Guest Blog: Phage Therapy – The Other Antibiotic Treatment

by G.W. (Bill) Riedel, PhD, MCIC


If I suggested that a cure for the cholera outbreak in Haiti could be found in the same rivers thought to be responsible for the outbreak in the first place, most people would consider me crazy. But they’d be wrong.


In 1896 the British bacteriologist, Ernest Hankin discovered marked antibacterial activity – against Vibrio cholerae, the bacterium that causes cholera – in the waters of the Ganges and Jumna rivers in India. He suggested that an unidentified substance (which passed through fine porcelain filters and was destroyed by heat) was responsible for this phenomenon and for limiting the spread of cholera epidemics.


It wasn’t until 1917, though, that French-Canadian microbiologist Felix D’Herelle – working at the Pasteur Institute – realized that the antibacterial activity discovered by Hankin was due to viruses that preyed on bacteria. D’Herelle named these viruses “bacteriophages” (phages for short).


Bacteriophages are viruses that are parasitic to bacteria and cannot multiply independently. Each phage can only infect a specific bacterial host, as it has to be able to link with special structures on the surface of the bacterial cell. Once attached, the phage injects its DNA into the host cell. The phage DNA hijacks the reproductive mechanism of the bacterial cell, causing the infected bacterium to produce 50 to 200 daughter phages in as little as 30 minutes. Finally, the infected cell bursts – releasing the new crop of phages and starting another cycle of infection and phage reproduction.


Prior to the discovery of the electron microscope in 1940, no one could see bacteriophages, even with high-powered conventional microscopes. Early studies of phage behavior and reproduction depended on adding phages to liquid cultures in which bacteria had grown, and observing the clearing of the turbid broth and destruction of the bacteria. In other experiments, scientists observed and counted clear zones in layers of bacterial growth on solid culture media.


Soon after he discovered and named bacteriophages, D’Herelle began to experiment with the possibility of using phages to cure, and even prevent, bacterial infections. The fruits of his efforts survive to this day in Tbilisi, Georgia at the Phage Therapy Center, which welcomes patients from all over the world.


In Poland, at The Hirszfeld Institute and of Immunology and Experimental Therapy, phage therapy is carried out under medical experimentation, ethical and compassionate use regulatory provisions similar to those that exist in most countries. A broad range of infections have been treated since the initial anti-staphylococcal treatment in 1925. The Institute requires that all patients treated must have previously been treated – unsuccessfully – with conventional methods such as antibiotics. Since the 1980s, their work with phages has been published in English language scientific journals. Very high success rates – 85% on average – have been obtained for infections caused by bacteria such as Escherichia, Klebsiella, Proteus, Enterobacter, Pseudomonas, and Staphylococcus aureus. Their success rates for treating Pseudomonas aeruginosa and Staphylococcus aureus, including MRSA strains, have been reported to be even higher than 85%.


Phage biology was not well understood in D’Herelle’s time, and results from early attempts at phage therapy treatments were inconsistent. Once antibiotics appeared, interest in phage therapy in the West waned – until antibiotic-resistance and superbugs rekindled research efforts. As of this writing, Phase I trials of phage therapy treatments are being planned or have been completed in the United Kingdom, Belgium, Australia and India.


In the USA, “phage therapy” (a.k.a. biocontrol) has received the most attention – and the greatest acceptance – in non-clinical applications. The FDA recognizes a bacteriophage preparation made by Intralytix as a safe antimicrobial for control of Listeria monocytogenes on ready-to-eat meat and poultry products. Another phage preparation, Agriphage, a phage product that is commercially available from Omnilytics, is used primarily to treat bacterial damage of tomatoes and peppers, and has been recognized as being compatible with organic food production. The status of clinical phage therapy in the US was laid out clearly in a March 31, 2009 Popular Science article, The Next Phage.


Is it absurd that phage biocontrol products are accepted in the West for prevention or treatment of contamination in food, but not available to patients suffering from antibiotic-resistant infections? I, for one, think so. If you are interested in learning more and forming your own opinion, the following resources will be helpful.


 

 

 

About the author: Before his retirement from Health Canada, G.W. (Bill) Riedel, PhD., MCIC, was Chief, Program Development and Evaluation Division, in Health Canada’s Field Operations Directorate. Bill organized and moderated a symposium entitled “Phage therapy as it applies to food public health bacteriology” at the 2003 Annual Meeting of the Institute of Food Technologists in Chicago, and he has given a number of presentations on phage therapy.

Guest Blog. Salmonella and Raw Meat: A European Tale

The following Guest Blog first appeared as Salmonella et viande crue, une histoire européenne on Le Blog d’Albert Amgar, a regular feature on ProcessAlimentaire.com, and is reproduced here in English (translation by Phyllis Entis) with the kind permission and cooperation of its author, Albert Amgar.


Salmonella and Raw Meat: A European Tale

 

A food poisoning incident has affected several dozen students at three colleges and a high school in and around Poitiers (see Salmonella, Steaks hachés et Tiac en France).

No information has been released as to the precise number of ill and/or hospitalized students. The only official communiqué from Vienne Préfecture gives neither data nor dates. In addition, this release only mentions two establishments. According to Agence France Presse, the students became ill between October 19th and 22nd, 2010.

“At first, we thought there were only 10-12 cases,” said Stéphane Jarlégand (Director of the Office of the Vienne Préfect), during a news conference. “On Tuesday, there were 52 cases, and today about 100.”

The first alarm was sounded by an emergency medicine practitioner in Poitiers, after eight people from the same school arrived at the university hospital’s emergency room, all with the same complaint. A regional health investigation team was activated in response to the alert.


