The patient developed complex and recurrent urinary tract infections following bladder tumor surgery. Klebsiella pneumoniae was detected in the patient’s urine in 2014, and prolonged antibiotic treatment led to the development of fully resistant strains of K. pneumoniae in the patient’s body. In January 2018, the patient was officially enrolled in phage therapy. Following diagnosis, the patient’s infection sites were identified in the left and right renal pelvis and bladder, compounded by urinary obstruction, making treatment highly challenging. The first three rounds of intravesical bacteriophage instillation were effective, but pulmonary Gram-negative bacteria could not be eradicated. During treatment, to relieve ureteral obstruction from the renal pelvis to the bladder, the patient underwent double-J stent implantation surgery; however, new strains of Klebsiella pneumoniae re-established infection from the renal pelvis to the bladder shortly after stent insertion and replacement. After specialist consultation, the team decided on a fourth treatment round: pyelostomy followed by bacteriophage irrigation through a stoma tube combined with intravenous antibiotics for one week, followed by discontinuation of antibiotics and continuation of phage therapy for another week, concluding with complete drug withdrawal and one month of continuous observation. Ultimately, the patient’s drug-resistant urinary tract bacteria were eradicated, urinary irritation symptoms improved markedly, and quality of life was significantly enhanced.
