Hani Hamdan lives in Burnsville and practices dentistry in Lakeville, Minn. He is a contributor and editor of Engagemn.com and a source in MPR's Public Insight Network.
One of my high school friends grew up to become an orthopedic surgeon. He works in a busy hospital in which he sees all kinds of cases — from trauma to congenital malformations to tumors. When I asked him what he considers the most difficult cases to treat, he said that the one thing that raises the hair on the back of his neck is not seeing a tumor on a radiograph; it's being able to see bone through the skin.
Why is that so scary to a surgeon, when wound repair is not a very difficult task? In a word: infection.
Good ol' bacteria, living on the skin and finding its way to exposed bone, can be as big a nightmare as a bone tumor. If the bacteria is, say, MRSA (methicillin-resistant Staphylococcus aureus), treatment can be so difficult that one of the accepted modalities of treatment has recently become "to live with the infection," meaning to simply accept the fact that it may never go away, and be prepared to have regular curettage treatments for a very long time. If you think that this is outrageous in the 21st century, you're probably right.
The world of dentistry has a similar nightmare: Bacteria causing osteomyelitis of the jaw can be as demanding to treat as requiring a jaw resection — having an entire chunk of the jaw removed and reconstructed surgically when antibiotics don't work. Other bacterial infections in the skin, urinary tract and intestines are becoming increasingly challenging to treat with antibiotics.
We thought that we were winning the war on bacteria because we have antibiotics on our side, but bacteria are developing resistance faster than we can develop new drugs. Recently, Dame Sally Davies, the United Kingdom's chief medical officer, warned that antibiotic-resistant bacteria are an imminent crisis that should be included on the government's official register of possible national emergencies, right next to terrorist attacks and natural disasters.
This makes clear that there is really no excuse for not exploring other ways of fighting bacteria, including bacteriophage therapy. Bacteriophages are viruses that specialize in attacking bacteria. They are naturally available and are capable of developing resistance to bacteria's resistance mechanisms in a race that they can run faster than we can make new antibiotics. You can read more about bacteriophage therapy here.
Sure, it sounds too good to be true — little soldiers that can work for us and eradicate nasty bugs. It also sounds scary; what if these viruses turn against us? I'm not urging that we start using bacteriophages immediately; all I'm saying is that there is no reason not to look at bacteriophages in a serious, comprehensive manner to explore them as a promising treatment method. So far, it appears that most researches view bacteriophages as a childish thought that can never be implemented on a large scale.
American pharmaceutical companies need to be at the forefront of bacteriophage research, because sooner or later, companies in other countries will start developing strain-specific bacteriophages for medical use. The country of Georgia, for example, has been using bacteriophages in hospitals for years. If someone gets a patent on them, our pharmaceutical companies may be left behind.
I remember a teenage girl I saw while on rotation at a hospital. She had a rare skin disorder that made her susceptible to chronic MRSA infection in the skin. Her whole skin was inflamed with redness, and topical antibiotics could only go so far. The infection was right there on the surface of her body, and we were unable to get it under control.
There are too many people out there with persistent bacterial infections against which doctors are powerless. We need to break free of thinking that antibiotics are the only answer, and start looking seriously at other options before it's too late.
Your support matters.
You make MPR News possible. Individual donations are behind the clarity in coverage from our reporters across the state, stories that connect us, and conversations that provide perspectives. Help ensure MPR remains a resource that brings Minnesotans together.