By coincidence, this week’s issue of Eurosurveillance contained a report concerning the investigation into a foodborne Salmonella outbreak in the Netherlands that was linked to the consumption of raw meat products.

“Between October and December 2009, 23 cases of Salmonella Typhimurium (Dutch) phage type 132, each with an identical multiple-locus variable-number tandem-repeat analysis (MLVA) profile (02-20-08-11-212), were reported from across the Netherlands. A case–control study was conducted using the food-consumption component of responses to a routine population-based survey as a control group. The mean age of cases was 17 years (median: 10 years, range: 1–68). Sixteen cases were aged 16 years or under. Raw or undercooked beef products were identified as the probable source of infection. Consumers, in particular parents of young children, should be reminded of the potential danger of eating raw or undercooked meat.”

This is the fourth food-borne outbreak in recent years linked to consumption of steak tartare and other raw beef products in the Netherlands [10-12]. In 2006 to 2008, despite intensive monitoring and control programmes, Salmonella was still found in-store in raw meats (such as steak tartare and ossenworst) intended for direct consumption [13]. Consumer awareness of the potential hazard of eating raw meat is central to good control. In particular, parents should be reminded that children are vulnerable to Salmonella infection and should not eat products containing raw or undercooked meat.”

The above caution was directed to parents, while the Vienne outbreak involves food service establishments. Even so, it’s worth remembering that this same point was made in the article “Why ‘just cook it’ won’t cut it.”

Clearly, for those who enjoy steak tartare – and I am one of them – Belgium’s AFSCA offers an excellent recipe on page 6 of its Bulletin de l’agence alimentaire fédérale (Bulletin no. 35, December 2009).

About Albert Amgar: Albert Amgar lives in Changé near Laval in Mayenne, France. He worked as young scientist at the Parasitology and Tropical Medicine Service of the Pitié Salpétrière Hospital and later spent 12 years in the pharmaceutical industry. In 1989, he became director of a new association of agro-food industrialists named ASEPT in Laval (France). He was the general manager of ASEPT until his retirement.

 

Supplementary Note

Agence France Presse reports that all of the illnesses were traced to a single production lot of imported beef. According to the European Union’s Rapid Alert System for Food and Feed, France has issued a notification that it has found Salmonella typhimurium in raw frozen beef burgers from Italy. The contaminated beef burgers were distributed to France, Andorra and Luxembourg. The name of the manufacturer, as is usually the case in these notifications, has not been released to the public.
– Phyllis Entis

Guest Blog: Reducing E. coli O157:H7 In Frozen Ground Beef

The following Guest Blog first appeared on Safety Zone, a regular blog feature on the Meatingplace.com site, and is reproduced here with the kind permission of its author, Dr. James Marsden.

Retail Frozen Ground Beef Patties and Risks of E. coli O157:H7

It’s time to recognize that retail frozen ground beef patties pose an increased risk to consumers and take steps to reduce that risk.

If you conduct a Google search using the words “frozen ground beef patties and E. coli”, you will see that this product category has been implicated in an inordinate number of cases, outbreaks and recalls. The Topps recall and other highly publicized events over the past several years resulted from contaminated frozen ground beef patties. The October New York Times story that described a devastating illness that resulted from E. coli O157:H7 contamination also involved retail frozen ground beef patties.

Frozen ground beef patties were also implicated in the 1993 Jack-in-the-Box outbreak and other early public health events involving E. coli O157:H7. Fast food chains have taken steps to assure the safety of frozen beef patties, including raw material and finished product testing, the implementation of validated cooking processes that fully inactivate E. coli O157:H7 and process control measures that guarantee proper cooking every time. These systems have been effective in controlling the problem in fast food restaurants and other restaurants that use frozen beef patties.

The problem still exists when consumers prepare retail frozen ground beef patties at home. This is because frozen patties are inherently difficult to cook uniformly and sufficiently to control pathogens. If all consumers were educated about the risks associated with frozen beef patties, and took the same steps that have been successful in restaurant preparation, the problem would be solved. This would require that great care be taken when cooking frozen beef patties and the universal use of thermometers to verify that the cooked product has reached a minimum temperature of 160 degrees F. Efforts to inform and encourage consumers to adhere to these practices should continue. However, it is not realistic to expect that all consumers will apply perfect cooking methods when preparing frozen ground beef patties. The risk of E. coli contamination in these products has to be reduced upstream.

Here are 6 steps that I believe would make frozen ground beef patties safer for consumers:

  1. Assure that beef carcasses are processed to minimize the risk of pathogen contamination.
  2. Apply a validated intervention to chilled beef carcasses prior to fabrication.
  3. Test beef trimmings for E. coli O157:H7 using N-60 sampling procedures at slaughter plant.
  4. Apply at least one validated intervention to beef trimmings before grinding.
  5. Adopt a test and hold policy for finished frozen ground beef patties that applies to every production lot (Microbiological testing procedures now allow for results in less than 24 hours).
  6. Implement a prominent labeling statement for frozen ground beef patties with consumer information that underscores the importance of proper cooking (in addition to safe handling labels).

These steps in addition to continued efforts to identify and implement pre-harvest interventions and carcass pasteurization technologies would reduce the risk of E. coli O157:H7 in retail frozen ground patties and also help restore consumer confidence in beef products in general.

About Jim Marsden: Dr. James L. Marsden is Regent’s Distinguished Professor of Food Safety and Security at Kansas State University, and the senior science advisor for the North American Meat Processors Association. He is the past president of the American Meat Institute Foundation in Washington, DC and a graduate of Oklahoma State University.