Georgia Bioterror and Superbugs
A 14 news feature
Hidden away in the backstreets of Tbilisi, the capital of Georgia, the Eliava Bacteriophage Institute is alone in the world. It's dedicated to a forgotten arm of science.
PROFESSOR AMIRAN MEIRPARIANI: Our institute is not only unique because of the nature of its work. It is also unique because it was the only institute in the whole world that was doing research on bacteriophages. We've been here for more than 80 years, working and developing the ideas that were first postulated by Eliava and d'Herelle.
Canadian scientist Felix d'Herelle first described bacteriophage in the 1920s at the Pasteur Institute in Paris. A bacteriophage is a virus which preys only on bacteria. Georgian scientist George Eliava worked with d'Herelle in Paris and later founded this institute in Tbilisi. While Eliava was arrested and executed by the KGB during a Stalinist purge in 1937, his institute remains and could now be at the forefront of the battle against super-resistant bacteria. Professor Amiran Meirpariani has walked the corridors of the Eliava institute for more than 40 years.
PROFESSOR AMIRAN MEIRPARIANI: If I tell you how old I am, you probably won't believe me. I'm 77 years old. I can still work. I can still think and I'm still active. And I probably have bacteriophages to thank for it.
The Professor has dedicated his life to the study of bacteriophage. He's convinced that these viruses offer remarkable prospects.
PROFESSOR AMIRAN MEIRPARIANI: 40 years of our experience, 40 years of my own experience of using bacteriophages for treatment and preventive therapy give me the right to say that I've never encountered a single case of complications or side effects caused by bacteriophages. The bacteriophage is always effective. If it is target-specific and is tailored to its target microbe, the bacteriophage will work 100%.
Bacteriophage have an impressive structure. The body of the virus Consists of a head in which its DNA is stored. It has six legs which attach themselves to bacteria and a tail that works like a hypodermic syringe, inserting its genes deep within the bacteria. Once inside, the phage genes multiply and burst out of the bacteria, killing it. Only a specific type of phage will work against a particular bacteria. It's an ideal alternative treatment when antibiotics are failing.
PROFESSOR AMIRAN MEIRPARIANI: We don't say to throw antibiotics out or that antibiotics are bad. Antibiotics are wonder drugs, very good drugs. But some microbes are antibiotic-resistant. What do we do with them? And their number is growing in catastrophic proportions.
Dr Zemphira Alvidze is Head of Production at the Eliava institute.
DR ZEMPHIRA ALVIDZE: I started here when I was a student from university and I am here 35 years. I use phage preparation for my children, for my grandchildren, I never use antibiotics and any time I recommend it and other patients use phages, and lot of many people come here and they tell us help them. But if our collection, if our preparation don't work against these bacteria, we can isolation new phages and we can do new preparation for new patients.
Using ancient equipment in primitive conditions, the scientists isolate new bacteriophage. It's a far cry from the institute's heyday when technicians were manufacturing up to two tonnes of bacteriophage a day to distribute throughout the Soviet Union. But when Georgia suddenly gained independence just over a decade ago, the institute's funding was abruptly terminated.
DR ZEMPHIRA ALVIDZE: It is a very difficult because sometimes we have no electricity, we have not salary, we have not nothing and nutrition media and something. But we love bacteriophages and we do everything for save these preparations.
DR ELIZABETH KUTTER: Of course I was shocked. I mean, most of the windows were broken, they didn't have heat, the power was out a lot of the time.
American scientist, and self-confessed bacteriophage fanatic, Dr Elizabeth Kutter, first came to Tbilisi in 1996. On the scientific grapevine, she'd heard about the wonderful work being done here. But so appalled was she at the working conditions she decided to take the institute under her wing.
DR ELIZABETH KUTTER: They went through 2.5 months where the institute had no electricity, even though the region did have electricity. So I started a non-profit foundation called Phage-biotics, and we contributed a little to help with that. And we're now supporting a total of seven young Georgian students to help bring new students into the field and for $2,000 we're able to help with these students to be able to stay. But without the foreign grants, they can't begin to make a living wage.
The institute may be a shadow of its former self, but Dr Kutter is determined that the knowledge gained here must be kept alive.
DR ELIZABETH KUTTER: This institute was the world leader. This was where most of the research happened and a lot of the production happened. For example, the central Ministry of Health required hospitals all over the former Soviet Union to sent antibiotic resistant strains of various bacteria here.
