Viruses versus Bacteria

Bacteriophages – a new hope

Maxim Rousseau, Polit.roo

Although bacteriophages have recently lost popularity in medicine, losing out to antibiotics in the competition, which turned out to be cheaper and easier to use, scientists now believe that it is bacteriophages that can play a key role in the fight against antibiotic-resistant bacteria.

Discovered in 1917 by French-Canadian biologist Felix d'herell, bacteriophages are tiny viruses that penetrate bacteria and kill them. By 2012, bacteriophages were grown for medical use only in Russia, Georgia and Poland. However, now bacteriophages have become a new hope in the fight against "super microbes" – bacteria that have become resistant to basic antibiotics. Therefore, in the last decade, research on bacteriophages has resumed in Europe and the USA.

Antimicrobial resistance poses a growing threat to global health, jeopardizing decades of medical progress and turning common infections into deadly ones, according to the World Health Organization. A UN report published last year suggested that annual deaths from drug-resistant diseases could rise from the current 700,000 to 10 million in 30 years if action is not taken. Developing countries are particularly vulnerable. According to a 2014 forecast, Asian and African countries will account for more than 90% of deaths caused by antibiotic-resistant bacteria by 2050.

In 2014, biomedical engineer Tobi Nagel from California founded the Phages for Global Health (PGH) project to help developing countries fight "super-microbes". "We have 30 years until the worst period of this crisis. It was possible to make medicines based on bacteriophages in less than 10 years. I became increasingly frustrated because the drugs I was working on in the United States, which usually cost one billion dollars to develop, were becoming inaccessible to most people living in developing countries," she says. – Bacteriophages are cheaper and faster to develop than conventional drugs, they can be used to minimize bacterial resistance in the future and have no side effects. They can be produced on relatively simple equipment available to scientists from developing countries who are most threatened by the spread of drug-resistant diseases."

Bacteriophages have their weaknesses. They act slower than antibiotics, are less resistant compared to chemicals and have a narrow spectrum of action: one bacteriophage affects only one type of bacteria. Phage therapy is usually applied individually, which makes it difficult to compare methods, and it is likely that bacteriophages are more effective against certain bacteria, while antibiotics work better against others. Therefore, modern researchers consider the optimal combination of two methods of treatment. More research is also needed to find out if the use of phages has any negative effects on the human body, but several side effects have been reported so far.

"Developing countries have special needs. Even common bacterial infections will have their own strains associated with specific countries," says Professor of microbiology Martha Clokie from the University of Leicester, who works at PGH. –For example, salmonella is found all over the world, but each African country probably has its own strains of these bacteria and, therefore, specific bacteriophages will be required."

Over the past three years, four two-week seminars have been organized in Africa, where about a hundred scientists have worked, who have passed on their knowledge to more than a thousand students. The fifth seminar, which was planned to be held in Malaysia, was postponed to next year due to the pandemic. In the new conditions, the work of PGH was transferred to online mode. Some of the training materials are available on the phage.directory website thanks to a grant from the Mozilla Foundation.

But the development of phage therapy faces great obstacles. The absence of clinical trials that meet international standards means that in most Western countries access to phages is either absent or possible only in exceptional cases. In many countries, there is no appropriate regulatory framework. So far, WHO has not officially included phage therapy in the action plan to combat antibiotic resistance, but Toby Nigel and her colleagues hope that this may change if the results of new clinical trials are positive.

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