Bacterio phages

 

We all know the drill. If we have an ear or throat infection, you go to the doctor. He gives you pills and you get better. But there are already patients who can not be helped anymore with normal antibiotics. They got resistant for it.

Every year 700,000 people die because they can be treated anymore. The WHO (World Health Organization) warns that antibiotic resistance has reached "alarming proportions".

But now there is an alternative to antibiotics, which might offer a solution to the problems. It's called bacteriophage, virtually unknown here. But a normal medicine in the country Georgia. It is already used for 100 years and you can buy it al the local pharmacist.

 

Names

2:23 Pranav Johri

 

2:40 Jean Francois Besson

 

3:11 dr. Mzia Kutateladze

Director Eliava institute

 

5:32 Dada Bolkvatze

microbiologist

 

10:16 dr. Jean-Paul Pirnay

molecular biologist

 

Script and narration. Starts at 2:00 (not 0:00)

 

02: 18: -02: 21

You came all the way from India to get better? Why?

 

02: 21:- 02: 25

I was reaching a point where antibiotics could not help.

 

00: 02: 25: -02: 29

I could not find a solution ...

 

02: 29: -02: 33

... within traditional Western

Medicine to arrest the problem.

 

02: 33- 02: 36

So I had to find another solution.

 

02: 37- 02: 43

A lot of French people come here. Why?

- For the same reason I did.

 

02: 43-02: 49

Because they did not get the expected result

with antibiotics.

 

 

02: 50- 02: 51

That's why they come here.

 

 

 

02: 51-02: 54

Is this the only way to get better?

- Yes.

 

03: 00-03:03

They say it is very tasty.

 

 

03: 10-03:16

Phage therapy has a very specific and special place

in the fight against antibiotic-resistance.

 

Voice/narration

3:19

VO: Here, in the middle of Tbilisi lies the Eliava Institute. The institute has been treating people with bacteriophages since 1923. It might sound strange, but here in Georgia a phage is as common as a pill. They are used for treating such ailments as throat, bladder and ear infections.

 

 

03: 34-03: 35

I got bacteriophages medicine

 

3:36

what did you get?

 

3:38 a bacteriophage for the stomach

 

3:41 Is it for yourself?

 

3:42 No, it is for my baby

 

3:43 Is this as normal for you as taking a pill?

3:46 Of course it is normal for us

 

3:48 This phage you have to drink.

 

3:53

VO: In the early 20th century bacteriophages and antibiotics were discovered around the same time. Antibiotics seemed to offer a more effective treatment, as one medicine could eradicate many different types of bacteria. Whereas a bacteriophage works differently. It is a virus that targets one specific type of bacteria. The broad usage of antibiotics ensured their dominance in Western medicine.

 

SB Russian music

 

4:24

VO: But not in the Soviet Union. Behind the iron curtain it was difficult to get proper antibiotics. They continued to use phages and have developed them since the end of communism. This is why the waiting room of the Eliava Institute is full of ill Georgians.

 

4:40

I try to get to the root of the problem and see if the phages will help.

 

4:45 what are the complaints.

 

 

4:47

VO: The patient has a consultation with a doctor, and a sample is taken, using an ear or cheek swab.

SB ahhh

4:54

VO: Then, the bacteria which is causing the infection must be isolated. Three days after submitting the sample the patient returns to the doctor. The bacteria is now cross-referenced against the six standard phages that are permanently in stock. If the bacteria responds to one of them, the phages can immediately be picked up at the pharmacy.

 

5:16 SB It’s a big lab

 

5:19

VO: But what if the bacteria cannot be killed by the six standard phages? Then a phage has to be custom made. And at the Eliava lab they have more than 100 years of experience with that.

 

 

5:30 If the standard phages not work, we look at our lab collection.

 

5:37

We try our phages against this bacterium/bacteria

 

5:40

We spread the bacteria over the entire glass.

 

5:43

Now we have to wait for it to dry.

 

5:48

Then we have to spot our different phages on the bacteria. 

 

5:55

And after that we have to incubate it over night.

 

6:00

And see the result the next day

 

6:07

 

The next day it looks like this.

 

6:10 On the clear spots it works.

 

 

6:12

This clear spots means that this phage

worked on this bacterium.

 

6:19 This one less, this one more.

 

6:23

We choose the best phages

 

and try to adapt the phage ...

 

6:27

... To get the most active phage for this specific

bacteria.

 

animation 6:31

VO: When the phages encounter the bacteria, they attach themselves to it. Once firmly attached, the phages injects its DNA into the bacteria, which replicates within it. The phages then secretes an enzyme that eventually bursts open the bacteria, releasing the phages virus to infect the remaining bacteria. This is repeated until the infection is eradicated.

 

SB: sound dish

6:50

VO: When the correct phage is identified, the pharmacists develop it into a drug. The treatment will be administered under the supervision of a doctor. The phage can be drunk, applied to the skin or inhaled. So that the problem can be tackled directly. Phages are offering treatment to people who have been failed by antibiotics.

 

7:13

You came all the way from India

to get better? Why?

 

7:16

I tried antibiotic treatment. I took about two months of antibiotics.

 

7:22

But my infection did not respond to antibiotics.

 

7:26

They didn’t work anymore.

They did not work.

 

7:30

I got tested and found out that the infection

was resistant to the antibiotics.

 

7:35 I got pain in the pelvis region.

 

7:38

VO: Pranav Johri is from New Delhi, India. He has chronic inflammation of his prostate. He has continuous fever and sometimes violent pains. As antibiotics have not worked, Phages are his last resort.

 

 

7:52

Do you also have a fever?

- No, I do not have a fever anymore.