PROFESSOR AMIRAN MEIRPARIANI: Bacteriophages, of course, were used in the Soviet Union. They were using bacteriophages in secret institutions, in child-care centres, kindergartens, schools, in military organisations. All our soldiers were taking bacteriophages, especially in summertime when intestinal infections were at their height.
CANADIAN MAN ON VIDEO: Now here I am in beautiful Tbilisi, Georgia, and I'm getting bacteriophage therapy.
The experience learned from battling resistant bacterial infections across the Soviet Union has attracted scores of desperate Western patients to Tbilisi. For many it's been a resounding success.
DR ELIZABETH KUTTER: I brought with me a man from Toronto who had had very severe osteomyelitis - which is an infection of the bone - he had had an incredibly badly smashed ankle and after four years still had holes in both sides of his ankle that were draining. He came and they treated him over a period of about a week in the hospital. First washing it with liquid phages and then putting in pieces of this phage-bioderm. They could stick it directly into his ankle.
CANADIAN MAN ON VIDEO: And they're using it in combination with all other therapies...
The Canadian patient recorded this video message.
CANADIAN MAN ON VIDEO: I want to tell my friends back home who are waiting for this medicine to hang on, it's on its way. And soon we'll all be enjoying the benefits of phage therapy.
With such incredible healing properties, it's difficult to comprehend why the West isn't pouring money into bacteriophage research and development. But Dr Kutter says scientific conservatism and a reluctance to invest in mass-testing of phages has kept big pharmaceutical companies away.
DR ELIZABETH KUTTER: In the West, there was the feeling that phage had been proven not to work. But that wasn't true. It was actually just not proven to work. The other thing in terms of big companies, pharmaceutical companies, is that phage are quite specific. So they're specific not only to a particular bacterium, but to particular strains of that bacteria. So if you're talking about something where you're willing to have a lot of different phages and test them to be sure they work against that bacteria, it works very well.
Phage-bioderm is the institute's latest product and one which is rapidly gaining world attention. Bacteriophage are embedded in a thin polymer film which is placed directly in and around the wound. Over a period of days, armies of bacteriophage go on a bacteria-destroying rampage, clearing the most stubborn infections. Bioderm has been used on all manner of skin infections and ulcers where patients were often facing amputation, like this man being treated for a diabetes-related complication. But perhaps its most remarkable feature is in the treatment of burns.
DR ELIZABETH KUTTER: Burns are one of the hardest things. When people die in the first few days after severe burns or radiation, a lot of that is from sudemonus infections, and that's what this works with.
In a small room adjoining the institute, an old machine spits out bacteriophage tablets. This is the commercial arm of the institute which they call Biopharm. When Georgia gained independence after the collapse of the Soviet Union, the desperate struggle to keep the institute afloat began.
NINA KALANDARESHVILI: We had no water. We got ourselves artesian water. We did it ourselves. We dug a hole and got water from it. So it was very, very difficult, but, naturally, hard work always yields some fruit.
Nina Kalandareshvili is Biopharm's Production Manager. The company produces a range of practical phage preparations aimed at controlling salmonella, e-coli, staphylococcus and a variety of other bacteria.
NINA KALANDARESHVILI: During these eight years we've been working non-stop to bring our production to something resembling a normal standard. But the state that is normal for Europe, America and other countries -- countries is still a long way away. And to reach it, one needs massive financial support.
Nina's love of bacteriophage isn't based on money alone. She claims it saved her son's life. Nina's son Irakli was badly wounded whilst serving in the Georgian army during the civil war with Abkhazia in 1993.
NINA KALANDARESHVILI: The situation was very difficult. It was so serious that the doctors were... let's say they were slightly sceptical about phage therapy. I kept insisting, and I was right.
Although worldwide recognition of their efforts hasn't yet come, the scientists here are already working on urgent solutions to international problems. In the past few months, they've developed bacteriophage to combat anthrax. And they're working on creating solutions to protect animals and crops against bio-terrorism. Scientists here hope that it won't be long before the rest of the world catches on.
PROFESSOR AMIRAN MEIRPARIANI: We preserved our intellectual potential. We still have our unique collection of bacteriophages... we have highly professional and qualified staff. So we can completely... supply the whole world with our knowledge, our experience and our professionalism.
