EVREA-Phage: Phage therapy against Enterococcus faecium
Antibiotic resistance is increasing at an alarming rate worldwide. New treatment options are urgently needed. Due to their specificity for certain bacteria, phages represent a conceivable alternative or supplement to antibiotics. The specificity of phages, but also the fact that they have no toxic side effects, make them important research objects in biomedicine. For Enterococcus faecium, the rise of vancomycin resistance in Germany in recent years is worrying, with striking dynamics of few sequence types. The EVREA-Phage project, which started in July 2022, aims to provide phage therapy for intestinal VRE reduction, especially to immunosuppressed patients. Immunocompromised patients—and in particular oncological patients—are frequently affected by intestinal VRE colonisation with domination and subsequent infection by VRE.
Immunosuppressed patients often show a typical excessive intestinal colonisation by the bacterium Enterococcus faecium. In the case of excessive colonisation, the actually harmless "intestinal inhabitant" can lead to intestinal cell damage with subsequent bloodstream infection, for example during the administration of chemotherapeutics.
In the EVREA-Phage project (Eradication of intestinal vancomycin-resistant Enterococcus faecium (VRE) using oral phage therapy), a selection is made from a large number and variety of phages that are specifically directed against the bacterium Enterococcus faecium, via numerous tests, of a few that act most efficiently against these target bacteria. After intensive preclinical investigations in a new in vitro intestinal model at the University Hospital Bonn and an in vivo mouse model at the Helmholtz Centre for Infection Research in Braunschweig, selected phages will be combined to form an efficient cocktail against VRE. This cocktail should be able to cover and kill as broad a spectrum of clinical patient strains of Enterococcus faecium as possible. The isolation of new phages against an extensive panel of bacteria is carried out in the phage laboratory of the Leibniz Institute DSMZ. The clinical isolates are mostly from the DZIF studies AEGON and R-Net.