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Context
The number of new antibiotics brought to market has been steadily declining since the 1980s, while antibiotic resistance is becoming widespread globally. According to the WHO, in 2050, there will be more deaths due to antibiotic resistance than to cancer.
Causes of mortality in 2014 and projected deaths due to antibiotic resistance in 2050, according to the O’Neill report published in 2014
An increasing number of patients are presenting infections caused by multidrug-resistant bacteria; for some, no antibiotic remains effective.
At the national level, an Antibiotic Resistance Interface has been established by INSERM to coordinate efforts against antibiotic resistance.
At the Hospices Civils de Lyon, the CRIOAc Lyon team has observed that implant-related infections (knee and hip prostheses), even in the absence of antibiotic resistance, are particularly difficult to control and can become chronic, with severe impacts on quality of life: partial or total disability, loss of autonomy, or even death from sepsis.
This issue is found in infections of all kinds, and the Lyon team has set itself the goal of addressing what is becoming a major public health challenge. They propose an alternative to antibiotics: phage therapy, as part of the PHAGEinLYON Clinic project.
This therapy uses natural bacterial predators—bacteriophages or phages—to destroy bacteria and eradicate bacterial infections.
Phages: Viruses That Are Friends to Humans
Phages are viruses found in large quantities in nature (billions per liter of water) and exclusively target bacteria. Each phage species attacks only one bacterial species, making it a highly targeted weapon, unlike antibiotics, which also attack beneficial bacteria (e.g., digestive flora). To do this, the phage attaches itself to the surface of its bacterial prey, injects its DNA into the bacterium, and then hijacks the bacterial machinery to produce hundreds of virus copies. These copies, upon release, literally cause the bacterium to burst, thereby destroying it permanently.
Moving Beyond Exceptional Use!
Our team has treated around 100 patients with phage therapy on an exceptional basis, under the supervision of the French National Agency for Medicines and Health Products Safety (ANSM). These patients had prosthetic infections or severe multidrug-resistant bacterial infections, with conventional treatments failing and their vital or functional prognosis at risk. These patients were in a therapeutic deadlock. They were treated “on compassionate grounds, and thus in a highly exceptional manner.” Because we have obtained very encouraging results, we must move beyond exceptional use!
Project Objective: Phage Therapy 2.0
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