When medicine won’t work

MARY REICHARD, HOST: Coming up next on The World and Everything in It: antibiotic resistance.

The first, true antibiotic was discovered in 1928 by Alexander Fleming. That changed everything, giving doctors a tool to cure once-deadly infectious diseases.

NICK EICHER, HOST: But during the last two decades, doctors have faced a growing problem: many of these infectious diseases have developed resistance to antibiotics.

According to the Centers for Disease Control and Prevention, at least 23,000 Americans die every year of an infection antibiotics can’t treat.

But alternative treatments are emerging.

WORLD Radio’s Sarah Schweinsberg reports.

SARAH SCHWEINSBERG, REPORTER: Alexander Sulakvelidze left his home country of Georgia for the United States in 1993. He came to work as a research scientist.

One day a physician friend told him about a patient who had come down with  a post-surgery infection.Typically, the infection would be cured with antibiotics, but the drugs weren’t working.

SULAKVELIDZE: He eventually died from this drug-resistant infection.

Sulakvelidze asked his friend if doctors had tried treating the patient with bacteriophages.

SULAKVELIDZE: And Glen came and looked at me was, you know, one of those looks that said, you know, what are you talking about?

Chances are—more than 20 years later—most Americans still don’t know what Sulakvelidze is talking about.

Today Bacteriophages—or “phages” for short—are one of several emerging alternatives to treat infectious diseases.

Dr. Anthony Fauci is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. Dr. Fauci says scientists are accelerating efforts to find alternative treatments to antibiotics as the problem of bacteria resistance grows.

FAUCI: It’s a worldwide problem.

Dr. Fauci outlines five potential solutions to bug resistance. The first is creating new and better antibiotics.  

FAUCI: There aren’t a lot of new antibodies in the pipeline. We’re trying to get more. A few years back, there were very few. The last few years there’ve been a few more, but we’re doing a little bit better.

A second strategy is developing new vaccinations, especially vaccinations that would protect surgical patients from hospital-borne illnesses. For example, Fauci says one day patients could get a staph infection vaccination weeks before a major surgery, like hip replacement.

FAUCI: If we develop vaccinations against them, you may be able to pre-condition them to be resistant to those microbes before you put them through the procedure that might lead to it.

Third is tricking bacteria out of a nutrient they need to survive. For instance, bacteria need iron to grow. Some scientists have discovered bacteria can’t tell the difference between iron and gallium. And gallium stops the bugs from growing.

Another strategy is building stockpiles of lab-engineered monoclonal antibodies. These are antibodies designed to target specific bacterias.

And finally….  

FAUCI: The other is the return of phage therapy.

Phages are the most common life form on the planet. Think 10 followed by 30 zeros. And they’re the viruses of bacteria. Every type of bacteria that exists has a specific bacteriophage following it around ready to eat it.

Dr. Fauci says a “return” to phage therapy because phages were first discovered more than 100 years ago. But as the West developed and used antibiotics, the Soviet Union and Eastern European countries were really the only places where doctors continued using phages. That’s why Alexander Sulakvelidze knew about them.

Today, as frustration with antibiotic resistance grows, phages are becoming promising partners for antibiotics.

Benjamin Chan is an associate research scientist at Yale University who studies and finds new bacteriophages. Because phages live where bacteria live, Chan visits places like sewage treatment plants, ditches, and ponds collecting samples.

CHAN: So in a mixed sample there’s tons of bacteria, tons of phages, you can use like a filter to remove all the debris and bacteria. And that leaves you just the viruses.

Chan then takes the phages and introduces them to a particular bacteria. If clear circles begin to appear in the petri dish, that means he’s found a bacteria’s killer phage.

CHAN: That would be where a phage landed and killed the area around the bacteria.

Chan’s phages have been used to treat infections in cystic fibrosis patients. In trials, phages have weakened the previously antibiotic-resistant bacteria to the point where antibiotics could once again kill the infection.

Phages can be used outside of the human body as well. After realizing Western doctors didn’t know much about phages, Alexander Sulakvelidze co-founded a phage research center called Intralytix.

Today, Intralytix has produced four FDA approved phage treatments for plants to prevent food-borne illnesses as well as phages that can be used in some livestock.

SULAKVELIDZE: This is just the beginning and there’s the whole thing is a platform technology.

NIH’s Dr. Anthony Fauci says more scientists like Chan and Sulakvelidze will have to continue digging into antibiotic alternatives because this problem isn’t going away.

FAUCI: Do I think it’s getting better? No, I think it’s getting worse, and that’s the reason why we’ve accelerated our efforts to combat antimicrobial resistance.

Reporting for WORLD Radio, I’m Sarah Schweinsberg.

(AP Photo/Elaine Thompson, File) In this Feb. 13, 2019, file photo, a health care worker prepares syringes.

WORLD Radio transcripts are created on a rush deadline. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of WORLD Radio programming is the audio record.