Doctors at the Saint-Luc university hospital in Brussels have saved the life of a 13-month-old baby using a revolutionary technique thought to be a world first. The baby was born with a liver condition that required a transplant. Afterwards it was struck by an infection of the liver and blood supply which did not respond to antibiotics. Instead, doctors at the hospital turned to a technique where Belgium is at the cutting edge of developments: using bacteriophages, or viruses which consume bacteria, to target the germs causing the infection.
The use of bacteriophages, often called simply phages, dates back around a century, but the technique fell out of favour with the rise of antibiotics. The existence of microbes that preyed on other microbes was discovered by the Canadian microbiologist Félix d’Hérelle, after other scientists had observed how, for example, the waters of the River Ganges had some mysterious power to protect from cholera.
The use of phages has continued in some countries, and has received more attention in recent years because of the diminishing efficacy of antibiotics and the development of antibiotic-resistant disease strains.
Among those interested in the new-old field is Lieutenant-Colonel Patrick Soentjens, head of the infectious diseases department of the military hospital in Neder-over-Heembeek in the north of Brussels.
Phages are the natural enemy of bacteria, and the hospital has been working with samples brought from Russia and Georgia, where use has been more or less constant since the discovery of the procedure. But as a military man, Dr. Soentjens, speaking to the VRT, describes his phages as the Special Forces of the combat against disease. “They have to be further taught, trained and kept in shape.” he said. “That’s the only way to make sure they remain effective for future treatments, because bacteria also evolve in time.”
The treatment of the Saint-Luc baby took 85 days, as the phages first reconnoitred the situation and then were “trained” to seek and destroy the bacteria causing the baby’s infection. This use of phages is unique in Belgium, where it has the status of pharmaceutical compounding – the creation of a tailor-made product to suit the specific needs of the patient. Compounding is a familiar process to pharmacists, but in this case the doctors were dealing with living creatures, not molecules.
Each phage has its own “passport,” and its safety is strictly supervised by Sciensano, the agency for medical safety. “In Germany, France, the Netherlands and the US they’re watching us like hawks – how have the Belgians done it,” said Dr, Soentjens. “The military hospital is a pioneer in this field.” He foresees applications in other intractable conditions – “cystic fibrosis for example, or chronic sinusitis, infections caused by implants, septicaemia and severe burns injuries. But we must not make the same mistake as with antibiotics, and use bacteriophages too often, because that could mean that in time they don’t work any more.”