Urinary tract infections (UTIs), notably cystitis, affect one in two women in their lifetime, with many experiencing recurring episodes.
These infections are not only painful and potentially serious, but also present a significant quandary for doctors.
The increasing prevalence of antibiotic resistance in UTIs forces doctors to prescribe antibiotics without certainty of their efficacy against the pathogen causing the infection, as identifying the exact pathogen using conventional diagnostics takes several days.
New Test and Therapy
Now, researchers from ETH Zurich, in partnership with Balgrist University Hospital, have developed a rapid test utilizing bacteriophages – natural viral predators of bacteria.
These phages have also been genetically modified to enhance their bacterium-destroying efficiency. The research was recently published in Nature Communications.
Phages are highly specialized viruses that infect only specific types or strains of bacteria.
The research team led by Professor Martin Loessner from ETH Zurich’s Food Microbiology research group leveraged this property.
They identified phages effective against the three main bacteria types implicated in UTIs: Escherichia coli, Klebsiella, and Enterococci.
The identified phages were then genetically modified to cause any infected bacteria to emit an easily measurable light signal.
With this method, the researchers could detect the UTI-causing bacteria directly from a urine sample in under four hours.
This quick detection could enable immediate prescription of appropriate antibiotics, mitigating resistance development and improving antibiotic stewardship.
The Promise of Phage Therapy
Phage therapies have been around for over 100 years but fell out of favor in Western industrialized countries following the discovery of penicillin.
However, the growing issue of antibiotic resistance has led to renewed interest in phage therapies.
Phages have the advantage of attacking a single target bacterium, akin to a sniper.
To maximize this, the researchers genetically modified the phages to not only produce new phages but also bacteriocins – proteins lethal to bacteria – inside the infected host bacterium. This dual-action attack enhances the therapy’s effectiveness.
Next Steps
The researchers from ETH Zurich, along with their partners from Balgrist University Hospital, will now test the efficacy of this new phage therapy in a clinical trial with selected patients.
“This is a proof of concept. There are numerous ongoing academic and commercial clinical trials globally, investigating the potential of natural and genetically optimized phages,” says Matthew Dunne, one of the final authors of the study.
However, he emphasizes that extensive clinical studies and regulatory adjustments, recognizing the evolving nature of phages, are required before such therapies can be widely applied in Western countries.
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The study was published in Nature Communications.
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