 

7:55

When I used phages

the fever disappeared.

 

8:02

I hope that the phage therapy

eliminates the infection.

 

 

 

8:08

As for the symptoms

 

I am 50% better from when I started phage therapy

 

8:17

VO: We visit the director of the Eliava Institute, she tells us that Pranav is one of a long list of foreign patients.

 

8:25

We have patients from New Zealand

 

and even a lady from Uruguay.

 

8:30

From France, Germany and China.

From all parts of the world.

 

8:38

VO: The range of infections that can be addressed is extensive. The medical departments are identified on the hospital’s doors. And for all the medical specialisations specific phages are developed. In this way, a phage was found to combat the aggressive hospital bacteria, pseudomonas. Jean-Francois Besson is suffering from a pseudomonas infection of the lungs.

 

8:57

You should take this twice a day.

Mornings and evenings.

 

9:01

Orally. You should drink it.

 

09: 03

The bacterium is spreading through my body ...

 

9:08

In this way we try to stop it.

 

9:11

That the infection can not infect your entire body.

 

09: 18

You are taking an experimental drug.

Are you not afraid?

 

09: 21

In Georgia it 's not experimental.

Here it is quite normal.

 

09: 25

It has been used for hundreds of years,

So that gives me confidence.

 

09: 31

I have found no side effects.

 

09:36

That's the big advantage: It only targets

the infection, nothing else

 

09: 43

They recognize and kill only specific bacteria

 

09: 46

E. coli, for example, has its own phage,

as has staphylococcus aureus.

 

09: 52

They have no effect on each other

and the normal microflora.

 

09: 58

So, no side effects?

 

10: 00

That's really important.

There are almost no side effects.

 

10:05

VO: But how is the situation outside of Georgia? We visit the Queen Astrid Hospital in Brussels, Belgium. They are working together with the Eliava institute to develop phages for Europe.

 

 

 

 

10: 15

We learn from their experience

with using the phages in the clinic.

 

 

10: 19

They learn from us.

 

10:22

How to produce phages

according to Western standards.

 

10:26

Because that is the missing link?

 

10:28

Yes, pretty much. I think so.

 

10:32

Then phages can be used for many diseases, here in Europe.

 

10:34

Right.

 

10:36

VO: In Brussels, Phages are now produced according to Western standards and hygiene regulations. The Belgian health minister has recently approved the use of phages. Meaning that Belgium will be the first country in Europe to make phages available in pharmacies.

 

10: 50

 

The first steps have been made

 

and it looks very promising..

 

10:54

So a doctor can prescribe a phage and

you will develop that in your lab?

 

10:58

Yes that's right.

 

11:00

 

Develop and produce

 

in accordance with certain standards ...

 

11:05

... and also with the necessary

quality control.

 

11:09

VO: But of course the question remains, will phages suffer from the same resistance problems as antibiotics. No, says the director of the Eliava Institute. Bacteria and phages are natural enemies of each other and so evolve together.

 

11:26

It is a natural struggle.

They coexist next to each other.

 

11: 30

 

It is an ecological interaction

 

between bacteria and viruses.

 

11: 36

It is a natural bacteria killer.

 

11:38

-That's the only thing we work with: natural.

 

11:40

VO: The Eliava Institute is the proud owner of an impressive collection of phages. These have been developed over the last hundred years, and new ones are continuously being added.

 

11: 50

We have a lot, up to 2000.

 

11: 53

 

Each lab has its own collection of phages.

 

- For his own medical specialty? Yes.

 

11: 59

So we really have a lot.

 

12: 00

 

Have you ever been unable to find a working phage?

 

 

12: 03

In my practice,

that never happened.

 

12: 09

 

I hope that many countries will get the licence,

the approval for phage therapy.

 

12: 15

This is necessary, especially at the present time ...

 

12: 18

 

... because the resistance to antibiotics

 

is a problem for everyone.

 

12: 23

 

For both developing countries as the

developed countries as much.

 

12: 27

It can help people.

-          Absolutely.

 

12: 30

Does it taste good?

 

12: 32

Not really.

 

12: 34

this treatment could change your life.

 

12: 38

It could, yes it could.

 

12: 41

 

That is what you are hoping for.

- Absolutely.

 

12: 44

You hope for a normal life.

Yes.

 

 

 

 

 

 

Music:

 

Title: EVIDENCE

Track: 39

Composer(s): Marshall Smith/Tom Fox

CD Code: ad2155

CD Title: Documentary Underscore Series - Medical -csi

Label: Adrenalin

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Title: Textural Healing

Track: 4

Composer(s): James Kelly

CD Code: rsm178

CD Title: Minimal Guitar Underscores Vol. 2

Label: Rsm

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Arpeggio

Track 14

Rutger Verberkmoes Componist en Uitvoerende

Buma stemra 1258187 

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Title: Smokescreen

Track: 2

Composer(s): Verberkmoes, Rutger

CD Code: 101dom030

CD Title: Timeless

Label: 101 Dark Orchid Music

Lengte: 25 sec

 

Title: FINGERPRINTS

Track: 3

Composer(s): Marshall Smith/Tom Fox

CD Code: ad2155

CD Title: Documentary Underscore Series - Medical -csi

Label: Adrenalin

Lengte: 1.18

 

Title: Doo Doo Doo

Track: 3

Composer(s): Villepigue, Chris/Jonathan Shaw

CD Code: bynd143

CD Title: Acoustic Pop

Label: Music Beyond

Lengte: 23 sec 

 

Title: Searching

Track: 6

Composer(s): James Kelly

CD Code: rsm178

CD Title: Minimal Guitar Underscores Vol. 2

Label: Rsm

Lengte: 1.27