On a fateful morning at the end of September 1928, Dr. Alexander Fleming, a bacteriologist from St. Mary’s Hospital, returned to his lab in London, having taken a summer vacation in Scotland. He found his lab bench messy, but it would prove one of the greatest mistakes in history. In multiple Petri dishes grew colonies of Staphylococcus aureus (a bacteria responsible for, surprise, staph infections). Still, Dr. Fleming noticed that a mold not intended to grow in the dish had dominated the controlled environment. This mold produced chemical weapons against the bacteria, which hindered the bacteria’s growth.
It took fourteen years for Dr. Fleming to harness the antibiotic he had discovered, to refine it, and to successfully treat the first patient, a ninety-year-old woman suffering from a streptococcal infection. From then on, humanity wielded Penicillin, and other antibiotics like it, as a potent drug against diseases that would otherwise mean death: the likes of Tuberculosis, Syphilis, Tetanus, Cholera, and E. coli.
The story, however, is not over.
Antibiotics hinder or kill bacteria by targeting their vital processes — the synthesis of the cell wall (their “hard” skin), the cell membrane (their “soft” skin), proteins (their building material), and nucleic acids (their DNA) — and plenty of bacteria share these processes. Antibiotics were praised as miracle drugs to humanity, and that reputation became a double-edged sword. On one hand, antibiotics saved millions of lives, but on the other hand, antibiotics became misused. The populous began overdosing on antibiotics or not finishing their antibiotics dosage. People took expired antibiotics for illnesses, animals were fed antibiotics for their meat, and humans took antibiotics for viral infections (antibiotics do nothing against viruses).
This HEAVY misuse of antibiotics constantly applied selective pressure on virulent bacteria and presented a perfect opportunity for new bacteria to evolve. Now take this concept, multiply it over dozens of patients (who may or may not wash their hands thoroughly) in a high-traffic area — say, a city hospital — and throw in the ability of bacteria to share these drug-resistant genes. It’s all but guaranteed that a multidrug-resistant strain will eventually arise from the sickening, germ-filled ashes. Basically, humanity forced bacteria to adapt, to become resistant to our drugs. Bacterial superbugs like Tuberculosis, Gonorrhea, and Methicillin-Resistant Staphylococcus Aureus (MRSA) are already raising concern in the medical community. If nothing is done, an ultimate superbug, if you will, that is infectious, deadly, and resistant to a wide variety of antibiotics could cause the next pandemic. An ultimate superbug is the nightmare scientists are trying to avoid.
The story is still not over.
In 1915, a British microbiologist named Frederick Twort discovered the bacteriophage, a virus fine-tuned to attack bacteria. Four years later, a French-Canadian microbiologist named Felix d’Herelle came up with the concept of phage therapy: a process in which a cocktail of these phages specific to a particular bacterium is injected into the host of a bacterial infection. These microscopic assassins are so precise, so specialized that human cells and good bacteria aren’t significantly affected; the phages only kill the virulent bacteria.
As simple as that may sound, the concept didn’t gain steam back in the 20th century in favor of antibiotics. Antibiotics were better understood and much easier to mass-produce. Antibiotic treatments, in many forms, were also much easier to sell to the public than injecting literal viruses into a patient. Nonetheless, phage therapy began to receive more attention as scientists looked for effective alternatives to antibiotics. And effective, I believe, phage therapy will prove to be.
Phages are the natural nemesis of bacteria and can be found wherever bacteria are: everywhere. If bacteria mutate and gain resistance against phages (as difficult as that is, considering the many genetically unique phages that may target a few strains), they may trade away resistance to our drugs; this means phages can be used in conjunction with antibiotics as treatment. While you only receive as many antibiotics as you are given, phages are programmed to multiply using bacteria; as they kill the targeted bacteria, the phages will become without a host and stop multiplying. They’re not harmful to humans, nor are they toxic to animals (think about your pets) or the environment.
Clinical trials have shown that there is some validity to the idea. The Center for Innovative Phage Applications and Therapeutics (IPATH) at UC San Diego School of Medicine published data from ten cases of phage therapy (through intravenous injection, or through the veins) to treat multidrug-resistant bacterial infections. Seven out of the ten cases had a successful outcome; there is hope, but many obstacles remain.
There is no way to mass-produce phages as of now. Definitive doses accounting for various factors are yet to be flushed out. Finding exact phages to target specific bacteria is tricky. The human immune system may react negatively to introducing, again, literal viruses to the body. Not all phages make for suitable treatments, and some bacterial strains may not have a phage associated with them at all.
The discovery of antibiotics still stands as one of the greatest advances in medical history; one of many monumental innovations in medicine like anesthesia, vaccination, insulin, and organ transplants. Phage therapy is the next weapon to be perfected and refined in this arms race against illness, ushering a new era of precision medicine and a healthier humanity.
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She will give birth to a son, and you are to give him the name Jesus, because he will save his people from their sins.
Matthew 1:21 NIV