a potential alternative when conventional antibiotics fail, has been unsuccessful in first clinical trials when used alone. Whether combining antibiotics with phages may enhance effectiveness remains to be tested in experimental models. Here, we use a murine model of Pseudomonas-induced VAP to compare the efficacy of adjunctive phage cocktail for antibiotic therapy to either meropenem or phages alone. Combined treatment in murine VAP results in faster clinical improvement and prevents lung epithelial cell damage. Using human primary epithelial cells to dissect these synergistic effects, we find that adjunctive phage therapy reduces the minimum effective concentration of meropenem and prevents resistance development against both treatments. These findings suggest adjunctive phage therapy represents a promising treatment for MDR-induced VAP, enhancing the effectiveness of both antibiotics and phages while reducing adverse effects.
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series Nature Communications
spelling doaj-art-095fbf2eef83435e97d2948eeb528eb52025-08-20T03:53:58ZengNature PortfolioNature Communications2041-17232025-05-0116111710.1038/s41467-025-59806-yAdjunctive phage therapy improves antibiotic treatment of ventilator-associated-pneumonia with Pseudomonas aeruginosaChantal Weissfuss0Jingjing Li1Ulrike Behrendt2Karen Hoffmann3Magdalena Bürkle4Chunjiang Tan5Gopinath Krishnamoorthy6Imke H. E. Korf7Christine Rohde8Baptiste Gaborieau9Laurent Debarbieux10Jean-Damien Ricard11Martin Witzenrath12Matthias Felten13Geraldine Nouailles14Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinPharmaceutical Biotechnology, Fraunhofer Institute for Toxicology and Experimental MedicineLeibniz Institute DSMZ-German Collection of Microorganisms and Cell CulturesInstitut Pasteur, Department of Microbiology, Bacteriophage Bacteria Host Laboratory, Université Paris Cité, CNRS UMR6047Institut Pasteur, Department of Microbiology, Bacteriophage Bacteria Host Laboratory, Université Paris Cité, CNRS UMR6047Infection Antimicrobials Modelling Evolution, Université Paris-Cité, Inserm, UMR 1137Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinDepartment of Infectious Diseases, Respiratory Medicine and Critical Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu BerlinAbstract Bacterial multidrug resistance poses an urgent challenge for the treatment of critically ill patients developing ventilator-associated pneumonia (VAP). Phage therapy, a potential alternative when conventional antibiotics fail, has been unsuccessful in first clinical trials when used alone. Whether combining antibiotics with phages may enhance effectiveness remains to be tested in experimental models. Here, we use a murine model of Pseudomonas-induced VAP to compare the efficacy of adjunctive phage cocktail for antibiotic therapy to either meropenem or phages alone. Combined treatment in murine VAP results in faster clinical improvement and prevents lung epithelial cell damage. Using human primary epithelial cells to dissect these synergistic effects, we find that adjunctive phage therapy reduces the minimum effective concentration of meropenem and prevents resistance development against both treatments. These findings suggest adjunctive phage therapy represents a promising treatment for MDR-induced VAP, enhancing the effectiveness of both antibiotics and phages while reducing adverse effects.https://doi.org/10.1038/s41467-025-59806-y
spellingShingle Chantal Weissfuss
Jingjing Li
Ulrike Behrendt
Karen Hoffmann
Magdalena Bürkle
Chunjiang Tan
Gopinath Krishnamoorthy
Imke H. E. Korf
Christine Rohde
Baptiste Gaborieau
Laurent Debarbieux
Jean-Damien Ricard
Martin Witzenrath
Matthias Felten
Geraldine Nouailles
Adjunctive phage therapy improves antibiotic treatment of ventilator-associated-pneumonia with Pseudomonas aeruginosa
Nature Communications
title Adjunctive phage therapy improves antibiotic treatment of ventilator-associated-pneumonia with Pseudomonas aeruginosa
title_full Adjunctive phage therapy improves antibiotic treatment of ventilator-associated-pneumonia with Pseudomonas aeruginosa
title_fullStr Adjunctive phage therapy improves antibiotic treatment of ventilator-associated-pneumonia with Pseudomonas aeruginosa
title_full_unstemmed Adjunctive phage therapy improves antibiotic treatment of ventilator-associated-pneumonia with Pseudomonas aeruginosa
title_short Adjunctive phage therapy improves antibiotic treatment of ventilator-associated-pneumonia with Pseudomonas aeruginosa
title_sort adjunctive phage therapy improves antibiotic treatment of ventilator associated pneumonia with pseudomonas aeruginosa
url https://doi.org/10.1038/s41467-025-59806-y
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