Doctors at Yale had a big problem. After operating on a 76-year-old man's heart, his chest became infected by bacteria. While this is an unfortunate post-op complication, it's usually remedied fairly easily with antibiotics. However, because many strains of viruses have adapted and become more and more resistant to these medicines, they found one particular bacteria, P. aeruginosa, would not leave the patient's system. With no other solutions, doctors turned to a local pond.
It turns out there's a certain type of virus, known as bacteriophages, or phages for short, that target bacteria like P. aeruginosa. Doctors have known about these viruses for over a century, but with easier, more reliable medicines like antibiotics at their disposal, physicians never saw a need to use them. Now, with so many strains of bacteria developing resistances to traditional treatments, that may be changing. At Yale, the doctors collected thousands of phages and injected them into the patient to kill his infection. On Thursday, March 8, they announced the treatment was a success and published their findings in Evolution, Medicine, and Public Health.
Phages are naturally occurring viruses that can't be made in a lab. Research teams went to many different bodies of water to collect samples and send them back to the hospital. Finally, testing water from the Dodge Pond in Niantic, Connecticut, researchers found phages that were programmed to kill P. aeruginosa. Since the treatment had never been attempted before, the medical team first got permission from the patient (who was also a doctor, coincidentally), and then secured FDA approval for the procedure.
Phage treatment could provide a helpful alternative to antibiotics, which are commonly overprescribed in the U.S., leading to resistant strains of bacteria that can survive almost anything we throw at them. Since antibioitics are also given to livestock like cattle and pigs, bacteria develop immunity in our food before we eat it. In November 2016, a Nevada woman was killed by a "superbug" that couldn't be killed by any of 26 antibiotics. Timothy Lu, an associate professor of biological engineering at MIT, commented:
Studies like this highlight the potential for phages. More studies need to be done, but anecdotes like this are really powerful.
3 responsibilities physicians have to combat the existential threat of antibiotic resistance:— James Maloy (@JamesMaloyMD) March 9, 2018
1) Be judicious when prescribing abx
2) Deescalate abx whenever possible
3) Stop supporting animal agriculture-- go Vegan! #vegan #AntibioticResistance #farming https://t.co/o1k3iGytYP
Lu also warns of phages' drawbacks, however:
Most antibiotics are pretty broad spectrum in nature. As a result, doctors are used to dispensing antibiotics without knowing which bacteria are present. But phages are different. It's really important to have a high confidence of the bacteria that is causing the disease.
i’m turning off my phone if anyone needs me i’ll be crying over antibiotic resistance— julie♡tori (@parkjnys) March 12, 2018
As resistance increases, phages are being thought of more and more. There's still much experimenting to be done, but Ben Chan, the Yale researcher whose idea it was to use the viruses on this patient, is putting together a library of microbes equipped to fight certain bacteria, and, according to him, his little phage armies are in much demand:
I get calls, emails, and texts pretty frequently.
Could this be the future of medicine?