How Scientists are Fighting Drug-Resistant Superbugs with Phages

"It's ridiculous just how virulent some of these bacteria get over time," says Dwayne Roach, assistant professor of bacteriophages, infectious disease and immunology at San Diego State University. But now CNN says doctors are fighting multi-drug-resistant superbugs with "nature's oldest predators - tiny tripod-looking viruses called phages designed to find, attack and gobble up bacteria."The microscopic creatures have saved the lives of patients dying from superbug infections and are being used in clinical trials as a potential solution to the growing problem of antibiotic resistance... In labs around the country, phage scientists are taking research and discovery to the next level... [Yale scientists] are busy mapping which phages and antibiotics are most symbiotic in the fight against a pathogen. Roach's San Diego State lab is investigating the body's immune response to phages while developing new phage purification techniques to prepare samples for intravenous use in patients. Currently, clinical trials are underway to test the effectiveness of phages against intractable urinary tract infections, chronic constipation, joint infections, diabetic foot ulcers, tonsillitis and the persistent, reoccurring infections that occur in patients with cystic fibrosis. The chronic infections common in cystic fibrosis are typically due to various strains of drug-resistant Pseudomonas aeruginosa - the same pathogen responsible for Horton's ear infection and the artificial tears outbreak. A number of labs are developing libraries of phages, stockpiled with strains found in nature that are known to be effective against a particular pathogen. In Texas, a new facility is taking that a step further - speeding up evolution by creating phages in the lab. "Rather than just sourcing new phages from the environment, we have a bioreactor that in real time creates billions upon billions of phages," said Anthony Maresso, associate professor at Baylor College of Medicine in Houston. "Most of those phages won't be active against the drug-resistant bacteria, but at some point there will be a rare variant that has been trained, so to speak, to attack the resistant bacteria, and we'll add that to our arsenal," Maresso said. "It's a next-generation approach on phage libraries." Maresso's lab published a study last year on the treatment of 12 patients with phages customized to each patient's unique bacterial profile. It was a qualified success: The antibiotic-resistant bacteria in five patients were eradicated, while several more patients showed improvements. "There's a lot of approaches right now that are happening in parallel," Roach said. "Do we engineer phages? Do we make a phage cocktail, and then how big is the cocktail? Is it two phages or 12 phages? Should phages be inhaled, applied topically or injected intravenously? There's a lot of work underway on exactly how to best do this...." Genetically engineering phages would allow scientists to target each person's unique mix of antibiotic-resistant pathogens instead of searching sewage, bogs, ponds, the bilge of boats and other prime breeding grounds for bacteria to find just the right phage for the job. Along with phage libraries, genetic engineering is also a key to churning out phages in mass, to distribute on a wider scale. In Russia and the country of Georgia, where phage therapy has been used for decades, patients can buy phage cocktails off the shelf in pharmacies.

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