A 14 news feature
Hidden away in the backstreets of Tbilisi, the capital of Georgia, the Eliava Bacteriophage Institute is alone in the world. It's dedicated to a forgotten arm of science.
PROFESSOR AMIRAN MEIRPARIANI: Our institute is not only unique because of the nature of its work. It is also unique because it was the only institute in the whole world that was doing research on bacteriophages. We've been here for more than 80 years, working and developing the ideas that were first postulated by Eliava and d'Herelle.
Canadian scientist Felix d'Herelle first described bacteriophage in the 1920s at the Pasteur Institute in Paris. A bacteriophage is a virus which preys only on bacteria. Georgian scientist George Eliava worked with d'Herelle in Paris and later founded this institute in Tbilisi. While Eliava was arrested and executed by the KGB during a Stalinist purge in 1937, his institute remains and could now be at the forefront of the battle against super-resistant bacteria. Professor Amiran Meirpariani has walked the corridors of the Eliava institute for more than 40 years.
PROFESSOR AMIRAN MEIRPARIANI: If I tell you how old I am, you probably won't believe me. I'm 77 years old. I can still work. I can still think and I'm still active. And I probably have bacteriophages to thank for it.
The Professor has dedicated his life to the study of bacteriophage. He's convinced that these viruses offer remarkable prospects.
PROFESSOR AMIRAN MEIRPARIANI: 40 years of our experience, 40 years of my own experience of using bacteriophages for treatment and preventive therapy give me the right to say that I've never encountered a single case of complications or side effects caused by bacteriophages. The bacteriophage is always effective. If it is target-specific and is tailored to its target microbe, the bacteriophage will work 100%.
Bacteriophage have an impressive structure. The body of the virus Consists of a head in which its DNA is stored. It has six legs which attach themselves to bacteria and a tail that works like a hypodermic syringe, inserting its genes deep within the bacteria. Once inside, the phage genes multiply and burst out of the bacteria, killing it. Only a specific type of phage will work against a particular bacteria. It's an ideal alternative treatment when antibiotics are failing.
PROFESSOR AMIRAN MEIRPARIANI: We don't say to throw antibiotics out or that antibiotics are bad. Antibiotics are wonder drugs, very good drugs. But some microbes are antibiotic-resistant. What do we do with them? And their number is growing in catastrophic proportions.
Dr Zemphira Alvidze is Head of Production at the Eliava institute.
DR ZEMPHIRA ALVIDZE: I started here when I was a student from university and I am here 35 years. I use phage preparation for my children, for my grandchildren, I never use antibiotics and any time I recommend it and other patients use phages, and lot of many people come here and they tell us help them. But if our collection, if our preparation don't work against these bacteria, we can isolation new phages and we can do new preparation for new patients.
Using ancient equipment in primitive conditions, the scientists isolate new bacteriophage. It's a far cry from the institute's heyday when technicians were manufacturing up to two tonnes of bacteriophage a day to distribute throughout the Soviet Union. But when Georgia suddenly gained independence just over a decade ago, the institute's funding was abruptly terminated.
DR ZEMPHIRA ALVIDZE: It is a very difficult because sometimes we have no electricity, we have not salary, we have not nothing and nutrition media and something. But we love bacteriophages and we do everything for save these preparations.
DR ELIZABETH KUTTER: Of course I was shocked. I mean, most of the windows were broken, they didn't have heat, the power was out a lot of the time.
American scientist, and self-confessed bacteriophage fanatic, Dr Elizabeth Kutter, first came to Tbilisi in 1996. On the scientific grapevine, she'd heard about the wonderful work being done here. But so appalled was she at the working conditions she decided to take the institute under her wing.
DR ELIZABETH KUTTER: They went through 2.5 months where the institute had no electricity, even though the region did have electricity. So I started a non-profit foundation called Phage-biotics, and we contributed a little to help with that. And we're now supporting a total of seven young Georgian students to help bring new students into the field and for $2,000 we're able to help with these students to be able to stay. But without the foreign grants, they can't begin to make a living wage.
The institute may be a shadow of its former self, but Dr Kutter is determined that the knowledge gained here must be kept alive.
DR ELIZABETH KUTTER: This institute was the world leader. This was where most of the research happened and a lot of the production happened. For example, the central Ministry of Health required hospitals all over the former Soviet Union to sent antibiotic resistant strains of various bacteria here.
