How a medieval “leechbook” could be the latest cutting edge treatment to defeat superbugs

Could new vaccines or even a medieval eye balm recipe provide new ways to defeat swarming armies of antibiotic-resistant superbugs?

There is no doubt that we are in desperate need of new solutions to combat infectious bacteria: the World Health Organization (WHO) ranks antimicrobial resistance among the top ten threats to global health, saying that by 2050 it will kill more people than cancer if resistance continues to rise at the current rate.

We also cannot count on better antibiotics.

In April, the WHO warned that none of the 43 antibiotics currently being developed can beat the 13 deadliest bacteria in the world, such as Acinetobacter baumannii and Pseudomonas aeruginosa, both of which cause blood infections and pneumonia.

Scientists are therefore taking a different approach and developing powerful non-antibiotic alternatives.

Vaccines are one of the most promising candidates.

Of course, we normally think vaccines protect us against viruses like Covid, but investigators are learning how to wield them against drug-resistant killer bacteria, either to treat infections or to prevent them.

Last month, US researchers announced that they had developed a vaccine against antibiotic-resistant Klebsiella pneumoniae, which causes pneumonia and infects some 10,000 people in England and Wales each year.

To alert our immune system to recognize and attack the Klebsiella bacteria, scientists took a telltale protein from its outer skin and inserted it outside of an inactive form of E. coli bacteria.

In tests, inoculated mice were able to overcome the Klebsiella infection, researchers from Tulane University reported in the journal Science Immunology.

In addition, rather than being injected, the vaccine only needs to be inhaled, making it easier to protect vulnerable patients in hospitals.

Inhaling the vaccine also appears to be very effective in priming immune cells in the lungs to fight bacterial infections, the researchers found.

Dr Jay Kolls, professor of internal medicine who led the study, says this approach could defeat other species of bacteria infecting the multidrug-resistant lungs.

“The main cause of pneumonia worldwide is Streptococcus pneumoniae, and there is no reason why this technology cannot theoretically be used for this pathogen as well,” he says.

Vaccines are also being developed against common bacterial diseases which are often resistant to antibiotics.

In another study published last month, Canadian researchers reported how a vaccine showed up to 90 percent success in protecting women from the misery of recurrent urinary tract infections (UTIs) in a trial involving over 1,400 patients.

The vaccine, called Uromune, is given by oral spray and contains inactivated bacteria from the four most common resistant strains that cause UTIs. This primers the patients’ immune system to target them.

It has already been given to more than 20,000 women in Canada as part of a pre-approval safety testing program.

But while the National Institute for Health and Care Excellence says antibiotic-resistant UTIs are on the rise, the Uromune vaccine is not yet approved for use by the NHS (although treatment can be obtained privately). Regulators are awaiting the outcome of long-term international trials.

Meanwhile, scientists in Spain revealed this month that they’ve come up with a new way to kill lethal antibiotic-resistant bacteria – by pitting infectious bacteria against each other.

The new approach from scientists at the Barcelona Center for Genome Regulation and Pulmobiotics comes from research on antibiotic-resistant Staphylococcus aureus that develops on the surface of implants such as catheters, pacemakers and artificial hips, causing deeply invasive and very dangerous infections.

Staph A is responsible for 80 percent of all infections contracted in hospitals, and these infections are highly resistant to antibiotics, often with devastating and far-reaching consequences.

A 2019 UK study in the journal EFORT Open Reviews, led by Imperial College London, found that more than 1,000 potentially risky operations need to be performed in the UK each year to replace only infected artificial knee joints, at an estimated cost of £ 100,000 per patient.

“Prosthetic joint infection is one of the most feared complications of knee replacement surgery due to its resistance to therapy with existing antibiotics,” the researchers said.

‘The [subsequent] the reinfection rate can reach 20 percent.

These infections are particularly dangerous because bacteria form “biofilms” – colonies that stick to surfaces to form impenetrable structures that prevent antibiotics from reaching the bacteria inside.

The professor of internal medicine, who led the study, says this approach to vaccines could defeat other species of bacteria infecting the multidrug-resistant lungs like pneumonia

These can be 1,000 times more resistant to antibiotics than floating bacteria, according to the Spanish research team.

Exacerbating the problem, the surfaces of medical implants are ideal growing conditions for biofilms.

To tackle this problem, Spanish scientists have come up with a whole new approach to treating these infections, which they call the world’s first “living medicine”.

This involves modifying the infectious bacteria Mycoplasma pneumoniae (which normally causes one type of pneumonia) so that it is not harmful to humans, but also produces two different chemicals that dissolve biofilms and attack cell walls. Staph bacteria embedded inside.

Using this bacterial Trojan horse, they were able to cure more than 80% of laboratory mice that had infected implants, simply by injecting it under their skin, according to a report published in the journal Molecular Systems Biology.

The researchers now plan to use the engineered bacteria to process biofilms in the breathing tubes of hospital patients and plan to begin clinical trials in 2023.

But the solutions don’t always have to be new, suggest researchers at the University of Warwick, who tested a concoction to defeat drug-resistant biofilms that was first formulated 1,000 years ago.

Called Bald’s Eyesalve, it’s made from onion, garlic, wine, and bile salts (made by the liver from cholesterol to break down fat in our diet) and was used to treat eye infections.

Researchers at the University of Warwick, pictured, have tested a concoction to defeat drug-resistant biofilms first formulated 1,000 years ago, and plan to begin clinical trials in 2023

Bald’s Leechbook from the 10th century, a leather-bound manuscript text held in the British Library and considered one of the first English medical textbooks, recommends that it be applied to the eye “at night with a feather”.

But last year, researchers at Warwick reported that the eye drops also work effectively against five strains of bacteria that cause biofilm infections: Acinetobacter baumannii, Stenotrophomonas maltophilia, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pyogenes.

While allicin, the active ingredient in garlic, can be effective against a variety of bacteria, it alone does not work against biofilms. It’s the winning combination of the other ingredients that makes the balm so effective, breaking down the biofilm’s defense, the researchers say.

Last October, the team reported that lab tests indicate the medieval remedy does not damage skin or eye tissue when applied directly to treat infections.

They added that it could, in the future, be developed to treat infected wounds, such as diabetic foot and leg ulcers.

Dr Freya Harrison, the University of Warwick scientist who led the research, says the eye drops could point the way for future research on eliminating bacteria.

“Most of the antibiotics we use today are derived from natural compounds, but our work underscores the need to explore not only unique compounds, but also mixtures of natural products to treat biofilm infections,” she says. .

“Future findings could be improved by studying combinations of ingredients, rather than single plants or compounds.”