In 2016, a researcher returned to the US from a trip to Egypt, sick with an antibiotic-resistant infection. He was dying. That's when his wife, an epidemiologist, suggested a Hail Mary. Why not try bacteriophages? Phages are viruses that eat bacteria, and if you mix phages that eat a specific bacteria into a "cocktail," they might fight the infection when antibiotics no longer will. In this case, they were fighting Acinetobacter baumannii, so they treated the patient with phages that target that specific bacteria.
He made a full recovery.
Bacteriophages are the focus of the career of UT Health San Antonio biochemistry and structural biology professor Philip Serwer, PhD. Scientists have known about phages for 100 years, but they have dismissed them as treatments for a couple of reasons.
“One of which was, they were not consistently effective,” Serwer explained. “You had to use them exactly the right way in order to get them to be effective.” But when they were effective, they were spectacularly effective, Serwer added. “Cases of typhoid fever were wiped out in a day or two.”
Professor, Biochemistry and Structural Biology
Joe R. and Teresa Lozano Long School of Medicine
The University of Texas Health Science Center at San Antonio
The development of antibiotics is the other reason scientists stopped pursuing treatments using phages. Antibiotics worked consistently and well, so there was no need to explore phage therapy. But, with antibiotic resistance projected to kill 39 million people between now and 2050, phages are getting a hard second look.
Serwer and UT Health are collaborating with scientists at Texas Biomedical Research Institute and Brooks Army Medical Center (BAMC) to improve phage therapy and make San Antonio a hub for the treatment of potentially deadly, antibiotic-resistant infections. Phages could be particularly useful at BAMC because it has a USAISR Burn Center. Burns are notorious for growing bacteria and becoming infected, which can lead to amputation or death. Doctors treat them with antibiotics.
“If they don't work, then what? What's next?” Serwer asked. “And that's phage therapy.”
Researchers at Texas Biomed are developing treatments for antibiotic-resistant tuberculosis, and phage therapy could be useful there, as well. TB killed more than a million people in 2023 and infected more than 10.6 million, according to the World Health Organization. It is the world's leading killer by a single infectious agent.
The San Antonio Medical Foundation donated $200,000 to this collaboration. Serwer says the objective is for patients with antibiotic-resistant infections to be able to get anything they need here, “and if we need to integrate our effort internationally, to get phages from other places, we would do that,” Serwer said.
The collaborative is also planning a phage database that could also act as a phage exchange.
“You'd put the bacterial strain that's causing a problem, anything you know about that strain, and ask the database if it has anything that might work,” Serwer explained. “The database will tell them if somebody has it, and tell them exactly where it is.”
A database is a long way off, but Serwer said it could democratize phage therapy as San Antonio scientists learn more. “This database could help extend that science to everybody.”
Science & Medicine is a collaboration between TPR and The University of Texas Health Science Center at San Antonio that explores how scientific discovery in San Antonio advances the way medicine is practiced everywhere.
