80-81 病毒15-1期3557.Indd

VIROLOGICA SINICA 2015, 30 (1): 80-81 DOI 10.1007/s12250-014-3557-0

INSIGHT

Experience of the Eliava Institute in bacteriophage therapy

Mzia Kutateladze

George Eliava Institute of Bacteriophages, Microbiology and Virology, Tbilisi 0160, Georgia

The rapid propagation of multi- phage discoverer, Felix d'Herelle in pathogenic bacterial strains has been drug resistant bacterial strains is 1923 (Figure 1A). This facility later relentlessly compiled at the institute. leading to renewed interest in bacte- named the George Eliava Institute The Eliava Analytical–Diagnostic riophage therapy. With challenges in of Bacteriophages, Microbiology Center provides the detection and the treatment of bacterial infections, and Virology (Figure 1B), which identification of bacterial and viral it is essential for people worldwide remains the current name. Although pathogens, which are the causative to understand how alternative ap- in past decades, the Eliava Institute agents of infectious diseases. Together proaches, such as bacteriophages, has undergone many changes, phage with antibiotic-susceptibility tests, could be used to combat antibiotic re- research and phage therapy have re- the center also performs phage-sus- sistant bacteria. The Eliava Institute mained the principal activities of the ceptibility tests. Another part of the of Bacteriophages, Microbiology and institute. Institute, Eliava Biopreparations, pro- Virology (Tbilisi, Georgia) is argu- The research conducted at this duces several phage preparations for ably the most famous institution in institute is focused on the use of bac- treatment and prophylaxis: Pyophage the world focused on the isolation, teriophages in the following areas: (phages against Staphylococcus au- study, and selection of phages active human therapy and prophylaxis, vet- reus, Escherichia coli, Streptococcus against a variety of bacterial patho- erinary applications, food safety, and spp., Pseudomonas aeruginosa, gens. environmental protection. Particular Proteus spp.); Intesti phage (Shigella, current attention is devoted to the Salmonella, entero-pathogenic E. coli, Brief introduction of the isolation and selection of effective Proteus, Enterococci, Staphylococci, Institute bacteriophages against antibiotic-re- and P. aeruginosa); Enkophage The Institute of Bacteriophages sistant bacterial strains. (Salmonella spp., Shigella spp., ente- in Tbilisi was founded by Georgian ro-pathogenic E. coli, Staphylococcus microbiologist Giorgi Eliava and Activities of the Eliava spp.); SES phage (Staphylococcus spp., French Canadian microbiologist and A large collection of phages and Streptococcus spp., E. coli); Fersis

Figure 1. (A) Felix d'Herelle and George Eliava working at the bacteriophage institute in Tbilisi in the 1930s. (B) The George Eliava Institute of Bacteriophages, Microbiology, and Virology. (Courtesy of the Eliava Institute)

Figure 2. Phage preparations produced by the Eliava Biopreparations for treatment and prophylaxis. (A) Staphylococcal bacteriophage. (B) Pyo-Phage (phages against Staphylococcus aureus, Escherichia coli, Streptococcus spp., Pseudomonas aeruginosa, Proteus spp.). (Courtesy of the Eliava Institute)

(Staphylococcus spp., Streptococcus 95% exhibiting signiﬁ cant improve- initiatives for the elaboration of new spp.); and Staphylococcal monophage ment and recovery. In no cases were phage preparations; and to explore (Figure 2). The preparations developed there complications or side effects the most appropriate organizational in Tbilisi have been studied through after phage application. development for broader production, extensive characterization as well as Phage preparations are used in acute application, and marketing of its bio- through preclinical and clinical trials. as well as in chronic patients. In chron- logical preparations. Many people from various parts ic cases, the main advantages of phage of the world currently express their treatment are in reducing the necessity Correspondence: willingness to undergo phage treat- for antibiotic use in complex therapies Phone: +995-322-381604, ment against different infections, in- by 50% and in prolonging remission Fax: +995-322-374910, cluding those that are caused by an- period (infection-free periods between Email: [email protected] tibiotic-resistant bacterial pathogens. colonization episodes). ORCID: 0000-0002-7566-7278 From 2012 to December 2014, the Eliava Phage Therapy International Future direction of the Institute Published online: 5 February 2015 Center has received 5,205 patient The Eliava Institute has developed visits. Among these, 3,290 visits new, phage-based products and tech- REFERENCES were for phage treatment. Phage nological approaches for their effec- preparations were also sent to anoth- tive, quality controlled production. Alavidze Z, Kutateladze M. Bacteriophage ther- er 130 patients abroad. Thirty-nine apy. 2001. New York: Academic Press, pp. Strong collaboration with the medical 89–92. foreign patients were treated at the community in the design of clinical Kutateladze M, Adamia R. 2008. Medicine et Center (from France, Canada, USA, trials according to international stan- Maladies Infectiouses, 38: 426–430. Romania, and Norway). Frequently dards is absolutely critical in sup- Kutateladze M, Adamia R. 2010. Trends Bio- observed diseases in our clinics in- porting the broader implementation technol, 28: 591–595. clude those in urology, gynecology, of phage therapy. The next step at Fitzgerald-Hughes D, Bolkvadze D, Balarjishvili internal medicine, and pediatrics. N, et al. 2014. J Antimicrob Chemoth, 69: the Eliava Institute is to commercial- 1148–1150. The overall outcome of these treat- ize phage-based products following Kutter E, Borysowski J, Miedzybrodzki R, et al. ments is exciting with more than international standards; to extend Norfolk: Caister Academic Press, pp. 257–288.