Are North Americans allowed to suffer and die from antibiotic-resistant superbug infections unnecessarily? In the next two days 44 Canadians and 110 Americans will die of antibiotic-resistant infections. The superbug deaths relentlessly advance causing 40,000 U.S. and 8,000 Canadian deaths annually.
While the mere mention of multiple antibiotic-resistant superbugs may strike doctors and patients with dread, they represent the opportunity to fulfill the raison d'être for the right bacteriophage. Superbugs' presence excites the reproductive machinery of the phage into action. In stealth, moon-lander fashion, the phage commandeers the reproductive system of superbug. In a short time (30 minutes) the superbug bursts open releasing more than 200 copies of phage, each looking for a superbug to conquer. While a superbug multiplies by dividing in two, the phage produces about 200 offspring for every superbug killed; clearly with those odds the superbug becomes the victim.
Bactericidal, heat-labile, filterable principles in the Ganges and Jumna rivers in India were discovered in the 1890s, and it was subsequently confirmed that many rivers with fecal pollution contained similar bactericidal agents. Tanner, in his 1944 textbook, "Food Microbiology," examines this phenomenon in some detail. It was d'Herelle, a French Canadian working in Paris at the Pasteur Institute, who demonstrated in 1917 that the bacteria-lytic activity was due to viruses specific for bacteria–he named them bacteriophages–"bacteria eaters" and also advocated the use of phages for the treatment of bacterial infections. Until 1940, phage therapy was widely practiced and researched, often with contradictory results, mainly because the biology of bacteriophages was poorly understood. With the introduction of antibiotics, phage therapy was essentially abandoned in the West until the 1980s when antibiotic-resistant superbug infections caused some Western scientists to re-examine their potential to cure human, animal and plant infections, as well as their potential for reducing or eliminating contamination from foods, ranging from vegetables to meats.
2002 to 2007 has been dubbed the "Window of Superbug Vulnerability," because new effective antibiotics are not likely to be available before 2007. The antibiotic-resistance superbug phenomenon is a human-created, regulatory-scientific misadventure that can be blamed on the massive abuse, misuse and overuse of antibiotics. As early as 1945, it was known that when natural pathogens are exposed to natural antibiotics they undergo adaptation and acquire resistance.
At present, in addition to established organizations in Georgia, Russia and Poland that are reportedly marketing therapeutic and prophylactic phage products against bacteria including Staphylococci, Streptococci, E. coli, Pseudomonas, Proteus, Salmonella, Shigella, Serratia, Klebsiella, Enterobacter, Campylobacter, Yersinia and Brucella, there are an estimated 10 companies located in the United States (Intralytix Inc: www.intralytix.com), Canada, India (GangaGen: www.gangagen.com) and Israel (Phage Biotech Ltd: www.phage-biotech.com) racing to provide a number of phage therapy products for a range of medical, animal husbandry, food processing and environmental applications. It is anticipated that the first phage-based products for treatment of meat and poultry will receive FDA approval soon; an "experimental use permit" from EPA has been granted for use of phages in the environment on non-food contact surfaces.
Dr. Elizabeth Kutter from Evergreen State College, Olympia, Washington has studied phages for 40 years and is now finding the phage for Escherichia coli, which is responsible for 60 food poisoning deaths annually. In 1997 she wrote a comprehensive review entitled, Phage Therapy: Bacteriophages as Antibiotics. (www.evergreen.edu/phage).
Doctors, relatives and non-mobile patients from countries where phage therapy is unavailable face a dilemma because commercially available phage therapy products may only be legally available for import on a case-by-case basis upon request to the appropriate regulatory agency under special access programs provided for under pharmaceutical product regulatory legislation. But can the bureaucratic processes be accomplished in time when a superbug infection rages? Phage therapy is currently available as a treatment option for those individuals with knowledge, money and time to travel; and the recent opening of the Phage Therapy Center, Mexico (www.phageinternational.com) should make treatment more available to citizens of the Americas.
When considering regulatory approval for these products, we are not talking about the approval of a new, promising molecule with unproven pharmaceutical potential; but rather we are talking about the re-approval and re-introduction of products and technologies previously used worldwide and that are today quite well understood from a scientific point of view (www.phages.org/PhageInfo.html).
For more information, see www.phagetherapy.com, where the following statement welcomes visitors: "One of the most exiting developments in combating disease is Phage Therapy. Join us in the exploration of this fast breaking field."
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