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The Illusion of ProgressThe 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to the old antibiotics there are few new antibiotics being developed because most pharmaceutical companies have withdrawn from developing antibiotics, in part because developing new antibiotics is a slow and costly process.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
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