Antibiotic Alternative? A Virus to Fight Bacteria

Maricruz Casares
May 11, 2019

Now Isabelle is still receiving the treatment, but has returned to school, and is learning to drive.

"I think it will pave the way for other such studies to help with getting the necessary trials carried out on bacteriophages so that they can be used more widely to treat humans", he said.

"The specificity is definitely our friend in terms of using phages in antimicrobial treatment", Hatfull said.

They tested individual phages known to infect bacterial relatives of the patients' strains, and mixed thousands of other phages together and tested the lot.

Strathdee, Hatfull and others stress that much more research is needed to determine how well phages, including genetically engineered phages, really might work and how safe they may be. The phage hijacks a bacteria's machinery and makes millions of copies of itself, which eventually leads to the cell bursting apart and its death.

For one of the viruses, they also looked for mutants among the population that proved especially efficient, using a toothpick to select the best killers of the lot. Her husband, Tom Patterson, PhD, was successfully treated in 2016 with a bacteriophage cocktail for an MDR Acinetobacter baumannii infection that had left him fighting for his life, and they've co-authored a book on the experience-The Perfect Predator.

M. abscessus and other bacteria often colonize the thick mucus that builds up in the lungs of people with cystic fibrosis, a genetic disease that afflicts some 80,000 people worldwide.

As she was recovering from the transplant, a preexisting chronic infection quickly spread throughout her body. And most of Hatfull's viruses were parasites of Mycobacterium smegmatis, a whole different species from the Mycobacterium abscessus that was multiplying inside the patient.

"For some patients, that's within a year despite aggressive treatment". Virtually all her lesions have cleared.

Doctors said there was nothing they could do, and that Isabelle had a less than 1% chance of survival.

He's a professor of biotechnology at the University of Pittsburgh.

"Cocktails of phages were used therapeutically in Europe and the United States during the pre-antibiotic era, and they are still prevalent in Russian Federation and Central and Eastern Europe today, for wound infections, gastroenteritis, sepsis and other ailments", wrote Charles Schmidt, a science writer, in a related article published in the journal Nature Biotechnology.

Unlike previous experiments, the researchers treating Isabelle used genetically modified phages which made them more effective than those occurring naturally.

His team identified three phages that appeared promising.

The therapy was injected into her blood stream twice a day and applied to the lesions on her skin, according to the journal Nature Medicine.

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Isabelle's mum, Jo, noticed the difference within weeks. Around the same time, Jo had been told her daughter was unlikely to survive.

Her mother noted that "within weeks, this unbelievable treatment from Mother Nature was having this incredible effect on her body". She passed her GCSE in maths, is studying A-levels and enjoys baking and gardening.

She told the BBC: "It's an incredible thing, it's still working slowly, it's just great being able to do all these things on my own without having any problems".

"We haven't cured her", Spencer said, adding that that today, 11 months since the start of Isabelle's treatment, the bacterium is still causing skin lesions "on occasion".

A colleague at the London hospital laid out the case: two patients, both teenagers.

But Hatfull warns that phages are not a mass cure for resistant infections. Phages have been used for decades to try to treat infections.

Dr Spencer told BBC News: "It's unbelievable really, but also tinged with sadness when I think of all the patients that did not survive as the treatment was not available in time for them". Offering advice on Isabelle's case, "he, by chance, knew a phage scientist in the [United] States, Graham Hatfull".

The treatment was modeled after the phage therapy given to UC San Diego professor Tom Patterson, who recovered after almost being killed by his antibiotic-resistant infection.

Phage therapy dates back a century, but until recently the idea was relegated to fringe medicine in most countries, mainly because of the advent of antibiotics.

However, scholars explain that the initial enthusiasm regarding the potential of phage therapy for many years.

Bacteriophages (depicted above) are viruses that can infect and destroy bacteria. Some infections, such as the hospital superbug Staphylococcus aureus, are known to be genetically homogeneous enough that a few phages could treat nearly all strains of the infection, raising the prospect of phage therapy becoming routine.

What does this mean for other infections?

Hatfull said: "We didn't think we'd ever get to a point of using these phages therapeutically".

"The idea is to use bacteriophages as antibiotics, as something we could use to kill bacteria that cause infection". But because phages need to match the particular strain of bacterium there was more work to be done.

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