The global superbug crisis isn’t on everyone’s radar like climate change is, but my family is trying to change that.
I am an infectious disease epidemiologist, yet my experience with antimicrobial resistance was intensely personal. While my husband and I were on vacation in Egypt in 2015, he became infected with a rare bacteria I hadn’t seen since my petri plates in college back in the 1980s. It infected an abscess in his abdomen and threatened to take his life.
By the time he was transported by air ambulance to an ICU back home in California, his bacteria had become resistant to all antibiotics. When I suddenly realised that he was going to die, I was shocked and terrified. I decided to do my own research, and found a paper on a 100-year-old cure that is barely used anymore – bacteriophage therapy.
Bacteriophages (phages) are viruses that prey upon bacteria, curing infections. They were commonly used in the 1920s and 30s, especially in the former Soviet Union. However, after penicillin was introduced in 1942, phage therapy was largely abandoned in the West.
Most of the physicians treating my husband had never heard of phage therapy when I proposed treating him with it after he had been hospitalised for several months in early 2016.
Although it is the standard of care in the former Soviet Union and parts of Eastern Europe, it is considered experimental by the Food and Drug Administration (FDA) and its European counterparts because clinical trials had not been done to show that it worked.
I connected with a global network of phage researchers across the world, and Texas A&M University turned their lab into a command centre. They offered to undergo a phage hunt to find some to match to my husband’s bacterial isolate.
Within three weeks, they and researchers from the US Navy had each prepared a phage cocktail active against Tom’s strain. After paperwork was submitted to the FDA, they gave emergency approval to administer phage for ‘compassionate use’. We began the treatment. A few days later, he woke from a deep coma and began his long recovery.
My husband’s case has been described as a watershed moment that revitalised phage therapy in the West. We used to consider our ordeal as the worst experience we could ever have, but now we realise we were privileged to have been able to leverage the resources we had to save his life.
Tom and I decided to write a book about our story, with the hope that it will educate others about the superbug crisis, and will ensure that phage therapy isn’t forgotten for another 100 years. Tom has had a near complete return to health, but the real impact of his case has been to see how it has influenced others.
When Tom’s case became public, his doctors and I began receiving requests for phage therapy from all over the world. We were able to help some who sought treatment from Georgia, Poland and Belgium. Some died before phages could reach them.
In response to these requests, my colleagues and I founded a non-profit centre to conduct clinical trials on phage therapy while helping patients with superbug infections obtain phage therapy if they are no longer responding to antibiotics.
The pharmaceutical industry has viewed phage therapy with scepticism until recently, in part because phages are naturally occurring organisms that were not easy to patent.
However, a 2019 report of the first genetically modified phage to successfully treat a young teen with a drug resistant infection may change that, especially since her bacterium is a cousin to tuberculosis – the biggest bacterial killer in the world.
Looking ahead, the use of genetically modified and synthetic phages that are more easily patented, as well as the developments of phage banks, may prompt a new era of antimicrobial therapy that could offer personalised phage therapy on demand. While phage therapy is unlikely to ever replace antibiotics, it deserves to be rigorously evaluated in clinical trials.
Mother nature gave us a green alternative to antibiotics. With an estimated 10 million trillion trillion phages on the planet, the supply of phage is almost infinite, and due to evolution, is ever expanding.
The US National Institute of Health is now funding phage research and clinical trials for the first time, and new start-up companies have begun working in this space.
Meanwhile, we are still working to develop a phage library that could be used to match phage to bacterial infections more easily, mounting a revolution on superbugs’ evolution – which offers huge hope for the future.
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