Antibiotic Alternative? A Virus to Fight Bacteria

Modesto Morganelli
Mag 9, 2019

After a nine-month stay at Great Ormond Street hospital, she returned to her home in Kent for palliative care, but recovered after her consultant teamed up with a U.S. laboratory to develop the experimental therapy.

Phages, also known as bacteriophages, are a type of naturally occurring virus that infects bacteria rather than the body's own cells.

No, some doctors have been using phages for almost a century.

"It was absolutely incredible the effect the phage had on her".

A breakthrough: Her consultant at Great Ormond Street Hospital in London worked with a team at the University of Pittsburgh to develop an untested phage therapy. Isabelle, for example, had lost two-thirds of her lung function.

Now: Holdaway is not fully cured, but her infection is under control.

Isabelle had big, black, festering lesions forming on her skin where the infection was taking hold.

But last May her life was saved by an experimental treatment called phage therapy.

The team at Great Ormond Street contacted Prof Graham Hatfull, at the Howard Hughes Medical Institute, in the U.S., who had the world's largest collection of phages.

"The patient was not responding to antibiotics", Hatfull said.

Phages work by infecting bacteria cells and killing them, but they are very specific in which infections they can target. "Our expertise is in the study of the bacteriophages, so we sought to try to find phages in our collection which would infect and kill this particular bacterial strain".

Each experiment took a week because the bacteria grow slowly.

Her parents made a decision to take her home where she would be surrounded by family. The other two weren't as effective, so Hatfull and his colleagues tweaked the phages' genomes, removing a gene, so the phages would kill the bacteria. The therapy was injected into her blood stream twice daily and applied to the lesions on her skin, according to Nature Medicine. And after six weeks of intravenous treatment every 12 hours, the infection was all but gone.

There were nearly no side effects.

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

Isabelle is still on the treatment, and it has been a slow, steady recovery.

Jo told BBC News: "When we left hospital, she literally looked like a skeleton with skin on, she was so poorly".

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

Her case, outlined in the journal Nature Medicine, follows the successful treatment previous year of a U.S. patient infected with a drug-resistant superbug and comes as the looming crisis of antibiotic resistance is fuelling a growing interest in phage research.

Technically, scientists can not be certain how effective the phage is without performing clinical trials.

Spencer said: "The bigger question is whether it could be used to treat other resistant bacteria". Phages can also be toxic.

The US team settled on three phages - two of which they genetically modified to make them more effective. "We are optimistic that in time it can completely clear the infection", Spencer says.

Jason Gill, a senior scientist at the center for phage technology at Texas A&M University, said phages could have huge potential to tackle drug-resistant infections. That turned the parasite into a killer, Schooley said.

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