01708nas a2200181   4500008004100000245013000041210006900171260000900240300001200249490000700261520105400268100001801322700003401340700003401374700002601408700003301434856005901467       2023                        eng d00aCase report: Analysis of phage therapy failure in a patient with a Pseudomonas aeruginosa prosthetic vascular graft infection0 aCase report Analysis of phage therapy failure in a patient with   c2023  a11996570 v103 a<p>Clinical case of a patient with a  multidrug-resistant prosthetic vascular graft infection which was treated with a cocktail of phages (PT07, 14/01, and PNM) in combination with ceftazidime-avibactam (CZA). After the application of the phage treatment and in absence of antimicrobial therapy, a new  bloodstream infection (BSI) with a septic residual limb metastasis occurred, now involving a wild-type strain being susceptible to ß-lactams and quinolones. Clinical strains were analyzed by microbiology and whole genome sequencing techniques. In relation with phage administration, the clinical isolates of  before phage therapy (HE2011471) and post phage therapy (HE2105886) showed a clonal relationship but with important genomic changes which could be involved in the resistance to this therapy. Finally, phenotypic studies showed a decrease in Minimum Inhibitory Concentration (MIC) to ß-lactams and quinolones as well as an increase of the biofilm production and phage resistant mutants in the clinical isolate of  post phage therapy.</p>1 aBlasco, Lucia1 aLópez-Hernández, Inmaculada1 aRodríguez-Fernández, Miguel1 aPerez-Florido, Javier1 aCasimiro-Soriguer, Carlos, S  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10235614/