BacterioPHAGE therapy for fracture-related infection due to Staphylococcus aureus (PhageS)

AO TC System


Fracture-related infections generally involve biofilm formation and are therefore always highly antibiotic tolerant, even in the absence of specific antibiotic resistance genes.



This project aims to determine the in vivo efficacy of a phage-loaded thermo-responsive hyaluronan gel as a local application mode for bacteriophage therapy of difficult to treat, antibiotic resistant orthopaedic device-associated infections. 


In a rabbit humerus osteotomy and LCP fixation model with S. aureus inoculation, the phage-loaded hydrogel was pipetted onto the LCP. After surgery, the animals were observed for one week after which they were euthanized. In the soft tissue, there was a significant decrease in bacterial load in the animals that received the phage-loaded hydrogel (Figure). 

  • Publication

    Onsea J, Wagemans J , Pirnay JP, Di Luca M , Gonzalez-Moreno M , Lavigne R , Trampuz A , Moriarty TF, Metsemakers  W-J (2020) Bacteriophage therapy as a treatment strategy for orthopaedic-device-related infections: where do we stand? Eur Cell Mater 39: 93-210. DOI: 10.22203/eCM.v039a13.

    Onsea J, Post V, Buchholz T, Schwegler H, Zeiter S, Wagemans J, Pirnay JP, Merabishvili M,D'Este M, Rotman SG, Trampuz A, Verhofstad MHJ, Obremskey WT, Lavigne R, Richards RG, Moriarty TF, Metsemakers WJ. Bacteriophage therapy for the prevention and treatment of fracture-related infection caused by staphylococcus aureus: a preclinical study. Microbiol Spectr. 2021;epub Dec 15:e0173621.

    Metsemakers W-J, Onsea J, Moriarty TF, Pruidze N, Nadareishvili L, Dadiani M, Kutateladze M. Bacteriophage therapy for human musculoskeletal and skin/soft tissue infections. Clin Microbiol Infect. 2023;epub Jan 17.

  • Presentation

    Onsea J. AOTCPP (AOTrauma Clinical priority program Bone Infection, Vienna, Austria). 21. September 2019. " BacterioPHAGE therapy for fracture-related infection due to S. aureus" (oral)


  • Partner

    Metsemakers WJ (MD) KU Leuven, Belgium

    Lavigne R (MD), KU Leuven, Belgium

    Trampuz A (MD), Charité, Berlin, Germany