No antibiotics worked, so this woman turned to a natural enemy of bacteria to save her husband’s life | CNN



CNN
 — 

In February 2016, infectious disease epidemiologist Steffanie Strathdee was holding her dying husband’s hand, watching him lose an exhausting fight against a deadly superbug infection.

After months of ups and downs, doctors had just told her that her husband, Tom Patterson, was too racked with bacteria to live.

“I told him, ‘Honey, we’re running out of time. I need to know if you want to live. I don’t even know if you can hear me, but if you can hear me and you want to live, please squeeze my hand.’

“All of a sudden, he squeezed really hard. And I thought, ‘Oh, great!’ And then I’m thinking, ‘Oh, crap! What am I going to do?’”

What she accomplished next could easily be called miraculous. First, Strathdee found an obscure treatment that offered a glimmer of hope — fighting superbugs with phages, viruses created by nature to eat bacteria.

Then she convinced phage scientists around the country to hunt and peck through molecular haystacks of sewage, bogs, ponds, the bilge of boats and other prime breeding grounds for bacteria and their viral opponents. The impossible goal: quickly find the few, exquisitely unique phages capable of fighting a specific strain of antibiotic-resistant bacteria literally eating her husband alive.

Next, the US Food and Drug Administration had to greenlight this unproven cocktail of hope, and scientists had to purify the mixture so that it wouldn’t be deadly.

Yet just three weeks later, Strathdee watched doctors intravenously inject the mixture into her husband’s body — and save his life.

Their story is one of unrelenting perseverance and unbelievable good fortune. It’s a glowing tribute to the immense kindness of strangers. And it’s a story that just might save countless lives from the growing threat of antibiotic-resistant superbugs — maybe even your own.

“It’s estimated that by 2050, 10 million people per year — that’s one person every three seconds — is going to be dying from a superbug infection,” Strathdee told an audience at Life Itself, a 2022 health and wellness event presented in partnership with CNN.

“I’m here to tell you that the enemy of my enemy can be my friend. Viruses can be medicine.”

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How this ‘perfect predator’ saved his life after nine months in the hospital

During a Thanksgiving cruise on the Nile in 2015, Patterson was suddenly felled by severe stomach cramps. When a clinic in Egypt failed to help his worsening symptoms, Patterson was flown to Germany, where doctors discovered a grapefruit-size abdominal abscess filled with Acinetobacter baumannii, a virulent bacterium resistant to nearly all antibiotics.

Found in the sands of the Middle East, the bacteria were blown into the wounds of American troops hit by roadside bombs during the Iraq War, earning the pathogen the nickname “Iraqibacter.”

“Veterans would get shrapnel in their legs and bodies from IED explosions and were medevaced home to convalesce,” Strathdee told CNN, referring to improvised explosive devices. “Unfortunately, they brought their superbug with them. Sadly, many of them survived the bomb blasts but died from this deadly bacterium.”

Today, Acinetobacter baumannii tops the World Health Organization’s list of dangerous pathogens for which new antibiotics are critically needed.

“It’s something of a bacterial kleptomaniac. It’s really good at stealing antimicrobial resistance genes from other bacteria,” Strathdee said. “I started to realize that my husband was a lot sicker than I thought and that modern medicine had run out of antibiotics to treat him.”

With the bacteria growing unchecked inside him, Patterson was soon medevaced to the couple’s hometown of San Diego, where he was a professor of psychiatry and Strathdee was the associate dean of global health sciences at the University of California, San Diego.

“Tom was on a roller coaster — he’d get better for a few days, and then there would be a deterioration, and he would be very ill,” said Dr. Robert “Chip” Schooley, a leading infectious disease specialist at UC San Diego who was a longtime friend and colleague. As weeks turned into months, “Tom began developing multi-organ failure. He was sick enough that we could lose him any day.”

Patterson's body was systemically infected with a virulent drug-resistant bacteria that also infected troops in the Iraq War, earning the pathogen the nickname

After that reassuring hand squeeze from her husband, Strathdee sprang into action. Scouring the internet, she had already stumbled across a study by a Tbilisi, Georgia, researcher on the use of phages for treatment of drug-resistant bacteria.

