Are Phage Viruses the Forgotten Cure for Superbugs? [Excerpt]

A new book follows a crop of biotech start-ups as they race to turn tiny bacteriophage viruses into a new weapon against antibiotic resistance

By Anna Kuchment

Excerpted from The Forgotten Cure: The Past and Future of Phage Therapy, by Anna Kuchment. (Copernicus Books, 2011. Reprinted by?permission of Springer Science+Business Media)

In April 2002, Fred Bledsoe was doing construction work on his parents' lake house near Fort Wayne, Indiana, when he stepped on a rusty nail that bore through his shoe and lodged in the sole of his foot. Bledsoe cleaned up the wound and drove to a nearby hospital where doctors gave him a tetanus shot. Case closed, he thought.

One week later, his foot swelled up, and the wound began oozing pus. Bledsoe, a burly, quiet man with a graying goatee, was a one-time factory worker out on disability leave and battling diabetes. He decided to pay an office visit to his brother, Larry, a general practitioner, who prescribed a 10-day course of antibiotics. That seemed to do the trick; Fred felt much better. But in August, the infection came back with a vengeance. His foot tripled in size?"it looked like a football," said his sister, Saharra?and a new infection site appeared at the base of his big toe. He couldn't wear normal shoes, much less walk. Larry had his brother hospitalized, and doctors started him on a heavy course of IV antibiotics. They also implanted Gentamicin, an antibiotic that looks like a small string of pearls, near Bledsoe's big toe so that a high concentration of medicine could be delivered directly to the site of the infection. But diabetes had damaged the circulation in Bledsoe's foot, making it more difficult for the antibiotics to penetrate deeply enough and for his body's own white blood cells to help beat back the invading organisms. Though the wound seemed to improve on the surface, the bacteria had taken up residence near the bone, where the Gentamicin could no longer reach them. Nine weeks later, Bledsoe's physicians gave up. "My doctor told me I'd have a good quality of life without my toes," he says.

A short time later Bledsoe's sister, Saharra, caught an episode of the CBS news program "48 Hours." An episode called "Silent Killers" discussed the increasing incidence of antibiotic-resistant infections. After reporting on two scary cases?a woman whose paper cut turned into a blood infection, an 18 month old girl who nearly died from an ear infection?the story turned to a case that was eerily similar to Fred's. Alfred Gertler, a jazz musician from Toronto, Canada, had developed an infection in his ankle after fracturing it while hiking in Costa Rica. As with Fred, doctors had advised him to have his foot amputated.

Gertler refused to listen to his physicians. Desperate for an alternative, he had scoured the medical literature until he came upon a magazine article describing a treatment called "bacteriophage therapy." Practiced in the United States until the 1940s and still used in parts of Eastern Europe, it pits tiny viruses?bacteriophages, or phages for short?against disease-causing bacteria. These viruses, the most ubiquitous organisms on earth, are bacterial parasites: they reproduce by attacking and destroying deadly germs.

The world's oldest institute dedicated to the study and practice of phage therapy is in Tbilisi, the capital of the former Soviet Republic of Georgia. Unable to find a cure in the state-of-the-art hospitals of Canada, Gertler bought himself a plane ticket to the Third World. There, doctors infused his wound with an amber-colored broth teeming with the invisible creatures. After three days of treatment, he reported, his infection was gone. Though it recurred later, after he returned to Canada, it was in a mild enough form that doctors could finally fuse together his anklebones.

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