2006.01) A61P 31/04 (2006.01) SANTIAGO TORIO, Ana; C/O SNIPR BIOME APS., C12N 15/113 (2010.01) Lerso Parkalle 44, 5.Floor, DK-2100 Copenhagen (DK

2006.01) A61P 31/04 (2006.01) SANTIAGO TORIO, Ana; C/O SNIPR BIOME APS., C12N 15/113 (2010.01) Lerso Parkalle 44, 5.Floor, DK-2100 Copenhagen (DK

) ( (51) International Patent Classification: HAABER, Jakob Krause; c/o SNIPR BIOME APS., Ler¬ A61K 38/46 (2006.01) A61P31/00 (2006.01) so Parkalle 44, 5.floor, DK-2100 Copenhagen (DK). DE C12N 9/22 (2006.01) A61P 31/04 (2006.01) SANTIAGO TORIO, Ana; c/o SNIPR BIOME APS., C12N 15/113 (2010.01) Lerso Parkalle 44, 5.floor, DK-2100 Copenhagen (DK). GR0NDAHL, Christian; c/o SNIPR BIOME APS., Lerso (21) International Application Number: Parkalle 44, 5.floor, DK-2100 Copenhagen (DK). CLUBE, PCT/EP20 19/057453 Jasper; c/o SNIPR BIOME APS., Lerso Parkalle 44, (22) International Filing Date: 5.floor, DK-2100 Copenhagen (DK). 25 March 2019 (25.03.2019) (74) Agent: CMS CAMERON MCKENNA NABARO (25) Filing Language: English OLSWANG LLP; CMS Cameron McKenna Nabarro 01- swang LLP, Cannon Place, 78 Cannon Street, London Lon¬ (26) Publication Language: English don EC4N 6AF (GB). (30) Priority Data: (81) Designated States (unless otherwise indicated, for every 1804781. 1 25 March 2018 (25.03.2018) GB kind of national protection av ailable) . AE, AG, AL, AM, 1806976.5 28 April 2018 (28.04.2018) GB AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, 15/967,484 30 April 2018 (30.04.2018) US CA, CH, CL, CN, CO, CR, CU, CZ, DE, DJ, DK, DM, DO, (71) Applicant: SNIPR BIOME APS. [DK/DK]; Lers DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, Parkalle 44, 5.floor, DK-2100 Copenhagen (DK). HR, HU, ID, IL, IN, IR, IS, JO, JP, KE, KG, KH, KN, KP, KR, KW, KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, (72) Inventors: SOMMER, Morten; c/o SNIPR BIOME APS., MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, Lerso Parkalle 44, 5.floor, DK-2100 Copenhagen (DK). OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, MARTINEZ, Virginia; c/o SNIPR BIOME APS., Ler¬ SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, so Parkalle 44, 5.floor, DK-2100 Copenhagen (DK). TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. VAN DER HELM, Eric; c/o SNIPR BIOME APS., Lerso Parkalle 44, 5.floor, DK-2100 Copenhagen (DK). (54) Title: TREATING & PREVENTING MICROBIAL INFECTIONS (57) Abstract: The invention provides methods for treating or pre¬ g id i¬ n as er n ic ic or c¬ Figure 5. [Continued on next page] (84) Designated States (unless otherwise indicated, for every kind of regional protection available) : ARIPO (BW, GH, GM, KE, LR, LS, MW, ML, NA, RW, SD, SL, ST, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, LV, MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK, SM, TR), OAPI (BF, BJ, CF, CG, Cl, CM, GA, GN, GQ, GW, KM, ML, MR, NE, SN, TD, TG). Published: — with international search report (Art. 21(3)) — before the expiration of the time limit for amending the claims and to be republished in the event of receipt of amendments (Rule 48.2(h)) TREATING & PREVENTING MICROBIAL INFECTIONS TECHNICAL FIELD [0001] The invention provides methods for treating or preventing microbial (eg, bacterial) infections and means for performing these methods. In particular, treatment of infections requiring rapid or durable therapy is made possible, such as for treating acute conditions such as septicemia, sepsis, SIRS or septic shock. The invention is also particularly useful, for example, for treatment of microbes for environmental, food and beverage use. The invention relates inter alia to methods of controlling microbiologically influenced corrosion (MIC) or biofouling of a substrate or fluid in an industrial or domestic system. [0002] The invention also useful for the treatment of pathogenic bacterial infections in subjects receiving a treatment for a disease or condition, such as a transplant or a treatment for cancer, a viral infection or an autoimmune disease. BACKGROUND [0003] Septicaemia is an acute and serious bloodstream infection. It is also known as bacteraemia, or blood poisoning. Septicaemia occurs when a bacterial infection elsewhere in the body, such as in the lungs or skin, enters the bloodstream. This is dangerous because the bacteria and their toxins can be carried through the bloodstream to a subject’s entire body. Septicaemia can quickly become life- threatening. It must be rapidly treated, such as in a hospital. If it is left untreated, septicaemia can progress to sepsis. [0004] Septicaemia and sepsis aren’t the same. Sepsis is a serious complication of septicaemia. Sepsis is when inflammation throughout the body occurs. This inflammation can cause blood clots and block oxygen from reaching vital organs, resulting in organ failure. The US National Institutes of Health (NIH) estimates that over 1 million Americans get severe sepsis