Phages and phage therapy

• when did bacteria evolve

  • 4 billion years ago
  • initiated life on earth
  • through evolution, bacteria started photosynthesising, generating oxygen
• how many bacterial cells are in a gram of soil

  10 billion
• why was bacteria dangerous in the early 1900s

  • 1 in 20 infants died in their first year
  • strep throat could be fatal
  • 90% of children with bacterial meningitis died
• why is AMR bad

  • third biggest global killer after stroke and heart disease
  • costs $1 billion and takes 9 years to get a new antibiotic to market
• why are randomised clinical trials with phages hard

  • phages are highly specific so phages selected for a treatment might not match patient strains
  • dosing of phages is not like any other drug as it self-catalyses at the site of infection
• Test Case study: Co-infection at Great Ormond Street

  • Klebsiella and Enterobacter co-infection
  • Tight deadline as patient undergoing stem cell therapy in a few weeks
  • Received strain and had 2 phages against Klebsiella within 24 hours from CPL library
  • Screened >2000 wastewater and citizen samples in 72 hours
  • 165 Klebsiella phages
  • 166 Enterobacter phages
  • Top four phages per strain ready for clinical use within 20 days of receiving strain