Medical experts believe our cavalier use of antibiotics has sparked a growing global health crisis.
The Centers for Disease Control and Prevention say antibiotic resistance is one of the biggest public health challenges of the modern day. Each year in the U.S., at least 2 million people get an antibiotic-resistant infection, and at least 23,000 people die, according to the CDC.
But what if doctors could solve the problem by using viruses that have evolved to attack these deadly superbugs?
In 2015, epidemiologist Steffanie Strathdee (@chngin_the_wrld) was on vacation in Egypt with her husband, Tom Patterson, when he fell violently ill. Doctors found “a giant abscess in his abdomen, the size of a small football,” Strathdee tells Here & Now’s Peter O’Dowd. She says the doctors cultured the abscess, which was filled with a “brown, putrid, murky fluid.”
“A couple of days later, it came back and the doctor came into the room at the ICU fully gowned and gloved and stood a distance away and said, ‘It's the worst news we could have had. I'm afraid it's the worst bacteria on the planet,” Strathdee recalls.
A drug-resistant bacteria called Acinetobacter baumannii had infected Patterson’s abdomen. And Strathdee’s nine month race to save his life began.
She discovered a little known treatment — called phage therapy — that not only saved Patterson’s life, but also might prove to be a new weapon in the battle against antibiotic resistance.
Strathdee and Patterson, both scientists at the University of California San Diego, have published "The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug" about Patterson's brush with death.
Patterson tells O’Dowd, “To be honest, it’s great to be alive.”
On when Patterson first got sick in Egypt
Patterson: “Well, we started off on this really wonderful trip in Egypt exploring pyramids. We were on the top of the ship, had a beautiful starlit dinner that night, and went to bed. About an hour later, I woke up and I was violently throwing up [and] assumed that I had food poisoning. And it just kept going and going and going, all night long. And in the morning, Steffanie said, ‘I'm calling a doctor,’ and I'm one of those stoic guys who likes to say, ‘No! I don't want to see a doctor,’ especially when you're in a developing country.
“We [have] visited well over 50 countries and so we carry ciprofloxacin in case we get something. In fact, that's the first thing we did, was I popped one of those pills and promptly threw it up.”
On what the doctors determined Patterson was sick with
Strathdee: “It's called Acinetobacter baumannii. And soon afterwards, the WHO, the World Health Organization, listed this organism as the most deadly superbug to human health. It was a wimpy bacterium a couple of decades ago. It's one though that is, what I consider to be, a bacterial kleptomaniac. It steals antimicrobial resistance genes from other bacteria and has become a superbug.”
On how Acinetobacter baumannii went from “wimpy” bacteria to superbug
Strathdee: “Well Tom, unfortunately now, is the poster child for this dystopian age of the global superbug crisis. We have been over using antibiotics, not just in people, but in livestock and agriculture and even aquaculture. And as a result of this, bacteria have been acquiring resistance genes. And this particular superbug got really clever about moving into spaces where we've knocked out other friendly bacteria in the microbiome.”
On phage therapy
Strathdee: “Phages are actually viruses that attack bacteria. They have evolved over a millennia. They're 100 times smaller than bacteria and they're everywhere — in soil, they're in water, they’re in our guts. And so as a result, we poop them out, and where you find phages are where you find cesspools full of bacteria.
“I reached out to total strangers around the U.S., which included a group from Texas A&M University, who turned their lab into a command center and basically worked on this 24/7 for the next few weeks and found phages that matched Tom's bacterial isolate. The FDA put us in touch with a group from the Navy Medical Research Center in Frederick, Maryland, and they too found several phages that matched Tom's bacterial isolate. So now we had two phage cocktails that were sent back to us. These had to be repurified by San Diego State University because when we realized that we had to inject these into his bloodstream, we wanted them to be as pure as possible. If they weren't, it could trigger septic shock and kill him.”
On why phage therapy isn’t more commonly used in the U.S.
Strathdee: “Phages were considered very finicky. You have to match the phage to the bacteria and not just any phage will kill any bacteria. And also, in the former Soviet Union, they had taken out phage therapy very vigorously. They didn't have access to antibiotics very easily and because Russia was an enemy to the West, if you were a proponent of phage therapy, you were considered a pinko, commie scientist.”
On Patterson’s experience being in a coma for three months
Patterson: “I was actually in a coma having hallucinations. And Steffanie came to me and I was able to hear her actually, even though I was in a coma. That's one of the interesting facts that I try to get out to people is when you talk to people and they’re in a coma, don't assume that they're just a loaf of bread. They can hear you sometimes. And she asked me if I wanted to live. And I, at that time, was hallucinating I was a snake, of all things, and I had to find out how to squeeze her hand to let her know that I wanted to live. And I wrapped my body around her hand and squeezed it and she went ahead and did her thing as a scientist.”
