Potential for bacteriophage therapy for Staphylococcus aureus pneumonia with influenza A coinfection

The ability of influenza A virus to evolve, coupled with increasing antimicrobial resistance, could trigger an influenza pandemic with great morbidity and mortality. Much of the 1918 influenza pandemic mortality was likely due to bacterial coinfection, including Staphylococcus aureus pneumonia. S. aureus resists many antibiotics. The lack of new antibiotics suggests alternative antimicrobials, such as bacteriophages, are needed. Potential delivery routes for bacteriophage therapy (BT) include inhalation and intravenous injection. BT has recently been used successfully in compassionate access pulmonary infection cases. Phage lysins, enzymes that hydrolyze bacterial cell walls and which are bactericidal, are efficacious in animal pneumonia models. Clinical trials will be needed to determine whether BT can ameliorate disease in influenza and S. aureus coinfection. Influenza A virus constantly evolves, and this, coupled with increasing antibiotic resistance, could trigger an influenza pandemic that causes immense mortality. Much of the 1918 influenza pandemic mortality was likely due to bacterial coinfection of the lung, including with Staphylococcus aureus (golden staph' which resists many antibiotics). The lack of new antibiotics suggests alternative antimicrobials, such as bacteriophages (viruses that can infect and kill bacteria), should be developed. Potential delivery routes for bacteriophage therapy (BT) include inhalation and injection into veins. BT has been used successfully in life-threatening lung infection cases. Bacteriophage lysins, enzymes that kill bacteria by destroying their cell walls, are effective in animal lung infection models. Clinical trials will be needed to determine whether BT can ameliorate disease in influenza and S. aureus coinfection.