Islamabad: A Pakistan-trained doctor Dr Saima Aslam and colleagues in the United States have reported encouraging results using four engineered bacteria-killing viruses alongside antibiotics to treat a drug-resistant infection in a kidney transplant patient.
Dr Saima Aslam graduated with honours from Aga Khan University in Karachi and is a professor of medicine at the University of California San Diego. She directs UC San Diego Health’s Solid Organ Transplant Infectious Diseases Service.
Scans showed an inflammatory mass inside the 65-year-old patient’s abdomen had shrunk from 744.6 to 373.4 cubic centimetres after eight weeks, a reduction of about 50 percent. After one year, it measured 82 cubic centimetres, an 89 per cent reduction.
The open wounds on his abdomen began improving within a week of starting the virus treatment. Follow-up urine and tissue cultures were negative for Escherichia coli, commonly known as E. coli, the bacterium associated with his illness.
Dr Saima Aslam is the first and corresponding author of the case report, published in Clinical Infectious Diseases on August 11, 2026. The authors described it as the first reported use of phage therapy for malakoplakia, a rare inflammatory condition often associated with persistent bacterial infection.
The patient underwent a kidney transplant in 2023 and subsequently developed repeated E. coli infections. A large mass associated with the bladder developed inside his abdomen, accompanied by open abdominal wounds that failed to heal despite prolonged treatment.
Tests showed that the bacterium was resistant to several groups of antibiotics and later became resistant to carbapenems, an important class used against serious bacterial infections. His disease continued to worsen despite repeated antibiotic courses, prompting doctors to seek an additional treatment.
Malakoplakia is thought to develop when immune cells called macrophages cannot properly clear bacteria and bacterial material, allowing chronic inflammation and masses to develop. It occurs particularly in people with weakened immunity, including transplant recipients, and conventional treatment involves prolonged antibiotics and careful adjustment of medicines that suppress the immune system.
Doctors used SNIPR001, an experimental preparation developed by Danish biotechnology company SNIPR Biome that contains four engineered bacteriophages. Treatment was administered under special US Food and Drug Administration permission for a single patient, with institutional ethical oversight.
Bacteriophages are viruses that infect bacteria, and SNIPR001 was designed to target E. coli. Its phages carry CRISPR-Cas machinery, a targeted DNA-cutting system intended to damage essential bacterial genes and kill the bacterial cells.
Earlier research published in Nature Biotechnology showed that the engineered preparation could act against different E. coli strains and reduce their numbers in animal experiments. Those findings provided a basis for clinical investigation, although animal results cannot establish effectiveness in patients.
In this patient, the preparation was given intravenously, applied directly to the abdominal wounds and injected into the mass. Antibiotics and other medicines were continued alongside the phages.
No adverse events were attributed to the phage treatment in the published case. The improvement provides an encouraging clinical observation, but because several treatments were given together, the response cannot be attributed to the viruses alone.
The report therefore does not establish that SNIPR001 can reliably cure this disease or other resistant infections. Larger studies and longer follow-up are needed to assess effectiveness and the risk of recurrence.
UC San Diego’s phage programme describes the treatment as unlicensed in the United States, with selected patients able to receive it through special FDA access procedures. It also explains that a patient’s bacteria must be cultured and tested to identify suitable phages, making laboratory matching an essential part of treatment.
A separate trial published in The Lancet Microbe in 2026 tested oral SNIPR001 in 36 healthy volunteers. It found no serious adverse events in the treatment groups, but the reduction in E. coli levels was not statistically significant, and it did not test treatment of malakoplakia.
The case comes amid growing concern about antibiotic resistance, which can leave serious infections increasingly difficult to treat. In its 2025 surveillance report, the World Health Organization estimated that one in six laboratory-confirmed infections involving the common bacterial pathogens it assessed worldwide in 2023 were resistant to antibiotic treatment.
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