The Illusion of Progress

The illusion of progress!

It was at an annual meeting of The American Society for Microbiology, in
Chicago in the early 1970's that antibiotic-resistance and hand-washing
were the topics de rigueur. Someone even hid in bathrooms and
established that a significant percentage of microbiologists failed to
wash their hands after using the facilities. I met a newly minted Ph.D. in
hand-washing whose project it was to study hand-washing habits of
hospital personnel and try to increase the practice. His favourite story,
and it may have been just a cooked-up joke, was that one day he
covered the mirror in a hospital washroom with a sign that read: All
hospital employees must wash their hands before returning to work.
Watching to gage the effect of the message he saw a doctor head for
the washroom door after using the john. When he called to the doctor:
Sir did you not read the message? The doctor turned and with a cold
stare retorted: I am not going back to work. I am going to the cafeteria to
have my lunch!

Teaching hospital employees to wash their hands appears to be as
effective as teaching the ten commandments and expecting the murder
rate to go down and it is worth remembering that even after a person
washes their hands, "from the microbial perspective human beings are
nothing more than walking microbial planets; there are 5-10 times more
microbes living on and in every human being than there are human cells
in our bodies."

Fast forward to 2008: A report entitled: "The Epidemic of
Antibiotic-Resistant Infections:" published in Clinical Infectious Diseases,
2008:46, Jan. 15, page 155 starts as Follows: "We are in the midst of an
emerging crisis of antibiotic resistance for microbial pathogens in the
United States and throughout the world." As of the year 2000 an
estimated 70,000 deaths due to nosocomially acquired, drug-resistant
infections occurred per year in hospitals throughout the United States.
Methicillin-resistant Staphylococcus aureus seriously sickened more than
94,000 Americans in 2005 and almost 19,000 died, more than 17,000
Americans who died of AIDS-related causes. It is also noted that as
more bacteria become resistant to the old antibiotics there are few new
antibiotics being developed because most pharmaceutical companies
have withdrawn from developing antibiotics, in part because developing
new antibiotics is a slow and costly process.

In Canada the official body counters tell us that an estimated that 8,000 to
12,000 Canadian patients die annually from mainly hospital acquired
antibiotic-resistant, superbug infections. That would mean that between
January 1, 2000 to April 30, 2008 there will have been as many as
100,000 Canadian victims of superbug infections.

Against so much bad news it would be logical that the news media
would jump on any opportunity to publish any good news. Recently, at
the Bacteriophage 2008 meeting in the UK, initial Phase II clinical trail data
of the first fully-regulated clinical trail (by Western standards) to test
whether phage therapy really works as a treatment option for superbug
infections were released. One would have expected a media flurry,
especially since the trail reported positive results. To date only two such
reports can be found when using Google-News with the string "phage
therapy." The first report which this author found was entitled:
"Technology to defeat bacterial infections shows positive results" was
published by Disease/Infection News, 25-Feb-2008 at
http://www.news-medical.net/print_article.asp?id=35541 . In this trail the
UK company Biocontrol Ltd. used bacteriophages against Pseudomonas
aeruginosa bacteria which are often resistant to traditional antibiotics.
Over a 17 months period a double-blind Phase II trail took place at a
specialist London hospital involving 24 patients with chronic ear
infections that were not responding to antibiotic treatments. Significant
improvements amounting to a mean 50% reduction in symptoms were
noted as compared to a mean of only 20% in the control group who did
not receive phages. The company now plans to do Phase III trails for the
ear treatment as soon as possible - where is government support when
it is needed? The company is also looking at the possibility of treating
patients with cystic fibrosis where lung infections with Pseudomonas
aeruginosa are common and dangerous.

What should be of interest to Canadians is that phage therapy was
discovered by the French-Canadian microbiologist Felix d’Herelle in 1917
and has been used continuously to treat bacterial infections for almost
100 years mainly in Eastern Europe. In Canada it can be made available
to patients under the Special Access Program of our Food and Drugs
Act; however, it is important to remember that phage therapy will not
replace the need for new antibiotics or increased sanitation in hospitals.
Perhaps the most important aspect of phage therapy is that phages kill
bacteria by a completely different mechanism than do chemicals,
including antibiotics. Therefore they would compliment the treatment of
infections when antibiotics fail.

G.W. (Bill) Riedel, PhD
42 Richlin Cres.
Ottawa, On K2B 8K4
Tel/fax: 613-828-5756
Net: briedel@magma.ca

Phages

Amazing Phage by Winston Churchill Fellow Grace Filby