A phone call later, Strathdee discovered phage treatment was well established in former Soviet bloc countries but had been discounted long ago as “fringe science” in the West.

“Phages are everywhere. There’s 10 million trillion trillion — that’s 10 to the power of 31 — phages that are thought to be on the planet,” Strathdee said. “They’re in soil, they’re in water, in our oceans and in our bodies, where they are the gatekeepers that keep our bacterial numbers in check. But you have to find the right phage to kill the bacterium that is causing the trouble.”

Buoyed by her newfound knowledge, Strathdee began reaching out to scientists who worked with phages: “I wrote cold emails to total strangers, begging them for help,” she said at Life Itself.

One stranger who quickly answered was Texas A&M University biochemist Ryland Young. He’d been working with phages for over 45 years.

“You know the word persuasive? There’s nobody as persuasive as Steffanie,” said Young, a professor of biochemistry and biophysics who runs the lab at the university’s Center for Phage Technology. “We just dropped everything. No exaggeration, people were literally working 24/7, screening 100 different environmental samples to find just a couple of new phages.”

While the Texas lab burned the midnight oil, Schooley tried to obtain FDA approval for the injection of the phage cocktail into Patterson. Because phage therapy has not undergone clinical trials in the United States, each case of “compassionate use” required a good deal of documentation. It’s a process that can consume precious time.

But the woman who answered the phone at the FDA said, “‘No problem. This is what you need, and we can arrange that,’” Schooley recalled. “And then she tells me she has friends in the Navy that might be able to find some phages for us as well.”

In fact, the US Naval Medical Research Center had banks of phages gathered from seaports around the world. Scientists there began to hunt for a match, “and it wasn’t long before they found a few phages that appeared to be active against the bacterium,” Strathdee said.

Dr. Robert

Back in Texas, Young and his team had also gotten lucky. They found four promising phages that ravaged Patterson’s antibiotic-resistant bacteria in a test tube. Now the hard part began — figuring out how to separate the victorious phages from the soup of bacterial toxins left behind.

“You put one virus particle into a culture, you go home for lunch, and if you’re lucky, you come back to a big shaking, liquid mess of dead bacteria parts among billions and billions of the virus,” Young said. “You want to inject those virus particles into the human bloodstream, but you’re starting with bacterial goo that’s just horrible. You would not want that injected into your body.”

Purifying phage to be given intravenously was a process that no one had yet perfected in the US, Schooley said, “but both the Navy and Texas A&M got busy, and using different approaches figured out how to clean the phages to the point they could be given safely.”

More hurdles: Legal staff at Texas A&M expressed concern about future lawsuits. “I remember the lawyer saying to me, ‘Let me see if I get this straight. You want to send unapproved viruses from this lab to be injected into a person who will probably die.’ And I said, “Yeah, that’s about it,’” Young said.

“But Stephanie literally had speed dial numbers for the chancellor and all the people involved in human experimentation at UC San Diego. After she calls them, they basically called their counterparts at A&M, and suddenly they all began to work together,” Young added.

“It was like the parting of the Red Sea — all the paperwork and hesitation disappeared.”

The purified cocktail from Young’s lab was the first to arrive in San Diego. Strathdee watched as doctors injected the Texas phages into the pus-filled abscesses in Patterson’s abdomen before settling down for the agonizing wait.

“We started with the abscesses because we didn’t know what would happen, and we didn’t want to kill him,” Schooley said. “We didn’t see any negative side effects; in fact, Tom seemed to be stabilizing a bit, so we continued the therapy every two hours.”

Two days later, the Navy cocktail arrived. Those phages were injected into Patterson’s bloodstream to tackle the bacteria that had spread to the rest of his body.

“We believe Tom was the first person to receive intravenous phage therapy to treat a systemic superbug infection in the US,” Strathdee told CNN.

“And three days later, Tom lifted his head off the pillow out of a deep coma and kissed his daughter’s hand. It was just miraculous.”

Patterson awoke from a coma after receiving an intravenous dose of phages tailored to his bacteria.

Today, nearly eight years later, Patterson is happily retired, walking 3 miles a day and gardening. But the long illness took its toll: He was diagnosed with diabetes and is now insulin dependent, with mild heart damage and gastrointestinal issues that affect his diet.

