Can phages reduce our reliance on antibiotics?

Chris Smith asked Tom Ireland, author of a book on the topic...

Tom - It's not feasible to just keep making more antibiotics to solve this issue. There's this lack of commercial interest at the moment, which is a real problem. But even if we do get new antibiotics coming online soon, resistance will emerge to those antibiotics really quickly too. We're just using too many of them. They're being flushed out into our waterways, they're in hospitals and clinics. So we really need completely new ideas and approaches and in my book I talk about this idea of using the natural enemy of bacteria which are phages, the viruses that infect bacteria. And what's neat about phages is that they're exquisitely well evolved to kill bacteria. They do this amazing thing where they sense the bacteria, land on it like a little lunar lander on the outside of it, inject their genes into the bacteria, essentially hijacking the bacterial cell to become a virus factory. And then when the bacteria is full of cloned viruses, the virus issues this final command for the bacterial cell to kill itself and pop itself open.

Chris - Like a party balloon full of glitter.

Tom - Yes. But kind of horrible and icky and viral. But I'm sure if you are suffering from a drug resistant infection and these phages start working, it would be like a celebratory balloon popping full.

Chris - It really does save lives, doesn't it? We had, on this programme, the scientists who helped a young lady who had cystic fibrosis and was suffering from a disseminated infection with a particular bug, a bit like TB. That had gone all over her body and it was resistant to all the antibiotics we had and they found some bacteria phages that they gave to her and saved her life.

Tom - Yeah. I think I know the case you're talking about and one of the phages that was used in that case was found on a rotten aubergine in someone's compost heap in Cape Town. So that's another thing that's very cool about using phages is they are absolutely everywhere. There's trillions of them probably in this room as we speak. You can find them in sewers or a stream or a lake. And as I mentioned earlier, wherever you find nasty bacteria, you find potentially medically useful phages. So we'll go from this situation where we might spend years and years developing a chemical antibiotic, but actually it is possible to also just pluck a virus out of a sewer and use that as an antibiotic, which gives us hope for this very scary crisis of drug resistance that we're facing.

Chris - One of the first guests we had when I first started making radio programmes was a gentleman who was trying to tackle MRSA, and he'd made a nose spray that could spray bacteria phages into the nose to decolonise a person before they went into hospital for an operation. He told me the Ganges in India is one of the best places to get water samples for bacteria phages because it's so polluted. There's so many different bacteria in there, you can find any phage you like living in there.

Tom - Yeah. It's a wonderful introduction to the book actually. We are talking about this river that's known as a holy river with this cleansing spirit. And people in India, they go on pilgrimages to the Ganges and they bathe in the Ganges, which is absolutely full of the worst bacteria on the planet. But this idea that it can heal people has remained for centuries. And some people think that it's because it's actually full of these viruses that can prevent diseases. So interestingly, epidemics that should go downstream through the Ganges stop, or they go upstream instead. And it's thought that's because of the kind of protective properties of all the bacteria phages and viruses found in that water.

Chris - Or it could just be the people who survive the experience are so fit and they're so healthy that nothing's going to kill them. So it could be that too. It could be survival bias, couldn't it?