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December 15, 2017

Bacteria keep outsmarting our best antibiotics. Is it time to try a different approach?

Daily Briefing

    Antibiotic resistance is a growing threat in the United States, with more than a dozen types of bacterial infections in the country now resistant to all or nearly all currently available treatments—but researchers armed with government funding are looking at "out-of-the-box" ways to fight off bacteria, Jennifer Haberkorn writes for Politico.

    The current state of hospital antibiotic stewardship

    A growing threat

    According to Politico, public health experts say antibiotic-resistant infections could surpass cancer as one of the most deadly medical conditions in the world—causing 10 million deaths annually by 2050—if researchers do not identify ways to curb them.

    But addressing antibiotic-resistant infections is easier said than done. According to Politico, antibiotics are difficult to develop and do not generate as much revenue for drugmakers as treatments that patients take long-term.

    Government steps in

    In response to the growing threat, former President Barack Obama's administration in 2015 initiated a national effort to combat antibiotic resistance, focused on both policy and medical practice improvements, such as bolstering antibiotic surveillance and determining how to best use existing antibiotics.

    In addition, NIH under the initiative distributed $5 million to 24 research projects focused on 'unconventional, sometimes controversial' ways to treat bacterial infections that do not involve antibiotics, Politico reports.

    A look at the research

    According to Politico, the out-of-the-box, NIH-funded research projects vary in focus. For instance, several focus on ways to stop bacteria from infecting humans, others are looking at ways to use new technology—such as light therapy—to treat bacterial infections, and about one-third are examining how researchers could use bacteria that are not harmful to humans to target dangerous bacteria.

    One project focuses on a practice known as bacteriophage therapy, which was first developed in the early 20th century but fell off once antibiotics were introduced in the market, Politico reports. The practice involves using bacteriophages, which are viruses that use specific enzymes, called lysins, to kill harmful bacteria while leaving the body's normal bacteria unharmed. According to Politico, the University of California-San Diego in April announced that it had successfully used bacteriophage therapy to treat a U.S. patient who had contracted a drug-resistant strain of Acinetobacter baumannii.

    However, some stakeholders have expressed concerns that bacteriophage therapy could be risky because the practice involves live viruses that could react unpredictably once inside the body. In addition, critics of the practice note that, thus far, it has been difficult for scientists to match bacteriophages to the bacteria they can destroy. Another concern is that the bacteria eventually could become resistant to their corresponding bacteriophages.

    David Thanassi, a professor and researcher at Stony Brook University, is heading a separate NIH-funded project that is searching for a drug that would alter harmful bacteria so that they no longer pose a risk to humans or can no longer adhere to the body. Thanassi said, "The idea of how to disarm the bacteria—there has yet to be an approach that has come to market, but there is a lot of promise in this."

    In another project, Michael Hamblin, a professor at Harvard Medical School, is researching whether dyes and light—which already can be used to kill bacterial infections on the skin—could be used to eradicate bacterial infections under the skin. Under such a method, nontoxic dyes that attach to bacteria would be injected into a patient's skin. Physicians then would shine specifically colored lights on the skin, and the combination of dye, light, and oxygen would kill the bacteria, according to Hamblin. He explained, "When you put them together, it is highly reactive—it can virtually kill anything dead."

    A 'high risk,' but 'high reward' investment

    Dennis Dixon, who oversees the bacteriology and mycology branch at NIH's National Institute of Allergy and Infectious Diseases, called NIH's research investment "high risk," but add that the efforts also could result in a "high reward." He added that bacterial infections "are always going to be around us; they're always going to be a problem. That's why we want to have a multipronged approach to dealing with them when we need to" (Haberkorn, Politico, 12/13).

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