“He isn’t back surfing again, because he can’t feel the bottoms of his feet, and he did get Covid-19 in April that landed him in the hospital because the bottoms of his lungs are essentially dead,” Strathdee said.

“As soon as the infection hit his lungs he couldn’t breathe and I had to rush him to the hospital, so that was scary,” she said. “He remains high risk for Covid but we’re not letting that hold us hostage at home. He says, ‘I want to go back to having as normal life as fast as possible.’”

To prove it, the couple are again traveling the world — they recently returned from a 12-day trip to Argentina.

“We traveled with a friend who is an infectious disease doctor, which gave me peace of mind to know that if anything went sideways, we’d have an expert at hand,” Strathdee said.

“I guess I’m a bit of a helicopter wife in that sense. Still, we’ve traveled to Costa Rica a couple of times, we’ve been to Africa, and we’re planning to go to Chile in January.”

Patterson’s case was published in the journal Antimicrobial Agents and Chemotherapy in 2017, jump-starting new scientific interest in phage therapy.

“There’s been an explosion of clinical trials that are going on now in phage (science) around the world and there’s phage programs in Canada, the UK, Australia, Belgium, Sweden, Switzerland, India and China has a new one, so it’s really catching on,” Strathdee told CNN.

Some of the work is focused on the interplay between phages and antibiotics — as bacteria battle phages they often shed their outer shell to keep the enemy from docking and gaining access for the kill. When that happens, the bacteria may be suddenly vulnerable to antibiotics again.

“We don’t think phages are ever going to entirely replace antibiotics, but they will be a good adjunct to antibiotics. And in fact, they can even make antibiotics work better,” Strathdee said.

In San Diego, Strathdee and Schooley opened the Center for Innovative Phage Applications and Therapeutics, or IPATH, in 2018, where they treat or counsel patients suffering from multidrug-resistant infections. The center’s success rate is high, with 82% of patients undergoing phage therapy experiencing a clinically successful outcome, according to its website.

Schooley is running a clinical trial using phages to treat patients with cystic fibrosis who constantly battle Pseudomonas aeruginosa, a drug-resistant bacteria that was also responsible for the recent illness and deaths connected to contaminated eye drops manufactured in India.

And a memoir the couple published in 2019 — “The Perfect Predator: A Scientist’s Race to Save Her Husband From a Deadly Superbug” — is also spreading the word about these “perfect predators” to what may soon be the next generation of phage hunters.

VS Phages Sanjay Steffanie

How naturally occurring viruses could help treat superbug infections

“I am getting increasingly contacted by students, some as young as 12,” Strathdee said. “There’s a girl in San Francisco who begged her mother to read this book and now she’s doing a science project on phage-antibiotic synergy, and she’s in eighth grade. That thrills me.”

Strathdee is quick to acknowledge the many people who helped save her husband’s life. But those who were along for the ride told CNN that she and Patterson made the difference.

“I think it was a historical accident that could have only happened to Steffanie and Tom,” Young said. “They were at UC San Diego, which is one of the premier universities in the country. They worked with a brilliant infectious disease doctor who said, ‘Yes,’ to phage therapy when most physicians would’ve said, ‘Hell, no, I won’t do that.’

“And then there is Steffanie’s passion and energy — it’s hard to explain until she’s focused it on you. It was like a spiderweb; she was in the middle and pulled on strings,” Young added. “It was just meant to be because of her, I think.”

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Why Cristiano Ronaldo’s move to Saudi Arabia means so much for the Gulf monarchy’s sporting ambitions | CNN

Editor’s Note: A version of this story appears in today’s Meanwhile in the Middle East newsletter, CNN’s three-times-a-week look inside the region’s biggest stories. Sign up here.


Abu Dhabi, UAE
CNN
 — 

It’s a partnership that’s been hailed as “history in the making.”

One of the world’s most famous soccer stars landed in the Saudi capital Riyadh on Tuesday, where Cristiano Ronaldo was received in an extravagant ceremony, with excited children sporting his new club’s yellow and blue jerseys.

