{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:56:34Z","timestamp":1790016994427,"version":"4.0.1"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"US\u2013Israel Binational Science Foundation","award":["#2017123"],"award-info":[{"award-number":["#2017123"]}]},{"name":"Israel Science Foundation IPMP","award":["#ISF_1349\/20"],"award-info":[{"award-number":["#ISF_1349\/20"]}]},{"DOI":"10.13039\/501100000833","name":"Rosetrees Trust","doi-asserted-by":"publisher","award":["A2232"],"award-info":[{"award-number":["A2232"]}],"id":[{"id":"10.13039\/501100000833","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UC San Diego Chancellor\u2019s Innovation Fund","award":["n.a."],"award-info":[{"award-number":["n.a."]}]},{"name":"Milgrom Family Support Program","award":["n.a."],"award-info":[{"award-number":["n.a."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Phage therapy is an experimental therapeutic approach used to target multidrug-resistant bacterial infections. A lack of reliable data with regard to its efficacy and regulatory hurdles hinders a broad application. Here we report, for the first time, a case of vancomycin-resistant Enterococcus faecium abdominal infection in a one-year-old, critically ill, and three times liver transplanted girl, which was successfully treated with intravenous injections (twice per day for 20 days) of a magistral preparation containing two Enterococcus phages. This correlated with a reduction in baseline C-reactive protein (CRP), successful weaning from mechanical ventilation and without associated clinical adverse events. Prior to clinical use, phage genome was sequenced to confirm the absence of genetic determinants conferring lysogeny, virulence or antibiotic resistance, and thus their safety. Using a phage neutralization assay, no neutralizing anti-phage antibodies in the patient\u2019s serum could be detected. Vancomycin-susceptible E. faecium isolates were identified in close relation to phage therapy and, by using whole-genome sequencing, it was demonstrated that vancomycin-susceptible E. faecium emerged from vancomycin-resistant progenitors. Covering a one year follow up, we provide further evidence for the feasibility of bacteriophage therapy that can serve as a basis for urgently needed controlled clinical trials.<\/jats:p>","DOI":"10.3390\/v13091785","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T02:41:07Z","timestamp":1631068867000},"page":"1785","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Bacteriophage Rescue Therapy of a Vancomycin-Resistant Enterococcus faecium Infection in a One-Year-Old Child following a Third Liver Transplantation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-4881","authenticated-orcid":false,"given":"Kevin","family":"Paul","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Kinder-UKE, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2566-0772","authenticated-orcid":false,"given":"Maya","family":"Merabishvili","sequence":"additional","affiliation":[{"name":"Burn Centre, Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, B-1120 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9967-730X","authenticated-orcid":false,"given":"Ronen","family":"Hazan","sequence":"additional","affiliation":[{"name":"Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 9112001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Christner","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uta","family":"Herden","sequence":"additional","affiliation":[{"name":"Department of Visceral Transplantation, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gelman","sequence":"additional","affiliation":[{"name":"Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 9112001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leron","family":"Khalifa","sequence":"additional","affiliation":[{"name":"Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 9112001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8994-3114","authenticated-orcid":false,"given":"Ortal","family":"Yerushalmy","sequence":"additional","affiliation":[{"name":"Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 9112001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunit","family":"Coppenhagen-Glazer","sequence":"additional","affiliation":[{"name":"Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 9112001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Harbauer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kinder-UKE, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Schulz-J\u00fcrgensen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kinder-UKE, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8587-4433","authenticated-orcid":false,"given":"Holger","family":"Rohde","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutz","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Visceral Transplantation, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saima","family":"Aslam","sequence":"additional","affiliation":[{"name":"Center for Innovative Phage Applications and Therapeutics, Division of Infectious Diseases and Global Public Health, University of California, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Rohde","sequence":"additional","affiliation":[{"name":"Leibniz Institute DSMZ\u2014German Collection of Microorganisms and Cell Cultures GmbH, 38124 Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Nir-Paz","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Infectious Disease, Hadassah University Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6863-5219","authenticated-orcid":false,"given":"Jean-Paul","family":"Pirnay","sequence":"additional","affiliation":[{"name":"Burn Centre, Laboratory for Molecular and Cellular Technology (LabMCT), Queen Astrid Military Hospital, B-1120 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Singer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kinder-UKE, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2900-8378","authenticated-orcid":false,"given":"Ania Carolina","family":"Muntau","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kinder-UKE, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jaut.2016.06.005","article-title":"Biliary atresia: A comprehensive review","volume":"73","author":"Lakshminarayanan","year":"2016","journal-title":"J. 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