On when the phage therapy began working on Patterson
Strathdee: “Three days after we started injecting phages into Tom's bloodstream, he woke up, he lifted his head off the pillow, and kissed his daughter's hand. I wasn't there at that particular moment, but I know that the ICU just exploded and everybody was giving high fives and tears were streaming down people's faces. And when I ran into the hospital the next day to see Tom, unfortunately, he was septic again. He was in a coma, and we thought that we were killing him. We stopped the phage therapy, and we realized within a day that it was another bacteria that got out of his gut. So we restarted the phage therapy and two days later, he woke up, and from then he was making a full recovery. It was the happiest day of my life, to be honest.”
On the advancement of phage therapy today
Strathdee: “I mean, clearly the success of Tom's case went viral and in a good way this time. And a lot of people are now using phage therapy intravenously around the world where they hadn't been doing this before. But even if Tom died, I knew that we're both scientists and that we would at least be offering some information about what to do or what not to do. And we monitor this very carefully. The case report was published. We've now treated several other cases successfully, not just at U.C. San Diego, but around the world.”
On what it means to Patterson to be alive and healthy again
Patterson: “I'm doing great. I'm back to work. We just came back from Costa Rica birdwatching and hiking, but I have to say, for every day you're in the hospital, it's five days of recovery, so I'm three years out of the hospital and it's about four years to get a full recovery, so I'm still regaining strength.
“I mean, I have to say, it's a very emotional experience. You take a physical toll, but you also get a psychological toll. Myself, Steffanie, [and] my daughters suffer from PTSD as a result of this, but I'm here to talk about this because I'm trying to pay forward what all of the people that went out of their way contributing phages and all their knowledge to save my life. And so what I'm hoping is, my experience will result in saving many, many more lives.”
Book Excerpt: 'The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug'
By Steffanie Strathdee and Tom Patterson
I never dreamed I’d be outwitted by a wimpy bacterium. I’d tracked a killer virus across multiple continents to wage the war against AIDS, through the trenches and at the table with policymakers at a global level. Viruses were to be feared. Bacteria? Not so much. At least not this one. I’m an infectious disease epidemiologist, director of a global health institute at a major US university, and of all people, I should have been able to protect my husband from a bacterium I’d last seen in my undergrad days, when we’d handled it without concern in basic lab experiments. If someone had told me that one day this microbial mutant would have us on death watch and I’d soon be injecting my husband with a legion of killer viruses to try to save him, I would have thought they’d lost their marbles. And yet, here we are.
The holidays—Thanksgiving, Christmas, New Year’s, and Valentine’s Day—have passed in a blur. Tom is hardly recognizable beneath the web of IVs, monitor cables, drains, tubes, and other medical paraphernalia. His once thick silver hair, which stylists swooned over, has fallen out in clumps, and the skin on his feet and hands is peeling off in layers. He has lost more than a hundred pounds from his six-foot-five-inch frame. We have not lost hope, and on this day, like every day, we are strategizing how to beat this thing. But at this moment I am doing it on my own. Tom is lapsing in and out of consciousness, an improvement over the coma, but still . . .
The tone of the clinical conversation among the specialists and other medical staff around Tom has changed in some subtle way. It’s hard to nail down. His labs and vital signs fluctuate as they have for three months now, so it’s not that. It’s something between the lines, something they’re not saying, that I’m unable to decipher. Since our lives went from bliss to hell in a handbasket, it’s been all I could do to learn enough about anatomy and medicine just to keep up with their conversation. I’m a researcher, not a doctor, but even I know something about bedside manner. And theirs has shifted.
What’s obvious at first glance in the scientific literature just confirms what we already know: Tom is up against, as one study says, “a difficult- to-treat pathogen whose antibiotic resistance patterns result in significant challenges for the clinician.” No shit, Sherlock. What we’ve got here is one of the most lethal bacteria known to humankind, a “superbug,” that has mutated to resist all existing antibiotics. Recent advances in exploratory research on how to fight this superbug have all been experimental, meaning that there was insufficient data to prove that they worked, so none were approved for general use, leaving Tom’s docs at a dead end in their hunt for approved treatment options. Among novel ideas out there, was an approach I vaguely remember studying briefly as an undergrad—the use of viruses that prey on bacteria—but that idea appears to be nothing more than a footnote in the margins of modern medicine.
Tom lies motionless, the steady hum and beeps of monitors the only sign of life, and I try to distract myself, emailing our graduate students about their latest papers from the corner of his room. In my busy mode, trying to keep at least a nominal tether to the real world, I dial in to a conference call to join my senior colleagues on a university retreat in San Francisco. I was supposed to be there, too. But in the months since the war against pandemics took a personal turn, everyone we know has heard what Tom and I are up against and where we’re holed up. Several of my colleagues ask how Tom is doing. I give them the latest rundown before telling them that I have to ring off. We say our goodbyes, and as I get ready to hang up, the chair of the meeting, a retired surgeon and former university chancellor, asks a question quietly to my colleagues, thinking I’m no longer on the phone.
Excerpted from THE PERFECT PREDATOR by Steffanie Strathdee and Thomas Patterson, published on February 26, 2019 by Hachette Books, a division of Hachette Book Group. Copyright 2019 Steffanie Strathdee and Thomas Patterson.
This segment aired on March 6, 2019.