Bacteriophages – Multi-resistant bacteria treated with viruses

The mycobacterium

Robert Klatt

  • Multidrug-resistant bacteria always cause more dead
  • With many infections help bacteriophage
  • It concerns specialized virusesdie individual bacterial strains kill without attacking beneficial bacteria or cells in the body
  • Soon it starts too Germany one clinical studyin the people with cystic fibrosis With treated bacteriophage want

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

Pittsburgh (United States). Multidrug-resistant bacteria are becoming an ever-growing problem in medicine. According to data from the World Health Organization (WHO), antibiotic resistance is today one of the most common causes of death in the world. In addition to the new antibiotics, so-called bacteriophages can also help against multidrug-resistant bacteria. These are viruses that infect bacteria.

Bacteriophages attack bacteria through special receptors and then multiply in their cells. The bacterial cell then explodes from the mass of newly produced viruses and the bacterium dies. Since phages specialize in certain types of bacteria, they do not destroy beneficial bacteria or cells in the body during therapy. The main problem with bacteriophage therapy is therefore finding the appropriate phage.

To date, almost no studies on bacteriophages

So far, bacteriophages have mainly been used in the former Eastern Bloc. In Western countries, bacteriophages have rarely been used or studied in daily clinical practice since the development of antibiotics. In view of the multi-resistant pathogens, however, this has changed in recent years. Scientists at the University of Pittsburgh published a single case study with promising results in the journal Nature Medicine around 2019. They then received inquiries from doctors around 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 bacteriophage study in the journal Clinical Infectious Diseases. The study involved 20 subjects infected with antibiotic-resistant mycobacteria, mostly strains of the Mycobacterium abscessus species.

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

Treatment of Mycobacterium abscessus infections

According to study leader Graham Hatfull, Mycobacterium abscessus infections are a nightmare for doctors. “While they are not as common as some other infections, they are some of the most difficult to treat with antibiotics,” says Hatfull.

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

Bacteriophage without side effects

No side effects were observed in the clinical study. Furthermore, there is no evidence that the bacteria developed new resistance as a result of the treatment. “This gives considerable weight to the impression that the therapy is safe,” says Hatfull.

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

Clinical study in Germany

A clinical study on bacteriophages is also expected to start in Germany in the second half of the year. According to Holger Ziehr, head of pharmaceutical biotechnology at the Fraunhofer Institute of Toxicology and Experimental Medicine (ITEM), the test persons should only be people with cystic fibrosis infected with the bacterium Pseudomonas aeruginosa. As part of the study, you will receive a combination of three phages that cover most P. aeruginosa strains. The first results will be published in the next year.

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

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

Clinical Infectious Diseases, doi: 10.1093 / cid / ciac453

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