Issue 149
Phage therapy successfully treats bacterial prostatitis after multiple failed antibiotic treatments – Behind the case report
Apurva Virmani Johri
Pranav Johri
This week, Apurva Virmani Johri and Pranav Johri of Vitalis Phage Therapy take us behind their recently published phage therapy case report, which describes the successful treatment of a patient with prostatitis using phages (done at the Eliava Phage Therapy Center).
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Phage alert
Urgent need for Pseudomonas aeruginosa phages for a patient in Switzerland
[Thanks to the 15+ labs who have responded!! We'll be in touch soon with next steps!]
We are urgently seeking Pseudomonas aeruginosa phages for a cystic fibrosis patient in Switzerland. (More than 140 phages have already been tested, but this patient strain is resistant to all of them so far!)
Ways to help at this stage:
- By sending your phages for testing on the patient's strain
- By receiving the strain and testing your phages
- By receiving the strain and using it to search for new phages against the organism
- By helping spread the word about this request
- By providing us with names/email addresses of labs you think we should contact
Please email staff@phage.directory if you can help in any way, or if you would like further details/clarification.
Let’s make a difference, Phage Directory
Urgent need for Stenotrophomonas phages for a patient in the USA
[Thanks to the 3 labs who have responded!]
We are urgently seeking Stenotrophomonas phages for a patient in the USA.
Ways to help at this stage:
- By sending your phages for testing on the patient's strain
- By receiving the strain and testing your phages
- By receiving the strain and using it to search for new phages against the organism
- By helping spread the word about this request
- By providing us with names/email addresses of labs you think we should contact
Please email staff@phage.directory if you can help in any way, or if you would like further details/clarification.
Let’s make a difference, Phage Directory
Updates
Viruses modulate carbon cycling, but it's been unknown whether they're active under winter conditions. Gareth Trubl (Lawrence Livermore National Lab) and colleagues published a new paper on active virus-host interactions at sub-freezing temperatures in Arctic peat soil. They used stable isotope probing targeted metagenomics to study Arctic soils under simulated winter conditions, and detected substantial active virus-host interactions. This highlights viruses as major community-structuring agents that likely modulate carbon loss in peat soils during winter. (Plus, it highlights how their technique illuminated interactions that would have been missed with standard metagenomics).
Be sure to check out the 2-min video on this paper!
Michael Shamash (McGill University) and colleagues published a new paper in The ISME Journal describing phages in the infant gut: a framework for virome development during early life.
Elhanan Tzipilevich (Duke University) and colleagues published a new paper in mBio showing how phage-resistant bacteria reveal a role for potassium in root colonization.
Lyman Ngiam (University of Queensland) and colleagues published a paper in Environmental Microbiology showing that phages isolated from non-target bacteria demonstrate broad host range infectivity against multidrug-resistant bacteria.
Shen-Yuan Hsieh (Quadram Institute Bioscience) and colleagues published a new paper in Viruses showing a comparison of PCR vs. PCR-free DNA library preparation for characterising the human faecal virome.
Jobs
The Adriaenssens Lab at the Quadram Institute Biosciences, UK is seeking a PhD student to determine the role of phages in the gut microbiome.
The Sommer Lab at the Novo Nordisk Foundation Centre, Copenhagen is seeking a PhD student to use synthetic biology to develop engineered bacterial therapeutics for the gut microbiome.
The White Lab at the University of St Andrews, Scotland are seeking a PhD student to investigate bacterial immune systems in the important soil bacterium and model organism Bacillus subtilis.
APC Microbiome, Ireland is hiring a post-doctoral researcher to elucidate the specific nature of the saccharidic receptors recognised by Streptocococcus thermopilus phages through a combined genetic and biochemical approach.
The University of Exeter, UK is hiring a Research Technician jointly with the Defence science and technology laboratory (Dstl) to investigate alternative antibiotic therapies against pathogenic bacteria that currently represent a health threat for our society.
Community board
Happy #WorldPhageWeek everyone! Don't forget to join in the Phage Week #scicomm challenge on Twitter. Keep an eye out on Twitter each day for a new prompt to answer! A selected winner will receive a custom art piece from Dr. Ellie Jameson. We look forward to seeing your posts!
The Ibadan Bacteriophage Research Team is celebrating World Phage Week 2021 with a webinar series on October 29 (3-5PM West African Time) and Oct 30 (1-4PM West African Time). The theme will be "Assessing the Readiness of the Global Phage Community in Combatting AMR".
Come hear talks by Prof. Graham Hatfull, Prof. Jesca Nakavuma, Prof. Zuzanna Drulis-Kawa, and Dr. Jessica Sacher. Register at https://ibadanphageresearchteam.org!
Applications are now open for the Southeast Asia Virtual Phage Workshop which will be hosted in March 2022 by the NGO Phages for Global Health.
Topics and activities will include:
- Learning essential aspects of phage biology
- Exploring experimental techniques for isolating and characterizing phages
- Understanding antibacterial applications of phages in people, animals and crops
- Expanding the international network of phage scientists
Up to 50 scientists will be selected through a competitive application process.
Thank you to everyone that joined us for our October PHAVES, which was a talk by Bjorn Criel on the PhaLP database for phage lytic proteins that their group has developed — watch the recording here!
If you miss any of the PHAVES events you can always watch the recordings on the Phage Directory YouTube.
Jessica Sacher will chair the next Phage Phun session, which will be Wednesday Oct 27 at 9AM Pacific. Join us for this informal virtual networking session by registering here. (If you’re already signed up for the PHAVES series or a past Phage Phun, no need to register again; we’ll send you the link closer to the date).
