BAKTERIOPHAGEN
Prof. Dr. Christian Kühn
Why phages?
The increase in antibiotic-resistant germs poses a major challenge for medical professionals worldwide. The development and spread of antibiotic resistance has led to the emergence of multi- and even pan-resistant bacteria.
In 2017, the World Health Organization (WHO) published a list of bacteria for which new antibacterial drugs are urgently needed. One of the possible alternatives to established antibiotic therapy is the use of lytic bacteriophages.
Bacteriophages (or phages) are viruses that can only infect bacterial cells. They are divided into two main types - lytic phages or temperate phages. Lytic bacteriophages can be used as antibacterial agents as they are not integrated into the host bacterial genome and active infection leads to bacterial dissolution (cell lysis).
Phage therapy in Germany
Despite the proven effectiveness of lytic bacteriophage therapy, bacteriophages are only admitted as medicinal products in the following countries: Russia, Georgia, Kazakhstan and Slovakia. In other countries, including the Federal Republic of Germany, the use of bacteriophages is only possible as a last resort therapy in accordance with § 37 of the Declaration of Helsinki.
We have already successfully treated 24 patients with phages for whom conventional antiobiotic therapy was no longer effective. This 59-year-old patient with a severe chronic Staphylococcus aureus infection of his aortic arch prosthesis is an example of this. Just 5 days after the end of local phage therapy using suction irrigation drains, the signs of infection had subsided and no more bacteria could be detected in the irrigation fluid. The PET-CT examination after 7 months shows the high effectiveness of the phage therapy.
The following link will take you to the website of the National Center for Phage Therapy.
1.
Rubalskii E, Ruemke S, Salmoukas C, Boyle EC, Warnecke G, Tudorache I, Shrestha M, Schmitto
JD, Martens A, Rojas SV, Ziesing S, Bochkareva S, Kuehn C, Haverich A. Bacteriophage Therapy for
Critical Infections Related to Cardiothoracic Surgery. Antibiotics (Basel). 2020 May 5;9(5):232. doi:
10.3390/antibiotics9050232. PMID: 32380707; PMCID: PMC7277081.
2.
Rubalskii E, Ruemke S, Salmoukas C, Aleshkin A, Bochkareva S, Modin E, Mashaqi B, Boyle EC,
Boethig D, Rubalsky M, Zulkarneev E, Kuehn C, Haverich A. Fibrin glue as a local drug-delivery
system for bacteriophage PA5. Sci Rep. 2019 Feb 14;9(1):2091. doi: 10.1038/s41598-018-38318-4. PMID:
30765740; PMCID: PMC6376040.
3.
Fursov MV, Abdrakhmanova RO, Antonova NP, Vasina DV, Kolchanova AD, Bashkina OA, Rubalsky
OV, Samotrueva MA, Potapov VD, Makarov VV, Yudin SM, Gintsburg AL, Tkachuk AP, Gushchin
VA, Rubalskii EO. Antibiofilm Activity of a Broad-Range Recombinant Endolysin LysECD7: In Vitro
and In Vivo Study. Viruses. 2020 May 15;12(5):545. doi: 10.3390/v12050545. PMID: 32429199; PMCID:
PMC7291189.
4.
Salmoukas C, Ruemke S, Rubalskii E, Burgwitz K, Haverich A, Kuehn C. Vascular Graft Pre-
Treatment with Daptomycin Prior to Implantation Prevents Graft Infection with Staphylococcus
aureus in an In Vivo Model. Surg Infect (Larchmt). 2020 Mar;21(2):161-168. doi: 10.1089/sur.2019.124.
Epub 2019 Oct 1. PMID: 31573423.
5.
Ruemke S, Rubalskii E, Mashaqi B, Burgwitz K, Haverich A, Salmoukas C, et al. Evaluation of Gram-
Positive and Gram-Negative Bacterial Adherence on Four Different Vascular Prosthetic Grafts In
Vitro. Austin J Surg. 2019; 6(15): 1200.