It may seem strange during a pandemic that has killed millions and turned the world upside down, but a certain type of virus, bacteriophages, could save just as many lives.
Georgia, a small country in the Caucasus, is at the forefront of research on bacterial resistance to antibiotics.
Long overlooked in the West, bacteriophages, or bacteria-eating viruses, are now being used on some difficult medical cases, like this Belgian woman who developed a life-threatening infection after being injured in the 2016 bombing in Brussels airport.
After two years of ineffective antibiotic treatment, bacteriophages sent from Georgia defeated his infection in three months.
“We use these phages that kill harmful bacteria” to treat patients when antibiotics fail, says Mzia Kutateladze, of the Georgian Institute of Bacteriophages Eliava.
Even a trivial infection can “kill a patient because the pathogen has developed resistance to antibiotics”, adds Ms Kutateladze.
Phages, known for a century, had been largely forgotten when antibiotics revolutionized medicine in the 1930s.
– Stalin’s henchman –
The man who contributed most to their development, the Georgian scientist George Eliava, was executed in 1937 on the orders of another Georgian, Lavrenty Beria, Stalin’s henchman and chief of his secret police.
Eliava had worked at the Institut Pasteur in Paris with the French-Canadian microbiologist Felix d’Herelle, one of the two men credited with discovering phages, and had persuaded Stalin to invite him to Tbilisi in 1934 .
But their collaboration had ended when Beria had had Eliava killed, for a reason that remained mysterious.
With the World Health Organization declaring antimicrobial resistance a global health concern, phages, which can target bacteria while leaving human cells intact, are making a comeback.
According to a recent study, superbugs could kill up to ten million people a year when antimicrobial resistance, due to the overuse of antibiotics, reaches its peak, which could occur within 30 years.
While phage-based drugs cannot completely replace antibiotics, the researchers point to major advantages: cheapness, no side effects, no damage to organs or intestinal flora.
“We produce six standard phages which have a broad spectrum (of use) and can cure multiple infectious diseases”, assures Lia Nadareishvili, a doctor at the Eliava Institute.
However, in 10 to 15% of patients, the standard phages do not work and “we must find phages capable of killing the bacterial strain concerned”, she specifies.
Phages suitable for rare infections can be selected from the institute’s huge collection, the richest in the world, or found in sewage, polluted water or soil, says Kutateladze.
The institute can even “train” the phages so that they “can kill more and more different harmful bacteria.” “It’s a cheap and easily accessible therapy,” she says.
A 34-year-old American mechanical engineer who has been suffering from a chronic bacterial disease for six years told AFP that he “already felt an improvement” after two weeks at the Tbilisi institute.
– Ultimate treatment –
“I’ve tried every treatment possible in the United States,” said Andrew, who only wanted to give his first name, and is one of hundreds of patients from around the world who come to Georgia each year for treatment from the latest luck.
Beyond medicine, phages are already used to prevent food from spoiling and can be used in agriculture “to protect crops and animals from harmful bacteria,” says Kutateladze. The Eliava Institute has already conducted research on bacteria targeting cotton and rice.
Bacteriophages are also able to fight against biological weapons or fight bioterrorism, Canadian researchers having published in 2017 a study on their use to counter an attack with anthrax in crowded public places.