Learning About Phage
Here are some articles on phage therapy in the scientific literature to consider:
Colistin resistance: a major breach in our last line of defence
Phage therapy: From biological mechanisms to future directions
From a Harrowing Experience, Comes a Professional Calling
Steffanie Strathdee, PhD, had to navigate care for her husband who became gravely ill with a multidrug resistant bacterial infection while they were on vacation overseas. He recovered thanks to the use of phage therapy. From that experience, she has dedicated her life to getting phage therapy to the masses.
In 2015, psychiatrist Tom Patterson and his wife, Steffanie Strathdee, who is an epidemiologist, were on vacation in Egypt when Tom became violently ill. His condition quickly deteriorated, and he became delirious experiencing vivid hallucinations. Steffanie called their travel insurance company who commissioned a lear jet to fly them to Frankfurt, Germany to another hospital a few days later.
Patterson went into a coma and was placed on a ventilator. At his worst stage, his body was sucking calcium from his bones, muscle was being eaten to generate energy in order for him to survive, and he was on the verge of kidney failure.
They performed an endoscopy and realized he had an abscess in his abdomen, a pseudo cyst the size of a football that was infected with Acinetobacter baumannii, a multidrug resistant (MDR) pathogen that can be very difficult to treat.
Initially, 3 antibiotics were administered, but after 2 weeks, none of them resolved the Acinetobacter baumannii infection. He was flown back to the US, and after several ups and downs in Patterson’s condition, Steffanie investigated other options and came across bacteriophage (phage).
After a series of conversations with clinical investigators, the FDA, and the Navy, the Pattersons were granted a compassionate use for bacteriophage treatment. Without the treatment being FDA approved, it was required to have special permission to use the experimental therapy in the United States. After his treatment, Patterson’s condition resolved and he made a miraculous recovery. For those interested in learning more about their experience, people can read their memoir here.
Lessons Learned
“I'm an infectious disease epidemiologist, so you would think that I would have been aware of about how serious the antimicrobial resistance crisis is. And yet, it caught me blindsided,” Strathdee said. “I thought, yes, I knew what a superbug was. I knew that they were a problem, but I didn't think that a bacterial infection that you could acquire on vacation would turn deadly, so quickly...The second lesson was that my husband and I carried [the antibiotic] ciprofloxacin in case we ever got traveler's diarrhea. And, it's not a good idea to take antibiotics without a physician overseeing the situation, because in that sense, you're actually promoting antimicrobial resistance.”
Slideshow: From Multidrug Resistant Infection to Full Recovery to a New Vocation
Forming a Phage Center
From that terrible experience of having to navigate Tom’s care, Strathdee decided to dedicate her professional life to the cause of bringing phage to the masses. She is now the Co-Director at the Center for Innovative Phage Applications & Therapeutics (IPATH) at the University of California, San Diego. It was the first dedicated phage therapy center in North America when it opened in June 2018. Now there are a few other centers scattered across the US as well as internationally.
In the US, phage therapy can be administered on a compassionate use only, so there is a whole process people have to go through in order for patients to gain the ability to use phage. Strathdee and IPATH can help navigate that.
“In the US, if someone has a multidrug resistant bacterial infection that is no longer responding to antibiotics, they can contact us at IPATH or email us at: ipath@ucsd.edu,” Strathdee said. “We are a nonprofit, and we can help assess whether the patient is eligible for phage therapy under the current FDA guidelines for compassionate use. And we will help the physician in the protocol. But in between that, the phage has to be found that are a match for the bacterial isolate in question. And sometimes that can be a tricky prospect.”
Strathdee views phage as an alternative or adjunct to antibiotics. And despite it gaining traction, it will likely take several more years before phage can be prescribed like antibiotics.
“We've not really studied [phage] until fairly recently as a therapeutic,” Strathdee said. “Clinical trials are necessary to convince regulatory bodies like the FDA to license it alongside antibiotics—those clinical trials are just being done now.”
Contagion spoke to Strathdee about her experience, how phage can be used as a therapeutic, and insights on the work being done at IPATH.
Recent Videos
Related Content
