It may seem strange after a pandemic that has killed millions and turned the world upside down, but viruses could save just as many lives.
A battle between antibiotic-resistant bacteria and “friendly” viruses is taking place in a petri dish in a laboratory in the Georgian capital Tbilisi.
This small Caucasus nation has pioneered research into a groundbreaking way to combat the looming nightmare of bacteria becoming resistant to the antibiotics the world depends on.
Long overlooked in the West, bacteriophages, or bacteria-eating viruses, are now being used in some of the most difficult medical cases, including a Belgian woman who developed a life-threatening infection after being injured in the 2016 Brussels airport bombing.
After two years of unsuccessful antibiotic treatment, bacteriophages from Tbilisi cured their infection within three months.
“We use these phages that kill harmful bacteria” to cure patients when antibiotics fail, Mzia Kutateladze of the Eliava Institute of Bacteriophages told AFP.
Even a banal infection could “kill a patient because the pathogen has developed resistance to antibiotics,” said Kutateladze.
In such cases, phagotherapy is “one of the best alternatives,” she added.
Phages have been known for a century, but were largely forgotten and discarded after antibiotics revolutionized medicine in the 1930s.
It didn’t help that the man who contributed most to its development, Georgian scientist Giorgi Eliava, was executed in 1937 on the orders of another Georgian, Lavrentiy Beria, Stalin’s most notorious henchman and head of his secret police.
Eliava had been working at the Institut Pasteur in Paris with the French-Canadian microbiologist Felix d’Herelle, one of the two men credited with discovering phages, and persuaded Stalin to invite him to Tiflis in 1934.
But their collaboration was cut short when Beria had Eliava killed, though his motive still remains a mystery.
With the World Health Organization now declaring antimicrobial resistance a global health crisis, phages are making a comeback, especially as they can attack bacteria while leaving human cells intact.
A recent study warned that superbugs could kill up to 10 million people a year if antimicrobial resistance reaches a tipping point due to antibiotic overuse. That could come within three decades.
Although phage-based drugs can’t completely replace antibiotics, researchers say they have major benefits, as they’re cheap, don’t have side effects, or damage organs or gut flora.
“We produce six standard phages, which have a broad spectrum and can cure several infectious diseases,” said Eliava Institute doctor Lia Nadareishvili.
However, in about 10 to 15 percent of patients, standard phages don’t work, and “we need to find ones that are capable of killing that particular strain of bacteria,” she added.
Tailor-made phages targeting rare infections can be selected from the institute’s vast collection — the richest in the world — or found in sewage or polluted water or soil, Kutateladze said.
The institute can even “train” phages so that “they can kill more and more different harmful bacteria”.
“It’s a cheap and easily accessible therapy,” she added.
treatment as a last resort
A 34-year-old American mechanical engineer who has been suffering from a chronic bacterial disease for six years told AFP that after two weeks at the institute in Tbilisi he “already felt an improvement”.
“I’ve tried every possible treatment in the United States,” said Andrew, who gave only his first name.
He is one of hundreds of patients from around the world who come to Georgia every year for treatment as a last resort, Nadareishvili said.
As the traditional arsenal of antimicrobials is quickly depleted, more clinical trials are needed for phagotherapy to be approved more widely, argued Kutateladze.
In 2019, the US Food and Drug Administration (FDA) approved a clinical trial to use bacteriophage to cure secondary infections in COVID patients.
Beyond medicine, phages are already being used to stop food spoilage, and they “can be used in agriculture to protect plants and animals from harmful bacteria,” Kutateladze said.
The institute has already conducted research on bacteria targeting cotton and rice.
Bacteriophages also have the potential to repel biological weapons and combat bioterrorism. Canadian researchers published a study in 2017 on their use to counteract an anthrax attack on crowded public spaces.
Fighting antibiotic resistance with phages
© 2022 AFP
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