Antibiotic Resistance

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Presentation transcript:

Evolving Antibiotics and other Fairy Tales The Quest for the “Perfect Antibiotic” by Chris Engdahl

Antibiotic Resistance Mutations create novel antibiotic antagonists (β-lactamase) Strong selective pressures (i.e. antibiotics) eliminate nonresistant strains Interspecies competition promotes virulence factors Those strains immune survive to reproduce

Antibiotic Resistance Methicillin-resistant Staph. aureus (MRSA) Vancomycin-resistant enterococcus (VRE) Streptococcus pneumoniae Salmonella Campylobacter Pseudomonas aeruginosa (Burn victims) Escherichia coli And many, many more…

Antibiotic Resistance Graphic example of natural selection and evolution in action Novel antibiotics quickly lose efficacy New resistant strains emerge fast

Are We Screwed? (Perhaps not…)

Ganges River, 1896 Considered a dirty river Bacteriologist Ernest Hankin determines an unfilterable antimicrobial agent preventing cholera outbreaks

Paris, 1917 Félix d'Hérelle discovers "an invisible, antagonistic microbe of the dysentery bacillus…” “... a virus parasitic on bacteria.“ Call his discovery a bacteriophage (“bacteria-eater”) Forgotten to Western Medicine with the Antibiotic Revolution (but not to Russia)

Enter the Phage Bacteria’s Natural Predator 9×108 virions/mm in oceans Arguably the most abundant life form on earth Infects 70% of marine bacteria

Bacteriophage Life Cycle

Phage antagonists exist for the following pathogens Corynebacterium diphtheriae Listeria monocytogenes Escherichia coli Salmonella typhi Multidrug Resistant Staphylococcus Areus (MRSA) Streptococcus pneumoniae Pseudomonas aeruginosa Shigela dysenteriae Vibrio cholerae Klebsiella pneumoniae Clostridium perfringens

Benefits of Phage Therapy Target specific Quick, easy, and cheap to grow “Evolving antibiotic” No documented side effects (GRAS organisms)

Shortcomings Body may mount immune response, decreasing efficacy Not all bacteria have a phage antagonist …yet Public perception Traditional stereotypes (Russian) Ineffective against viral infections

In Summary Phage Therapy is a novel, effective and evolving treatment for many bacterial infections Largely untested due to public perception (“live virus syndrome”) and Cold War politics Potential for genetic manipulation and enhancement Some Phase 1 clinical trials in progress now in Lubbock, TX FDA approved for meat processing against Listeria monocytogenes

Bibliography Articles Brüssow H "Phage therapy: the Escherichia coli experience“. Microbiology (2005) v. 151, p.2133-2140. Soothill JS (1994). "Bacteriophage prevents destruction of skin grafts by Pseudomonas aeruginosa". Burns 20 (3): 209–11. Duckworth DH, Gulig PA (2002). "Bacteriophages: potential treatment for bacterial infections". BioDrugs 16 (1): 57–62. Pirisi A (2000). "Phage therapy—advantages over antibiotics?". Lancet 356 (9239): 1418. "Stalin's Forgotten Cure" Science 25 October 2002 v.298 Thiel, Karl (January 2004). "Old dogma, new tricks—21st Century phage therapy". Nature Biotechnology (London UK: Nature Publishing Group) 22 (1): 31–36. Wommack KE, Colwell RR (March 2000). "Virioplankton: viruses in aquatic ecosystems". Microbiol. Mol. Biol. Rev. 64 (1): 69–114. Hyperlinks http://www.cfsan.fda.gov/~rdb/opa-g198.html - FDA Agency Response Letter GRAS Notice No. GRN 000198 http://www.youtube.com/watch?v=9hzUjx_oD8E - Bacteriophage life cycle a la Youtube http://www.phage.ulaval.ca/index.php?pageDemandee=1 - Félix d'Hérelle Reference Center for Bacterial Viruses www.phagetherapycenter.com/ - Phage Therapy Center of Tbilsi, Georgia. “…effective treatment solution for patients who have bacterial infections that do not respond to conventional antibiotics”