PROFESSOR AMIRAN MEIRPARIANI: Bacteriophages, of course, were used in the Soviet Union. They were using bacteriophages in secret institutions, in child-care centres, kindergartens, schools, in military organisations. All our soldiers were taking bacteriophages, especially in summertime when intestinal infections were at their height.
CANADIAN MAN ON VIDEO: Now here I am in beautiful Tbilisi, Georgia, and I'm getting bacteriophage therapy.
The experience learned from battling resistant bacterial infections across the Soviet Union has attracted scores of desperate Western patients to Tbilisi. For many it's been a resounding success.
DR ELIZABETH KUTTER: I brought with me a man from Toronto who had had very severe osteomyelitis - which is an infection of the bone - he had had an incredibly badly smashed ankle and after four years still had holes in both sides of his ankle that were draining. He came and they treated him over a period of about a week in the hospital. First washing it with liquid phages and then putting in pieces of this phage-bioderm. They could stick it directly into his ankle.
CANADIAN MAN ON VIDEO: And they're using it in combination with all other therapies...
The Canadian patient recorded this video message.
CANADIAN MAN ON VIDEO: I want to tell my friends back home who are waiting for this medicine to hang on, it's on its way. And soon we'll all be enjoying the benefits of phage therapy.
With such incredible healing properties, it's difficult to comprehend why the West isn't pouring money into bacteriophage research and development. But Dr Kutter says scientific conservatism and a reluctance to invest in mass-testing of phages has kept big pharmaceutical companies away.
DR ELIZABETH KUTTER: In the West, there was the feeling that phage had been proven not to work. But that wasn't true. It was actually just not proven to work. The other thing in terms of big companies, pharmaceutical companies, is that phage are quite specific. So they're specific not only to a particular bacterium, but to particular strains of that bacteria. So if you're talking about something where you're willing to have a lot of different phages and test them to be sure they work against that bacteria, it works very well.
Phage-bioderm is the institute's latest product and one which is rapidly gaining world attention. Bacteriophage are embedded in a thin polymer film which is placed directly in and around the wound. Over a period of days, armies of bacteriophage go on a bacteria-destroying rampage, clearing the most stubborn infections. Bioderm has been used on all manner of skin infections and ulcers where patients were often facing amputation, like this man being treated for a diabetes-related complication. But perhaps its most remarkable feature is in the treatment of burns.
DR ELIZABETH KUTTER: Burns are one of the hardest things. When people die in the first few days after severe burns or radiation, a lot of that is from sudemonus infections, and that's what this works with.
In a small room adjoining the institute, an old machine spits out bacteriophage tablets. This is the commercial arm of the institute which they call Biopharm. When Georgia gained independence after the collapse of the Soviet Union, the desperate struggle to keep the institute afloat began.
NINA KALANDARESHVILI: We had no water. We got ourselves artesian water. We did it ourselves. We dug a hole and got water from it. So it was very, very difficult, but, naturally, hard work always yields some fruit.
Nina Kalandareshvili is Biopharm's Production Manager. The company produces a range of practical phage preparations aimed at controlling salmonella, e-coli, staphylococcus and a variety of other bacteria.
NINA KALANDARESHVILI: During these eight years we've been working non-stop to bring our production to something resembling a normal standard. But the state that is normal for Europe, America and other countries -- countries is still a long way away. And to reach it, one needs massive financial support.
Nina's love of bacteriophage isn't based on money alone. She claims it saved her son's life. Nina's son Irakli was badly wounded whilst serving in the Georgian army during the civil war with Abkhazia in 1993.
NINA KALANDARESHVILI: The situation was very difficult. It was so serious that the doctors were... let's say they were slightly sceptical about phage therapy. I kept insisting, and I was right.
Although worldwide recognition of their efforts hasn't yet come, the scientists here are already working on urgent solutions to international problems. In the past few months, they've developed bacteriophage to combat anthrax. And they're working on creating solutions to protect animals and crops against bio-terrorism. Scientists here hope that it won't be long before the rest of the world catches on.
PROFESSOR AMIRAN MEIRPARIANI: We preserved our intellectual potential. We still have our unique collection of bacteriophages... we have highly professional and qualified staff. So we can completely... supply the whole world with our knowledge, our experience and our professionalism.