Bacteriophages – multidrug-resistant bacteria treated with viruses

Mycobacterium

Robert Klatt

  • Multi-resistant bacteria always cause more deaths
  • With many infections they help bacteriophages
  • It is about specialized virusesdie individual bacterial strains kill without invading beneficial bacteria or body cells
  • It will also soon begin in Germany one clinical studyin people with cystic fibrosis WITH treated with bacteriophage will

Multi-resistant bacteria are causing more and more deaths. According to the study, phages (viruses) can help with many of these bacterial infections.


Pittsburgh (USA). Multi-resistant bacteria are becoming an increasing problem in medicine. According to the World Health Organization (WHO), antibiotic resistance is one of the leading causes of death worldwide today. In addition to new antibiotics, so-called bacteriophages can also help against multi-resistant bacteria. These are viruses that infect bacteria.


Bacteriophages attack bacteria through special receptors and then multiply in their cells. The bacterial cell then ruptures from the mass of newly formed viruses and the bacteria die. Because phages specialize in certain types of bacteria, they do not destroy beneficial bacteria or body cells during therapy. Thus, the primary problem with bacteriophage therapy is finding the right phage.


So far almost no studies on bacteriophages

Bacteriophages have so far been used mainly in the former Eastern bloc. In Western countries, bacteriophages have hardly been used or studied in everyday clinical practice since the development of antibiotics. However, with regard to multi-resistant pathogens, this has changed in recent years. Around 2019, researchers from the University of Pittsburgh published a single case study with promising results in the journal Nature Medicine. Then they received questions from doctors from all over the world.

Bacteriophages against antibiotic-resistant mycobacteria

Researchers from the University of Pittsburgh and the University of California have now published the results of another study with bacteriophages in the journal Clinical Infectious Diseases. The study involved 20 subjects infected with antibiotic-resistant mycobacteria, mostly strains of Mycobacterium abscessus.

16 of the 20 subjects suffered from metabolic mucosiscidosis, also known as cystic fibrosis (CF). In this disease, mucus can no longer flow out of the lungs and many other organs. This creates optimal living conditions for bacteria that cause inflammation and other health problems.

Treatment of Mycobacterium abscess infections

According to study leader Graham Hatfull, Mycobacterium abscess infections are a nightmare for doctors. “Although they are not as common as some other infections, they are among the most difficult antibiotics to treat,” Hatfull explains.

The researchers therefore administered various bacteriophages to the subjects by injection or inhalation. Study participants, including a five-year-old child, received at least 1 billion units twice daily for six months. Treatment was successful in eleven of 20 patients (55%). Four patients (20%) had no improvement and five patients (25%) had mixed results.


Bacteriophage without side effects

No side effects were observed in the clinical study. There is also no evidence that the bacteria develops new resistance as a result of the treatment. “It gives a lot of weight to the impression that the therapy is safe,” says Hatfull.

It is still unclear why the treatment did not work in all subjects. Hatfull sees phage used as a possible reason. “We haven’t figured out how to find or make a phage that will capture every strain of these patients. This remains one of the most important challenges for the future, “says the scientist.

Clinical study in Germany

A clinical trial with bacteriophages is due to start in Germany in the second half of the year. According to Holger Ziehr, head of pharmaceutical biotechnology at the Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), only people with cystic fibrosis who are infected with Pseudomonas aeruginosa should be tested. In the study, you will receive a combination of three phages that cover most strains of P. aeruginosa. The first results are to be published next year.

In addition, Ziehr describes the results of the current study as “impressive”. “This result cannot be denied,” says Ziehr. According to the phage expert, extremely heterogeneous subjects and various infections and types of pathogens make therapy difficult.

Nature Medicine, doi: 10.1038 / s41591-019-0437-z

Clinical Infectious Diseases, doi: 10.1093 / cid / ciac453

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