Bacterial infections that resist antibiotics are being tackled with an arcane therapy.An arcane therapy for bacterial infections that dwelled behind the Iron Curtain for decades is making a comeback in Western medicine as a potential white knight against superbugs.
Phage therapy involves infecting patients with viruses known as bacteriophages, which are the natural predators of bacteria, to kill the germs that antibiotics cannot.
Scientists hope these harmless viruses will cure patients who have been infected by bacteria that is resistant to antibiotics, causing chronic ear, nose and throat infections as well as life-threatening illnesses such as sepsis.
The first human trial of a phage therapy began at the Queen Elizabeth Hospital in Adelaide last week, when a female patient with chronic sinusitis started using a nasal rinse swimming with phages that target golden staph.
Meanwhile, researchers at the Westmead Institute’s Centre for Infectious Diseases and Microbiology have been awarded a $860,000 federal grant to isolate the phages that target E. coli and klebsiella, which cause sepsis in intensive care patients.
Phage therapy was discovered 100 years ago, but in the 1940s it disappeared behind the Iron Curtain while the Western world shifted to antibiotics.
But interest in the therapy has been reanimated by the growing phenomenon of “superbugs”, which have developed a resistance to the antibiotics that once killed them and now threaten the lives of their victims.
The Westmead Institute’s Carola Venturini said pharmaceutical companies were no longer investing in new antibiotics because bacteria were developing resistance so quickly that it had become a risky venture.
“There’s a big emphasis on alternative therapies like phage therapy,” Professor Venturini said.
“There are no side effects – the phages just target the bacteria. The biggest problem is, is it going to work and is it going to reach the bacteria we want to reach?”
One of the best sources of bacteriophages was in faeces, which researchers would access by raiding the fecal specimens of patients in the Westmead Hospital intensive care unit to build up a library of phages.
Sinus surgeon Peter-John Wormald, who is conducting the “first in man” study in Adelaide, said phages would potentially be a good solution for the 15 per cent of chronic sinusitis patients who did not respond to antibiotics after surgery.
“Most of our patients do really well without any problems but we’ve got a small cohort of patients who we think have got bacterial infections that have either got into the cells themselves where they can’t be reached by antibiotics, or they have biofilms, which are thousands of times more resistant to standard bacteria,” Professor Wormald said.
Following positive results in the laboratory, his current trial of nine patients was the first of its kind in the world, he said.
The Westmead Institute’s Jon Iredell, who is also head of Westmead Hospital’s Infectious Diseases Department, successfully treated a 67-year-old woman who had a stubborn urinary tract infection using phage therapy in 2010, after no drugs worked.
The Westmead study would investigate which combination of phages should be used to defeat the bacteria, as opposed to the old, ineffective method of sending in a single phage – against which the bug might adapt its defences.
“We use multiple viruses, so instead of sending in a single assassin we send in a hit squad,” Professor Iredell said.
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