Case report: Personalized triple phage-antibiotic combination therapy to rescue necrotizing fasciitis caused by Panton-Valentine leukocidin-producing MRSA in a 12-year-old boy

Front Cell Infect Microbiol. 2024 Sep 17:14:1354681. doi: 10.3389/fcimb.2024.1354681. eCollection 2024.

Abstract

Maximal standard-of-care (SOC) management could not stop the life-threatening progression of a necrotizing fasciitis induced by Panton-Valentine Leukocidin-producing Methicillin-Resistant Staphylococcus aureus (MRSA) in a 12-year-old boy. Multi-route phage therapy was initiated along with antibiotics against Staphylococcus aureus, Pseudomonas aeruginosa and Stenotrophomonas maltophilia, eventually leading to full recovery with no reported adverse events.

Keywords: MRSA; Panton and Valentine leukocidin (PVL); bacteriophage; necrotizing fasciitis; pediatric intensive care unit; phage therapy.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / therapeutic use
  • Bacterial Toxins*
  • Child
  • Exotoxins* / genetics
  • Fasciitis, Necrotizing* / drug therapy
  • Fasciitis, Necrotizing* / microbiology
  • Fasciitis, Necrotizing* / therapy
  • Humans
  • Leukocidins*
  • Male
  • Methicillin-Resistant Staphylococcus aureus* / drug effects
  • Phage Therapy* / methods
  • Pseudomonas aeruginosa* / drug effects
  • Staphylococcal Infections* / drug therapy
  • Staphylococcal Infections* / microbiology
  • Staphylococcal Infections* / therapy
  • Stenotrophomonas maltophilia / drug effects
  • Treatment Outcome

Substances

  • Leukocidins
  • Exotoxins
  • Panton-Valentine leukocidin
  • Bacterial Toxins
  • Anti-Bacterial Agents

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. BV is a FRIA (Fonds pour la formation à la Recherche dans l’Industrie et dans l’Agriculture) Grant Holder of the Fonds de la Recherche Scientifique-FNRS (grant number: FC 36489). CB is funded by the Fond de Recherche Scientifique (mandat de Spécialiste doctorant -F.N.R.S -FC 33595).