Genius MIT researchers propose feeding bacteria to fight infections

No, this is not a joke. Well, the “genius” part is, but the “feeding bacteria to fight infections” is not.

I saw this press release in IDSA’s Twitter feed. I read it and wondered anew at the reality disconnect between academic research and clinical application.

The gist of the story is that non-growing bacteria are less susceptible to antibiotics  and can persist through a course of therapy. The Collins lab at MIT showed that supplying the bugs with a carbon source and terminal electron acceptors – spurring them to grow – can reverse persistence and enable antibiotic-mediated killing. The PR suggests that this could be a new approach to fighting chronic infections: give the growth promoters along with the antibiotics and wipe out the infection.

From Understanding and Sensitizing Density-Dependent Persistence to Quinolone Antibiotics

Please.

I suppose this could work in some scenarios, and I bet it will work in the highly controlled animal models of infection that the Collins group is now testing.

But in actual real infections, releasing pathogenic bacteria from nutrient deprivation will sometimes free them up to metastasize and spread, leading to sepsis and death.

Sure, if appropriate and effective antibiotics are being given, then it’s plausible that the desired killing of bacteria will take place. But how likely is that? Current rates for inappropriate or inadequate antimicrobial therapy for serious infections ranges anywhere from 30% to 70% (see here, and here, and here, and here, and here). That’s not a problem that we are anywhere near to solving.

It’s inevitable that patients with indolent infections, known and unknown, would be killed by the growth-stimulation approach. It should never see the inside of a clinic.

Science in general and health in particular are full of hard problems. Good ideas that are fundamentally sound often end up bombing out. Collins’ work is important and interesting for what it tells us about how antibiotics kill bacteria – a subject that we know surprisingly little about. But it’s a bad idea for treating actual patients. No amount of credulous hype can change that.

Smart guys from MIT come up with cool technologies that are bad ideas, just like everyone else. Unfortunately, they tend to get funded anyway. I hope that grant reviewers and VCs can look past the coolness factor to put research funds to better use.