What are bacteriophages?
Bacteriophages (or simply “phages”) are bacterial viruses which attack bacteria, multiply within them, and then destroy them. They are “programmed” to destroy one or a few kinds of different strains of bacteria. Phages are widespread in nature and can appear naturally in food and in the human body (for example in the intestines). Phages can efficiently destroy bacteria which have acquired resistance to antibiotics and which are causes of life-threatening infections. It is this exceptional feature which determines whether to apply phages in treating bacterial infections.
What kinds of infections are treated at the Phage Therapy Unit?
Only patients suffering from chronic bacterial infections caused by Acinetobacter, Burkholderia, Citrobacter, Enterobacter, Enterococcus, Escherichia, Klebsiella, Morganella, Proteus, Pseudomonas, Shigella, Salmonella, Serratia, Staphylococcus, and/or Stenotrophomonas may be treated at the PTU. We do not treat other infections such as those caused by streptococci (Streptococcus), Mycobacterium tuberculosis, Propionibacterium acnes (bacteria that cause acne), Borrelia (bacteria that cause borreliosis), Helicobacter pylori, Haemophilus influenzae, or chlamydia. We treat for example: urinary infections, chronic bacterial prostatitis in men, vaginal infections, prosthetic joint infections, osteomyelitis, wound infections, leg ulcers, sinusitis, external and internal ear infections, skin infections, and upper and lower respiratory tract infections.
I have symptoms of bacterial infection but I do not know what bacteria cause it – may I be admitted for experimental phage therapy?
According to our protocol approved by the bioethics committee, we may admit for phage treatment only patients infected with identified bacteria. This means that the patient should have at least one result of bacterial culture to be treated for this infection. The exemption is infection with a multidrug-resistant bacterial strain. We do not provide differential diagnostics of the infections.
How are the phage preparations applied?
Our phage formulations are prepared in a liquid form. They are applied orally, locally, and/or rectally. For oral application you will take a medication which neutralizes acid (up to 20 minutes before oral administration of the formulation), or a stomach acid inhibitor in order to limit the destruction of the phages by stomach acid. By local application, the formulation will be applied 1-2 times daily as a wet compress (moist dressing), sitz bath, nose or ear drops, aerosol, gargling, irrigation of vagina, fistulas, or abscess cavity. By the rectal route 10-20 ml instillations of the formulation will be applied 1-2 times daily.
What are the obligatory tests required for admission to the experimental phage therapy other than microbiological cultures and phage typing?
These test include: general urine examination; erythrocyte sedimentation rate (ESR); peripheral blood morphology and blood smear; serum levels/activity of C-reactive protein (CRP – wide range), glucose, total bilirubin, asparagine transaminase (AST), alanine transaminase (ALT), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), alpha-amylase, creatinine, calcium, phosphate, total protein, D-dimer, thyroid-stimulating hormone (TSH); serum or urine level of beta-hCG (only in women of reproductive age); electrocardiogram (ECG); chest x-ray (postero-anterior view). They are ordered by the physician before beginning the treatment based on the current results presented by a patient.
Are there any other special tests required for admission for treatment of chronic bacterial prostatitis?
Yes. In the case of patients with prostatitis suspected to be caused by bacterial infection we perform at our Unit in Wroclaw a “four-glass test” (together with microscopic analysis of prostatic fluid), which is a gold standard in diagnosis of chronic bacterial prostatitis. This test is accompanied by a general examination of the prostatic fluid, which shows e.g. whether any inflammatory cells are present. It is possible to send us a sample (urine, semen, or prostatic fluid) for isolation of bacteria infecting the urogenital tract and its initial phage typing to make it more likely that we will have active phages against the pathogen which is the actual causative agent of the infection, but this does not replace our obligatory four-glass test.
How can I register for consultation at the Phage Therapy Unit?
You may obtain detailed information about the days and hours of consultations with our specialists and register by phone (+48 71 370 99 01 is available on working days between 8:15 am and 3:45 pm Warsaw time) or e-mail (firstname.lastname@example.org). We consult only previously registered patients. In some cases we may ask you to call and talk with our physician before registering.
Do I need to come to the Phage Therapy Unit personally to start the phage treatment?
Yes. You should come personally to the PTU in Wroclaw, Cracow or Czestochowa. We do not send the phage preparations abroad. You should come for control visits (every 2-4 weeks depending on the decision of the physician) for continuation of the treatment.
What is the phage typing procedure?
Phage typing is a procedure whose aim is to check the sensitivity of the given bacteria (strain) to the panel of phages from the collection of the Bacteriophage Laboratory of the IIET PAS. Based on its result the laboratory will choose or prepare the phage formulation for treatment.
Is it possible to perform the phage typing before visiting the Phage Therapy Unit?
Yes. We prefer to obtain just the bacterial strain isolated in the local laboratory and sent to us on an agar transport plate by courier delivery (it should survive transport at room temperature). Alternatively it is possible to send us a sample taken from a patient (e.g. a swab) for isolation of bacteria. Bacteria should survive in this transport agar container even a few days at room temperature. We always advise sending us the samples in duplicate (only one of them will be sent for microbiological culture, and the other will be used in case of any problems with the first one). In such a case you should also send an equivalent sample to your local microbiological laboratory for parallel bacterial culture. To obtain detailed instructions please refer to our Information.
Are children admitted to the experimental phage therapy?
What are the costs of the phage therapy at the Phage Therapy Unit?
At present the estimated total cost of phage therapy (including qualification procedure, consultations, diagnostic tests including microbiological culture and phage typing, and cost of the phage preparations) is 2800-5700 PLN (usually the treatment lasts 6-8 weeks). The initial treatment (ca. 2 weeks) costs 1500-2800 PLN. It varies individually and depends on the nature of the infection, number of isolated pathogens, and of course on the duration of treatment.
Is it possible to pay with credit card or Euro at the Phage Therapy Unit and its branches?
No. We accept only payments in cash in Polish zloty (PLN) for all procedures performed at the PTU (all payments are made to our institute’s account at the cashier’s office located in the institute’s building). Payments for some procedures performed by the Bacteriophage Laboratory of the IIET PAS can be made in advance directly to our institute’s account.