Patients of chronic bacterial prostatitis are often hit with a double whammy. Not only do they suffer from the morbidity associated with a chronic infection, but they also suffer because the site of the infection makes it difficult to treat with antibiotics. The prostate is a particularly difficult gland to treat when it comes to bacterial infections. Its epithelial lipid membrane only allows certain classes of antibiotics to penetrate, limiting the drugs available for treatment. This, coupled with increasingly antibiotic resistant strains of bacteria and biofilm formation, truly makes a medical practitioner’s job difficult when tackling a recurrent, chronic prostate infection. After multiple failed antibiotic treatments, the usual course to chart often becomes one of symptom management.
The Case Report – in brief
This was the predicament faced by the young male whom we have covered in our recent case report. After 5 failed courses of oral and IV antibiotics, he was advised a regimen of NSAIDs and pain killers to manage his symptoms and live with his condition. Unwilling to accept a diminished quality of life at a young age, he sought alternative treatments and came across phage therapy. He decided to undertake phage treatment at the Eliava Phage Therapy Center, Tbilisi, Georgia.
Meticulous testing led to result-based phage treatment, as opposed to empirical therapy that is most often prescribed in the case of antibiotic treatments. It took three courses of phage therapy to clear the infection, each course lasting for three months. Standard phage preparations as well as a customised phage preparation made by the Eliava Institute were used for this treatment.
Bacteriological analyses and imaging tests showed significant improvement in the subject’s condition during and after his treatment with phages. This was clinically correlated with symptomatic improvements reported by the subject.
Behind the Paper
The authors have collective and collaborative experience of facilitating phage treatment of patients at the Eliava Phage Therapy Center. Prostatitis patients visit the Center for their treatment from around the world, and their number has been increasing significantly over the last few years. We decided to utilize this experience to write this case report and make detailed information on phage therapy for prostatitis available in an open-access journal.
At the beginning, our aim was to write the paper as a cohort case study of multiple prostatitis patients who had taken phage therapy. One aspect that we decided on early was to ensure that we present each case in depth, with the patient’s condition history, bacteriology reports, imaging results and all other relevant details included. Without this, we believe the impact of the treatment on each individual patient would not have come through.
However, to collate this level of detailed data for multiple patients was proving to be a herculean task. Consequently, we decided to focus on one patient’s experience with prostatitis before, during, and after phage therapy. We also realised that by focusing on a single case, we were better able to do justice to the case presentation and discussion, making the report as impactful as we hoped for. And so, we authored the paper as a case report of an individual patient whose case encompassed a variety of details that we could report on – a complex, multi-pathogenic multidrug resistant infection, treated with multiple phage preparations.
The Relevance of this Case Report
AMR (Antimicrobial Resistance) is increasing at an alarming rate, posing a challenge to medical practitioners and patients alike. Patients today have more information gathering tools available at their disposal than ever before, especially with open-access research and medical journals. With this case report, we hope that patients suffering from chronic infections as well as their doctors can gain confidence in phage therapy from experiential reporting, even while data from clinical trials is awaited.
We also hope that an increasing body of such case reports for different conditions will give impetus to governments and research institutes to develop phage therapy as a credible and much needed alternative to antibiotics in the post-antibiotic era.
Learn more
Check out the full published case report:
Johri, A. V., Johri, P., Hoyle, N., Pipia, L., Nadareishvili, L., & Nizharadze, D. (2021). Case Report: Chronic Bacterial Prostatitis Treated With Phage Therapy After Multiple Failed Antibiotic Treatments. Frontiers in Pharmacology, 12, 1424.
Read more about Vitalis Phage Therapy:
December 2020 Capsid & Tail interview with Apurva and Pranav, describing the work Vitalis Phage Therapy has done to bring phage susceptibility testing to India: https://phage.directory/capsid/phage-susceptibility-india#article
May 2019 Capsid & Tail interview with Pranav about his experience receiving phage therapy at the Eliava Phage Therapy Center: https://phage.directory/capsid/phage-therapy-access-india#article
Vitalis Phage Therapy website: https://www.vitalisphagetherapy.com/
Many thanks to Atif Khan and Stephanie Lynch for finding and summarizing this week's phage news, jobs and community posts!
Apurva Virmani Johri
My husband, Pranav, and I founded Vitalis Phage Therapy after the successful treatment of his antibiotic-resistant multi-pathogenic chronic infection with phages at the Eliava Phage Therapy Center. As his primary caregiver during this time, I have seen first-hand the impact and suffering that chronic conditions can have on a person's life. When we discovered phage therapy and Pranav underwent his treatment with phages, it gave him a new lease of life. We decided then to make this treatment better known and better accessible, with a focus on our home country, India. The aim of Vitalis Phage Therapy is to make phage therapy accessible as a treatment option to every person suffering from an antibiotic resistant infection or chronic infection. Our activities include phage therapy awareness initiatives, establishing local treatment frameworks in India to enable people's access to phage therapy without travelling to another country, establishing diagnostic testing with phages in India to provide quicker access to the phage therapy, and working with medical institutions to facilitate phage therapy for their patients.
Pranav Johri
My journey goes from being India's first known phage therapy patient to becoming an advocate, facilitator and enabler for phage therapy. My wife and I founded Vitalis Phage Therapy after the successful treatment of my antibiotic-resistant multi-pathogenic infection with phages at the Eliava Phage Therapy Center. The aim of Vitalis Phage Therapy is to make phage therapy accessible as a treatment option to every person suffering from an antibiotic resistant infection or chronic infection. Our activities include phage therapy awareness initiatives, establishing local treatment frameworks in India to enable people to access phage therapy without travelling to another country, establishing diagnostic testing with phages in India to provide quicker access to the phage therapy, and working with medical institutions to facilitate phage therapy for their patients. The main opportunities that we are looking at are collaborations for furthering access to phage therapy and funding to scale up our activities.