| 黄创新,彭慧明,翁习生.噬菌体治疗关节假体周围感染的现状与展望：系统性文献综述.骨科,2025,16(3): 206-212. |
| 噬菌体治疗关节假体周围感染的现状与展望：系统性文献综述 |
| Current status and prospects of bacteriophage therapy for periprosthetic joint infections: systematic literature review |
| 投稿时间：2025-02-14 |
| DOI：10.3969/j.issn.1674-8573.2025.03.003 |
| 中文关键词: 噬菌体治疗 关节假体周围感染 抗生素耐药性 协同效应 临床转化 |
| 英文关键词: Bacteriophage therapy Periprosthetic joint infection Antibiotic resistance Synergistic effects Clinical translation |
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| 中文摘要: |
| 目的 评价噬菌体治疗关节假体周围感染（periprosthetic joint infection，PJI）的有效性与安全性，探讨其临床应用现状与展望。方法 系统性检索PubMed、Web of Science、Embase数据库，纳入14项研究（38例），评估噬菌体治疗PJI的临床结局。结果 噬菌体-抗生素联合治疗后，PJI的复发率明显降低，其中对金黄色葡萄球菌、铜绿假单胞菌等耐药菌清除效果显著。主要不良反应为一过性发热（5例）和肝酶异常（3例），无严重并发症。存在的局限性包括噬菌体筛选复杂（需特异性匹配宿主菌）、给药方案不统一（剂量范围103~1010 PFU/mL）、长期疗效证据不足（平均随访16.3个月）。结论 噬菌体治疗可作为耐药性PJI治疗失败后的挽救性治疗选择，未来需开展随机对照试验验证其疗效，并建立标准化治疗规范。 |
| 英文摘要: |
| Objective To evaluate the efficacy and safety of bacteriophage therapy in periprosthetic joint infection (PJI) and explore its current clinical applications and future prospects. Methods A systematic search of PubMed, Web of Science, and Embase databases was conducted, including 14 studies (38 patients) to assess clinical outcomes of bacteriophage therapy for PJI. Results A significant reduction in recurrence rates of PJI was observed following combined phage-antibiotic therapy, demonstrating marked effectiveness against drug-resistant pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa. Primary adverse events included transient fever (5 cases) and abnormal liver enzymes (3 cases), with no severe complications reported. Limitations involve the complexity of phage screening (requiring host bacteria-specific matching), non-standardized treatment protocols (dosing range: 103-1010 PFU/mL), and insufficient long-term efficacy data (mean follow-up duration: 16.3 months). Conclusion Bacteriophage therapy may serve as an adjunctive therapeutic option for drug-resistant PJI. Future randomized controlled trials are needed to validate its efficacy and establish standardized treatment protocols. |
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