Historically, mycobacteriophage have been used to "type" (i.e. "diagnose") mycobacteria, as each phage infects only one or a few bacterial strains. In the 1980s phages were discovered as tools to genetically manipulate their hosts. For instance, phage TM4 was used to construct shuttle
phasmids that replicate as large
cosmids in
Escherichia coli and as phages in mycobacteria. Phages with mycobacterial hosts may be especially useful for understanding and fighting mycobacterial infections in humans. A system has been developed to use mycobacteriophage carrying a
reporter gene to screen strains of
M. tuberculosis for
antibiotic resistance. In the future, mycobacteriophage could be used to treat infections by
phage therapy. In 2019 it was reported that three mycobacteriophages were administered intravenously twice daily to a 15 year-old girl with
cystic fibrosis and disseminated
M. abscessus subsp.
massiliense infection that occurred following lung transplant. The patient had clear benefit from treatment, and the phage treatment combined with antibiotics was extended for several years. In 2022 it was reported that two mycobacteriophages were administered intravenously twice daily to a young man with treatment-refractory
M. abscessus subsp.
abscessus pulmonary infection and severe
cystic fibrosis lung disease. Airway cultures for
M. abscessus became negative after approximately 100 days of combined phage and antibiotic treatment, and a variety of biomarkers confirmed the therapeutic response. The individual received a bilateral lung transplant after 379 days of treatment, and cultures from the explanted lung tissue confirmed eradication of the bacteria. == References ==