Novel use of bacteriophages in a refractory prosthetic joint infection
A clinical team at Samishta Hospital (SHRI), Guntur, has successfully treated a 72‑year‑old man suffering from a carbapenem‑resistant infection of an artificial knee joint using phage therapy, according to published reports. The case is reported as India’s first documented successful use of phage therapy for a carbapenem‑resistant prosthetic joint infection.
The infection, caused by Pseudomonas aeruginosa, was identified after the patient underwent knee replacement surgery in June 2025. The bacterium showed resistance to carbapenem antibiotics and persisted despite multiple surgical debridements, exchanges of prosthetic components and prolonged courses of intravenous antibiotics, the report said.
Selection and delivery of the phage cocktail
Faced with recurrent infection and high surgical risk because of the patient’s age and frailty, the treating team led by Dr Kalyan Chakravarthy Koganti sought an alternative. They collaborated with the phage laboratory of SRM University (Andhra Pradesh), headed by Dr Sutharsan Govindarajan, to isolate bacteriophages active against the patient’s bacterial strain.
Laboratory testing showed that while individual phages temporarily reduced bacterial counts, the pathogen regrew. Combining three specific lytic phages into a cocktail prevented regrowth in vitro. The clinical team then administered the phage cocktail directly into the infected joint through a drainage tube over a 10‑day period. Initially the antibiotic colistin was given alongside the phages to augment treatment, the report said.
By December the patient was in extreme pain (rated 9 out of 10), and further major surgery was considered too risky given his age and frail condition, the clinical account noted.
Outcome and follow‑up
Subsequent follow‑up showed clinical resolution of the infection. Joint‑fluid cultures taken in June 2026 were reported negative, and the patient remained healthy and antibiotic‑free at that assessment, according to the published case details. The episode is recorded in a case report published in the International Journal of Infectious Diseases (IJID Regions) on 22 October 2026.
- Pathogen: Pseudomonas aeruginosa resistant to carbapenems.
- Intervention: Three‑phage cocktail delivered intra‑articularly over 10 days; colistin used initially.
- Result: Clinical recovery and negative joint culture at follow‑up.
Context and implications
Prosthetic joint infections caused by multidrug‑resistant organisms pose major treatment challenges because resistance to last‑line antibiotics such as carbapenems limits options. Bacteriophages are viruses that infect bacteria; lytic phages multiply inside bacterial cells and cause cell rupture. Phage therapy is experimental in many settings and typically requires matching phages to the infecting bacterial strain, the report explained.
In this Guntur case, targeted phage selection at a specialised university laboratory, coordinated with the clinical team at SHRI, was central to the approach. The successful outcome in an elderly patient for whom further major surgery was deemed high risk highlights a potential role for personalised phage therapy in selected, refractory infections. The report did not make broader claims beyond the documented case.
| Event | Date |
|---|---|
| Knee replacement surgery | June 2025 |
| Recurrent infection and clinical deterioration | Late 2025 |
| Phage therapy administered (10 days) | Late 2025–early 2026 (as per case timeline) |
| Culture negative follow‑up | June 2026 |
| Case report publication | 22 October 2026 |
The clinical team’s account stresses that phage therapy requires laboratory matching and clinical oversight. As with any single‑case report, the findings are not a substitute for controlled clinical trials. For Guntur patients and clinicians, the case demonstrates a locally‑applied, inter‑institutional effort to manage a difficult drug‑resistant infection, and may encourage further research and regulated clinical use under appropriate oversight.
