A virus saves a man from a bacteria resistant to all antibiotics

In January 2020, a 56-year-old man arrived at a Boston hospital complaining of a striking skin rash that had spread down his left arm.

In a few months his situation became so critical that he had to be admitted without any of the applied treatments having an effect.

The story of how he overcame this crisis is a new example of the potential of viruses to fight antibiotic-resistant superbugs, a global pandemic with no apparent solution that kills more than AIDS, malaria and some tumors every year.

Antibiotic-resistant bacteria prey on people who are already weakened by other diseases or treatments.

These patients—hundreds of millions worldwide—are the most at risk of serious complications or even death from these infections.

The man who came to Brigham Women's Hospital that January 2020 was the perfect victim.

He had chronic kidney disease and arthritis in his joints due to a problem with his immune system that also caused neurological complications.

The doctors began to treat him with antibiotics without the situation improving.

A month later he had to be admitted.

The skin lesions on his arm became so large that doctors had to cut them open to remove the dead tissue.

None of the antimicrobials used could with the bacteria that caused the infection.

It was

, a pathogen in the tuberculosis family that can cause rashes and widespread damage to other organs.

In addition, the US patient suffered serious side effects from the toxicity of all the antibiotics he received.

A year later the infection had spread and the abscesses were getting bigger and more painful.

At that time, the Venezuelan-born doctor Francisco M. Marty suggested to his colleagues that perhaps a virus was capable of curing this patient.

The doctor was referring to bacteriophage viruses, pathogens specialized in killing bacteria.

For every known bacterium there is probably a virus capable of entering it and killing it.

All doctors had to do was find the right pathogen.

The doctors extracted microbes from the patient's wounds, sequenced his genome and searched 20 phages that had been studied before to eliminate infections with another superbug of the same family.

This is how Muddy was identified, a phage that in laboratory tests eliminated

Doctors got permission to use Muddy as an experimental treatment and injected it into the patient intravenously.

They also maintained antibiotic treatment.

The lesions improved in just two weeks.

The patient had no serious side effects.

Currently he continues to receive viral treatment and shows no signs of infection, explains Jessica Little, a Brigham physician and first author of the study that describes this case today.

"This is the first time that phage therapy has been applied to

," explains Little.

“In addition, it is the first case in which results are achieved with a single virus;

cocktails of various phages are typically employed,” he adds.

This case adds to the small but growing number of patients who have overcome superbug infections thanks to this experimental therapy.

The medical team has not identified the patient to preserve his privacy, but has published images showing the rapid evolution of his injuries after the experimental treatment.

His case leaves an interesting unknown.

The patient developed antibodies against the Muddy virus, but despite this there were no complications or relapses, Little points out.

"We need to better understand the interaction between these viruses and the patient's immune system, and if this can affect the success of treatment," adds the doctor.

In the study is a fond memory for Francisco M. Marty, the Brigham physician who first suggested phages and who died on April 9, 2021, falling off a cliff while taking photos in the Dominican Republic while on vacation.

CSIC researcher Pilar Domingo-Calap is one of the leading experts in Spain on the use of phages to defeat recalcitrant infections.

She recently managed to isolate phages to treat Dani Río, an 18-year-old boy who had been on the verge of death from an infection similar to that of the American patient.

“Using phages as a compassionate treatment is not new, but the fact that there are more and more cases and with positive results reinforces the need to regulate their use in clinical settings”, highlights this molecular biologist.

At the moment these treatments are only used as a last resort, when there are no other therapeutic options.

"Based on the patients' own strains, we look for phages in the environment and characterize them," says Domingo-Calap.

Phages are sometimes in the least expected places, such as hospital sewage where infections with superbugs occur.

One of the goals at the moment is to create "libraries" of phages identified, studied, and cataloged by the type of superbug they can kill.

One of the goals is to make phage cocktails against the most common superbugs that can be used so widely.

Superbugs are a direct consequence of antibiotic abuse.

The indiscriminate use to preventively treat any type of infection or to fatten cattle has caused many bacteria to develop immunity against many or all known antibiotics.

The goal now is to prevent the same thing from happening with phages.

That is why "lytic" viruses are sought that penetrate the bacteria and literally burst it.

It is important that they do not integrate their genome with parts of the bacteria's DNA;

Otherwise, they could become a vehicle for the transmission of resistance, which would return us to square one in the fight against this worrying pandemic.

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