each year. Between 28 and 50 percent of these patients may die from the condition. When the inflammation occurs with extremely low blood pressure, it’s called septic shock. Septic shock is fatal in many cases. [0005] The increase in average age of the population, more people with chronic diseases, on immunosuppressive drugs, and increase in the number of invasive procedures being performed has led to an increased rate of sepsis. People over 65 years old, particularly those who have health issues, are even more susceptible to sepsis than any other group. According to a study published in 2006, while people aged 65 years and older make up about 12% of the American population, they make up 65% of sepsis cases in the hospitals. [0006] Septicaemia is caused by an infection in a part of the body. This infection is typically acute. Many types of bacteria can lead to septicaemia. The exact source of the infection often can’t be determined. The most common infections that lead to septicaemia are: • urinary tract infections • lung infections, such as pneumonia • kidney infections • infections in the abdominal area [0007] Bacteria from these infections enter the bloodstream and multiply rapidly, causing acute infection and immediate symptoms. [0008] People who are already in the hospital for something else, such as a surgery, are at a higher risk of developing septicaemia. Secondary infections can occur while in the hospital. These infections are often more dangerous because the bacteria may already be resistant to antibiotics. There is a higher risk of developing septicaemia if the subject: • has severe wounds or bums • is very young or very old • has a compromised immune system, which can occur from diseases such as HIV or leukaemia • has a urinary or intravenous catheter • is on mechanical ventilation • is receiving medical treatments that weakens the immune system, such as chemotherapy or steroid injections [0009] The symptoms of septicaemia usually start very quickly. Even in the first stages of the illness, a person can look very sick. They may follow an injury, surgery, or another localized (eg, confined to one location) infection, like pneumonia. The most common initial symptoms are: • chills • elevated body temperature (fever) • very fast respiration • rapid heart rate [00010] More severe symptoms will begin to emerge as the septicaemia progresses without proper treatment. These include the following: • confusion or inability to think clearly • nausea and vomiting • red dots that appear on the skin • reduced urine volume • inadequate blood flow (shock) [00011] Septicaemia that has started to affect the organs or tissue function is an acute medical emergency. It must be rapidly treated at a hospital. Many people with septicaemia are admitted to a hospital’s ICU for treatment and recovery. It is recommended to never take a “wait and see” approach or try to treat the problem at home. It is crucial to get to the hospital right away if the subject is showing signs of septicaemia. Septicaemia has a number of serious complications. These complications may be fatal if left untreated or if treatment is delayed for too long. Septic shock [00012] One complication of septicaemia is a serious drop in blood pressure. This is called septic shock. Toxins released by the bacteria in the bloodstream can cause extremely low blood flow, which may result in organ or tissue damage. Septic shock is an acute medical emergency. People with septic shock are usually cared for in a hospital’s intensive care unit (ICU). The patient may need to be put on a ventilator, or breathing machine, if in septic shock. Acute respiratory distress syndrome (ARDS) [00013] Another complication of septicaemia is acute respiratory distress syndrome (ARDS). This is a life-threatening condition that prevents enough oxygen from reaching your lungs and blood. According to the National Heart, Lung, and Blood Institute (NHLBI), ARDS is fatal in about one- third of cases. It often results in some level of permanent lung damage. It can also damage the brain, which can lead to memory problems. Sepsis [00014] Sepsis occurs when the body has a strong immune response to the infection. This leads to widespread inflammation throughout the body. It is called severe sepsis if it leads to organ failure. People with chronic diseases, such as HIV or cancer, are at a higher risk of sepsis. This is because they have a weakened immune system and cannot fight off the infection on their own. Sepsis causes millions of deaths globally each year and is the most common cause of death in people who have been hospitalized. The worldwide incidence of sepsis is estimated to be 18 million cases per year. In the United States sepsis affects approximately 3 in 1,000 people, and severe sepsis contributes to more than 200,000 deaths per year.

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