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Stanford med student/HHMI fellow investigates bacteriophage therapy as an alternative to antibiotics

IMG_5145 croppedSecond-year medical student Eric Trac isn't one to shy away from a challenge. Trac's family is from Vietnam and he didn't speak much English as a child, but Trac and his mother overcame this hurdle by practicing English and studying together every night until the early morning hours so he could do well at school. Now, just 12 years later, Trac is a Howard Hughes Medical Institute (HHMI) fellow taking on a new kind of challenge: investigating an alternative to antibiotics.

Many people think that antibiotics are the only way to kill bacteria, but this isn't true. "Before we used antibiotics, we used bacteriophages,” Trac said. "Just like viruses attack people, bacteriophages attack bacteria. In other words, bacteria can get sick as well.”

Bacteriophages have been used since the early 1900s in countries like France, Poland and the U.S. to treat diseases such as cholera and dysentery. But interest in bacteriophage therapy, and its use, declined in the West after antibiotics were discovered in the 1920s. Now that bacteria are becoming increasingly resistant to antibiotics, researchers in the West are taking interest in the decades of bacteriophage research that continued in Eastern Europe and the former Soviet Union long after antibiotics became popular elsewhere. Unfortunately, many of these studies don't meet the scientific standards (e.g., double blind studies, experimental controls) that Western drug research requires.

So, for his year-long HHMI project, Trac and his mentors, bioengineer and physicist Stephen Quake, PhD, and pediatric pulmonary expert David Cornfield, MD, will test bacteriophage therapy — with the required scientific protocols — to see if it could be a viable, and safe alternative to antibiotics. His project will focus on two common bacteria, Pseudomonas aeruginosa and Staphylococcus aureus, that can cause life-threatening infections, especially in people with cystic fibrosis. “The need for alternative ways to kill these two bacteria is great,” Trac said.

The first phase of his three-part study will assess how well bacteriophages can control these two bacteria compared to antibiotics. To do this, Trac will grow the two types of bacteria on agar plates, treat some plates with antibiotics and some with bacteriophages, and measure how much of the bacteria each treatment kills.

For the second part of the project, Trac and his mentors aim to explore when, and how fast bacteria develop resistance to bacteriophages. They’ll use concepts from engineering (one of Trac's majors at Massachusetts Institute of Technology) to design a computer model that tests how much bacteriophage is optimal, and whether a single type of bacteriophage or a cocktail of many types of bacteriophages are better at slowing and preventing bacteriophage resistance.

This blend of engineering and medicine is the kind of research Trac wants to do in the future. "I'm very excited about this part of the study," Trac told me.

Lastly, Trac and his mentors will test the safety of bacteriophage therapy by adding bacteriophages to samples of human lung cells. This part of the study is needed because it’s not yet known how much bacteriophage therapy is safe to use, or if any collateral damage could occur as bacteriophages infect and kill bacteria.

For Trac, this HHMI project is an ideal way to explore his interests in medicine and engineering: "There are many research opportunities in medicine that relate to engineering. It [engineering] brings a new perspective to medical science." Who knows, this fresh perspective could be just the thing Trac needs to take on antibiotic-resistant bacteria, and any other medical challenge that comes his way.

Previously: Stanford med student/HHMI fellow testing new way to deliver treatment to heartStanford study: Not all dog bites should be treated with antibioticsThe end of antibiotics? Researchers warn of critical shortagesFree online course aims to educate about "pressing public health threat" of antibiotic resistance and Interactive online map helps researchers track spread of antibiotic-resistant bacteria
Photo courtesy of Eric Trac

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