Bacteriophage in Relation to Healing of Osteomyelitis

Abstract

In the treatment of osteomyelitis by the method of Orr, the open wound is protected by vaseline gauze under slight pressure and immobilized by plaster dressings. It is then left undisturbed for long periods. Success evidently depends in large measure upon the effective control of infection by the humors and cells of the patient. The possible influence of bacteriophage requires consideration. 1

A boy of 10 years, presenting open sinuses leading into the right tibia, the left tibia and the left humerus resulting from an original haematogenous osteomyelitis twice subjected to surgical operation elsewhere, and of one year's duration, was again subjected to surgical operation for removal of sequestra from both legs on September 9, 1929.

Pus from the right tibia was examined bacteriologically at this time, again at the first subsequent dressing on November 11, on December 9 and on December 23. Bacteriological examination of material from the left tibia was made on November 11 and December 9 and of material from the left humerus on November 7, December 9 and December 23. Native bacteriophage was not found in the arm wound. A stock anti-staphylococcus bacteriophage lytic for the wound strain, was introduced into the wound of the arm on December 9, which was followed by complete closure of the wound in 2 weeks. The data of these examinations are summarized in Table I.

The bacteriophage in the first specimen of pus from the right tibia was at once active against 2 stock strains of B. coli. Of greater interest is the fact that it was also active against the native strain of B. coli in the pus, so that after 5 serial filtrations of cultures of this organism, complete lysis was obtained with a titer of 1 × 10^-8.