The new antibiotics
“The Independent” – Health and Wellbeing
They can fight infections, promise fewer side effects and can
adapt when diseases resist them. Bacteriophages could be the answer to the MRSA
superbug. Jerome Burne reports
While the government invokes the spirit of Florence Nightingale in a -
surely desperate - bid to tackle the growing problem of antibiotic resistance
in hospitals, at least two UK biotech firms are engaged in a race to come up
with a 21st century solution. Both companies are also using a rather elderly
technique - discovered during the First World War - but bringing it up to date
with modern genetics.
While the government invokes the spirit of Florence Nightingale in a -
surely desperate - bid to tackle the growing problem of antibiotic resistance
in hospitals, at least two UK biotech firms are engaged in a race to come up
with a 21st century solution. Both companies are also using a rather elderly technique
- discovered during the First World War - but bringing it up to date with
modern genetics.
The winner will be the first to market an antibacterial product containing a
type of virus know as a "bacteriophage" - literally "bacteria
eater". First discovered in 1917 by the Frenchman Felix d'Herelle,
"phages" were used to treat conditions like infected wounds, ulcers,
typhoid and cholera for about 20 years but then, on the advent of antibiotics,
were forgotten in the West.
But phages are generating huge interest in research labs because, being
alive, they are able to mutate, making it much harder for bacteria to develop
resistance to them. A recent study in Science found that the phage that
attacks Bordetella, which causes whooping cough, can make billions of
variations in a key protein. Such versatility makes resistance unlikely.
Something new is certainly needed. A few years ago the first original
antibiotic compound for 35 years was introduced. Within two months resistance
to it had developed.
At least two of the companies in the race are working on phages to target
MRSA (methicillin-resistant Staphylococcus aureus) the main bacterium involved
in hospital-acquired infections that kill at least 5,000 people a year.
Each phage only infects a specific strain of bacteria, avoiding the
carpet-bombing approach of antibiotics, which knock out friendly gut bacteria
as well. Phages are also everywhere - probably the most numerous life form on
the planet; a millilitre of water from a river will contain about 200 million
of them. "We've patented a way of collecting phages from the wild,"
says Nick Housby of Novolytics, one of the companies in this race. "If a
new, resistant strain of MRSA emerged in hospitals we could have a phage to
attack it within a matter of weeks," he adds.
At least they could in maybe three or four years time, when their cocktail
of about eight different phages, one for each of the main resistant strains of
MRSA, has passed all the trials. Their first product will be a nasal spray to
kill off the MRSA that 30 per cent of people carry harmlessly in their
respiratory system, but which can be deadly to people with weakened immune
systems in hospital.
Although still fairly novel in the West, phages have long been used in
Phage-based treatments are still sold over the counter in some
eastern-European countries, their use supported by years of clinical
experience, although little of it backed by conventional trials. The only
detailed account of their use was published by the
Such reports cut little ice with the
The bug they are targeting is called Pseudomonas aeruginosa which is
responsible for, among other things, chronic ear infections and the clogging
mucus found in the lungs of people with cystic fibrosis. "We've already
run a successful trial on 10 dogs who had failed several rounds of antibiotic
treatment," says Harper.
But perhaps the most ingenious new phage line is coming from a firm called
Phico Therapeutics. "While I was working in the States some years ago I
discovered this protein that is able to totally shut down a bacterium's
DNA," says Heather Fairhead, the founder of the company. "The protein
is only found in a species of bacterium that forms spores when food supplies
run low," she explains. "It goes into a kind of suspended animation
and all its DNA becomes inactive." In Fairhead's system the phage is only
used as a delivery vehicle - "its one aim in life is to target bacterial
DNA, so it's perfect". The first application will be a barrier cream for
potential MRSA carriers in hospitals.
Sales of a successful product could be huge, and the rivalry between the
contenders is hotting up. "I should point out that we aren't using any
genetic modification in our product," Housby of Novolytics e-mailed me
"and our phages keep on reproducing, which Phico's don't. Fairhead was
equally keen to stress her rivals' shortcomings. "When you kill bacteria
using wild phages," she explained "they make the bacteria burst, so
toxins get spewed out, along with genetic material that can carry
resistance."
It's to sort out such possible issues that the trials need to be done. For
instance, although there should be no problems putting phages into creams or
ointments, some experts worry about putting them directly into the body.
"There's the possibility of the phage being mopped up by the immune system
or causing an allergic response," warns Geoffrey Hanlon of
There is a nice symmetry about the notion that an alliance between the
principles of Florence Nightingale and a revamped bit of Russian health care
may eventually roll back the advancing bacterial hordes.
