Using Phages to fight the rise of superbugs

As phages receive increasing attention from the scientific and medical communities, biomanufacturers are exploring ways to produce phages at an industrial scale.

In the early 20th century, before the era of antibiotics, physicians used phages to treat life-threatening infections. At the time though, this approach was a bit hit-and-miss. A phage might eliminate a bacterial infection in one patient, but not another. There was also a problem with supply — phage cultures required constant maintenance, and hospitals often didn’t have the resources for this. Then along came antibiotics which were broadly effective and fairly easy to produce and store. Phages were largely abandoned as a therapeutic. 

Now as antibiotic resistance in bacteria is on the rise, enabling the emergence of multi-drug resistant ‘superbugs’, scientists and clinicians are looking for other options. Phages are now emerging from the history books as a potential treatment for such superbugs. We now know that the hit and miss characteristic of phage treatments is due to the fact that phages are highly specific to certain bacteria. 

But what was once a disadvantage could now be very useful: it is anticipated that specific phages could soon be used to wipe out very specific bacterial infections, while leaving healthy bacteria alone. 

Phage therapy is still experimental, but there are already a small number of cases where phages have been successfully used as an emergency treatment for drug-resistant infections. For example, researchers in the US and UK recently used genetically-engineered bacteriophages to treat a potentially fatal drug-resistant mycobacterium abscessus infection in a young cystic fibrosis patient. It’s the first time engineered phages have been used in a human and, importantly, it appears to have worked. 

As phages receive increasing attention from the scientific and medical communities, biomanufacturers are taking note and are exploring ways to produce phages at an industrial scale. 

Ultimately, this involves letting phages do what phages do best: infecting bacteria. 

The aim is to grow extremely large cultures of specific strains of bacteria in highly specialised bioreactors, then add phages of choice and let the infection spread. The phages take over the cellular machinery of the bacteria, turning each one into a phage-making factory.