Infection Control Experts

We met Bjørn Waagsbø, a senior consultant at the department of infectious diseases and the leader of the antibiotics-team at St. Olav’s Hospital in Trondheim, with the goal to gain more information about antibiotics and resistant bacteria. According to Waagsbø, Norway is to a small scale affected by resistant bacteria. However, the most common resistant bacteria are Methicillin-resistant Staphylococcus aureus (MRSA), Extended spectrum betalactamase (ESBL) and Vancomycin-resistant enterococci (VRE). Waagsbø pointed out that typically health workers and some tourists that have been vacating in South-Europe are detected with these resistant bacteria. He further stated that resistance is a problem today because of prolonged and wrong use of antibiotics, people travelling and release of nonbiodegradable antibiotics in nature.

We explained the experimental details behind our project and Waagsbø was impressed by the idea, and thought it was interesting that we wanted to do research on an existing technology. He concerned us with the issue with pharmaceutical companies that develop new broad spectrum antibiotics to earn profit, rather than expand on new ideas that are unrelated to antibiotics. The interesting part with phage therapy in his opinion was the specificity of phages and that it works in a completely different manner from antibiotics. This can open a door for personalized medical treatment.

We Emailed with Gunnar Skov Simonsen, a Professor of Clinical Mircobiology at the University of Tromsø and Director of the Department of Microbiology and Infection Control at the University Hospital of North-Norway in Tromsø. He is also in charge of Norm – The Norwegian Organization for Surveillance of Antimicrobial Resistance. We asked him, how can we prevent resistant microbes, in addition to use less antibiotics. According to Simonsen it is important to avoid the need of antibiotics by reducing the incidences of infections. This can be achieved by vaccination, clean water and infection control in hospitals. Other antibacterial strategies are antibacterial surfaces (metals, nano-paint) and antivirulence methods.

We also asked for his opinion for the use of phage therapy as an alternative to antibiotics. He wrote that phage therapy has many fans and sceptics. From his point of view phage therapy has its challenges with routine use in hospitals and resistance against phages is also an issue. However, he suggested that chronic infections may be treated with “personalized” phages that correspond to its host bacteria. Simonsen states that restrictive use of the antibiotics is completely necessary today, but in the future phage therapy may be a solution.

Bacteriophage researcher

We talked to Hans Petter Kleppen on the phone. He took his PhD at the Norwegian University of Life Sciences (UMB). His thesis was entitled “Studies of bacteriophages infecting lactic acid bacteria of industrial food fermentations”. Today he is working as senior scientist at ADC Pharma AS, where he is studying phage therapy on Versiniosis caused by the bacteria Yersinia ruckeri in Atlantic salmon.

Kleppen was thrilled that we were working with phages and was more than happy to help us. He gave us useful information, literature recommendation and new perspectives to review, such as the kind of favourable traits we want the phages to evolve. He also explained the procedures that would favour lytic versus lysogenic cycles that was important to consider, and mentioned that addition of magnesium or calcium was good for the growth of phages.

We also talked about the pros and cons of phage therapy. According to Kleppen, phage therapy is an effective agent against multi-resistant bacteria, because the mechanism behind developing resistance in bacteria has no correlation to phages. This is the main advantage of phage therapy. Another benefit of phages is that they are specific and will only grow in their host bacteria, and in this way, leave other bacteria unaffected. The drawback of phage therapy is that the disease-causing bacteria must be identified, leading to strict diagnostic requirements.

Survey

We made a survey to gain public opinion about antibiotics, resistant bacteria, and the use of bacteriophages to treat infections. The survey was shared through our social media leading to 137 responses.

Based on the background information from the participants, the majority were between 21-30 years old, females, and a large number had post secondary education and master degree. They were young and educated, which without questions affected the survey results.

Most people hear about antibiotics sometimes and often. They think antibiotics are used in medicine and livestock in Norway, where the majority rank that the use of antibiotics in medical treatment as very important. While, more than half of the participants think it is unnecessary to use antibiotics in animal/livestock feed.

People say that they know a little bit and a good bit about antibiotic resistant bacteria. The majority thinks resistant bacteria is a problem today, and will also be an issue in the future. Almost all the participants are willing to use less antibiotics if necessary. Some people are comfortable using virus as an alternative to antibiotics, while others would use virus if they need to.

Conclusion: Based on this survey, young, educated people have general knowledge about antibiotics and are aware of its importance. They are enlightened about antibiotic resistant bacteria and are willing to take up the battle. Some of them would use virus, while others would use it if needed.

Click here to download survey results.