New Treatment Offers Hope for Tackling Antibiotic-Resistant Infections

When faced with the growing issue of antibiotic resistance, researchers worldwide have been channeling their efforts into developing different ways to approach the treatment of antibiotic-resistant infections. Now, researchers from two universities—Newcastle University and University of Birmingham—have found a different way to treat patients with bronchiectasis who also have chronic Pseudomonas aeruginosa lung infections, a bacterium that is known to have developed resistance to available antibiotics.

Researchers used a unique approach that consisted of removing antibodies from the bloodstream of these patients; they found that not only did the process result in reduced effects of the chronic infections, but it also resulted in a shorter hospital stay as well as less antibiotic use. The study was published in the American Journal of Respiratory and Critical Care Medicine.

Over 300,000 patients in the United Kingdom are plagued by bronchiectasis, a disease that is known to result in the “permanent enlargement of airways in the lung.” Symptoms of bronchiectasis “are debilitating for patients,” in that patients with the disease usually experience shortness of breath, a chronic cough that may result in coughing up blood, as well as chest pain. Chronic Pseudomonas aeruginosa lung infections are a common occurrence in bronchiectasis patients, but the fact that this bacterium is known as a multidrug-resistant pathogen, makes it even harder to treat patients who have the condition.

For the study, the researchers took a look at two bronchiectasis patients who also had multidrug-resistant chronic Pseudomonas aeruginosa infections: one male patient (aged 64 at time of study) had bronchiectasis since the age of 15, and one female patient (aged 69 at time of study) had the disease since childhood. Both patients volunteered to receive “explorative treatment,” that piggybacked off of past research that had been conducted by the team in 2014.

“These patients had an excess of a particular antibody in the bloodstream. In contrast to the protective effect normally associated with antibody, in these patients the antibody stopped the immune system [from] killing the Pseudomonas aeruginosa bacterium and this worsened the patients’ lung disease,” Ian Henderson, professor and director of the Institute of Microbiology and Infection at the University of Birmingham explained in a press release. “Perhaps counter-intuitively we decided to remove this antibody from the bloodstream and the outcomes were wholly positive.”

So, what was the process that the researchers used to do this? By working closely with kidney and immunology experts, the researchers used a technique called plasmapheresis, which is similar to kidney dialysis.

“We needed a brand new way of tackling this problem,” Tony De Soyza, Bronchiectasis service lead, Newcastle Upon Tyne Hospitals Trust and senior lecturer at Newcastle University shared in a press release. “The plasmapheresis involved the removal, treatment, and return of blood plasma from circulation, and was done 5 times in a week in order to remove antibody from the patients. We then replaced antibodies with those from blood donations.”

The results? The treatment restored the ability of the patients’ blood to kill the Pseudomonoas aeruginosa infection. Both patients reported a “rapid improvement in health and wellbeing, greater independence, and improved mobility.”

The findings of this study have several implications. According to Dr. Henderson, their findings suggest that the wellbeing of patients can be significantly improved “by reducing the need for treatment and the numbers of days spent in hospital, which will also help to reduce the reliance on antibiotics.” Using less antibiotics is one step in the right direction when it comes to fighting antibiotic resistance.

According to the press release, the treatment may be applicable to treating several other bacterial infections as well. Dr. Henderson concluded, “The next step is to do longer-term studies to investigate whether an earlier intervention, with slightly less aggressive therapies, could help prevent disease progression in patients.”