Hospital superbug MRSA haunts the West a lot these days. With the conventional antibiotics losing their efficacy, some suggest that bacteriophage, treatment through bacteria-eating virus could be a sensible option.
Initiated in the erstwhile Soviet Union during the Second World War, the bacteriophage is used as standard treatment in parts of Eastern Europe for bacterial infections from gangrene to strep throat.
Consequent on overuse, many bacteria have become bacteria- resistant. Drug firms are also reluctant to bring new brands onto the market. It can cost as much as £400m ($800m) to develop the drug and take as long as ten years, it is pointed out.
Meantime MRSA seems to be outfoxing healthcare authorities.
Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of bacteria that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin.
The organism Staphylococcus aureus is found on many individuals skin and seems to cause no major problems. However if it gets inside the body, for instance under the skin or into the lungs, it can cause important infections such as boils or pneumonia.
Staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems.
MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are known as CA-MRSA infections.
What has long made antibiotics so appealing is the fact that they eliminate so many types of bacteria in one go. Phages are more complicated: a certain type has to be found to combat each infection.
"But it's this specificity which makes them so attractive," says Dr Ron Dixon, Head of the Department of Forensic and Biomedical Sciences at Lincoln University. "It will only kill the bacteria you want it to."
The word bacteriophage literally means "to eat bacteria".Once the phage has entered the body, it attaches itself to the bacteria causing the infection, and shoots in its own DNA to make the bacteria start producing bacteriophages. Within 30 minutes, up to 200 new phage are created, according to Dr Dixon, and in the process the bacteria die.
The job done, the phage automatically start to disappear. And if the bacteria become resistant to the phage, as they have done to antibiotics, a new phage matched to the new bacteria can be developed. In order to inhibit resistance, a cocktail of phages would most likely be used in treatment.
There are no known side-effects, researchers stress, although there were significant numbers of deaths in the 1930s and 1940s.
Those pioneering this 21st Century drive to promote the therapy say these were mainly the result of a failure to understand the biology of phages, inaccurate diagnoses of patients in the first place and poor manufacturing procedures.
Nonetheless, few Western companies have so far ventured into the field of bacteriophage therapy.
Dr Nick Housby of Novolytics Limited - one firm which has - says this is because of the intellectual property rights surrounding the therapy, which has so long been used elsewhere. Phages are notoriously hard to patent, the process by which drug companies secure their future profits.
Novolytics is currently working on a cream which they say could combat MRSA. Inserted into the nose, where MRSA bacteria frequently linger, it is hoped the cream could combat more than 15 strains of the condition.
But it still needs to be subjected to two phases of clinical testing, and even if these proved it successful, it may take as many as five years for the cream to hit the market.
Separately, researchers are working with the Eliava Institute in Georgia, where an MRSA fighting phage has been developed, to see if it could have applications in the UK.