Oil-rich Saudi Arabia’s success in luring the five-time Ballon d’Or winner on a two-year contract with the kingdom’s Al Nassr FC is the Gulf monarchy’s latest step in realizing its sporting ambitions – seemingly at any cost.

According to Saudi state-owned media, Ronaldo will earn an estimated $200 million a year with Al Nassr, making him the world’s highest-paid soccer player.

Shortly after the 37-year-old’s signing with Al Nassr, the club’s Instagram page gained over 5.3 million new followers. Its official website was inaccessible after exceeding its bandwidth limit due to the sudden surge in traffic, and the hashtag #HalaRonaldo – Hello, Ronaldo in Arabic – was trending for days across the Middle East on Twitter.

Analysts say that his recruitment in Saudi Arabia is part of a wider effort by the kingdom to diversify its sources of revenue and become a serious player in the international sporting scene.

It is also seen as a move by the kingdom to shore up its image after it was tarnished by the 2018 dismemberment and killing of Washington Post columnist Jamal Khashoggi at the hands of Saudi agents, and a devastating war it started in Yemen in 2015.

Critics have decried the kingdom for “sportswashing,” an attempt to burnish one’s reputation through sport.

“I think Saudi Arabia has recognized a couple of years ago that to be a powerful nation internationally, you cannot just rely on hard power,” Danyel Reiche, a visiting research fellow and associate professor at Georgetown University Qatar, told CNN.

“You also need to invest in soft power, and the case of Qatar shows that this can work pretty well,” he said, adding that Saudi Arabia is following in the Qatari approach with sport, but with a delay of around 25 years.

Neighboring Qatar has also faced immense criticism since it won the bid to hosting last year’s FIFA World Cup in 2010.

Despite the smaller Gulf state facing similar accusations of “sportswashing,” the tournament has largely been viewed as a success, not least in exposing the world to a different view of the Middle East, thanks in part to Morocco’s success in reaching the semifinals and Saudi Arabia beating eventual World Cup champion Argentina in their opening group game.

Gulf nations engage in fierce competition to become the region’s premier entertainment and sporting hubs. The UAE, Saudi Arabia, Qatar and Bahrain, in close proximity to each other, each have their own Formula One racing event. But their competition hasn’t been confined to the region. Qatar, Saudi Arabia and the UAE have also bought trophy European soccer teams.

Riyadh is playing catchup with neighbors who have long realized the importance of investing in sports, said Simon Chadwick, professor of sport and geopolitical economy at SKEMA Business School in Lille, France, especially as its main source of income – oil – is being gradually shunned.

“This is part of an ongoing attempt to create more resilient economies that are more broadly based upon industries other than those that are derived from oil and gas,” Chadwick told CNN.

Ronaldo’s new club Al Nassr is backed by Qiddiya Investment Company (QIC), a subsidiary of the kingdom’s wealth fund, the Public Investment Fund (PIF), which has played a pivotal role in Saudi Arabia’s diversification plans.

“It is also a sign of interconnectedness, of globalization and of opening up to the rest of the world,” said Georgetown University’s Reiche.

The move is part of “several recent high profile moves in the sports world, including hosting the Andy Ruiz Jr. and Anthony Joshua world heavywight boxing championship bout in 2019, and launching the LIV Golf championship,” said Omar Al-Ubaydli, director of research at the Bahrain-based Derasat think tank. “It is a significant piece of a large puzzle that represents their economic restructuring.”

The kingdom has been on a path to not only diversify its economy, but also shift its image amid a barrage of criticism over its human rights record and treatment of women. Saudi Arabia is today hosting everything from desert raves to teaming up with renowned soccer players. Argentina’s Lionel Messi last year signed a lucrative promotional deal with the kingdom.

Hailed as the world’s greatest player, 35-year-old Messi ended this year’s World Cup tournament in Qatar with his team’s win over France, making his ambassadorship of even greater value to the kingdom.

The acquisition of such key global figures will also help combat the monarchy’s decades-long reputation of being “secretive” and “ultra-conservative,” James Dorsey, a senior fellow at the S. Rajaratnam School of International Studies in Singapore and an expert on soccer in the Middle East, told CNN’s Eleni Giokos on Wednesday.

Al-Ubaydli said that the kingdom wants to use high profile international sports “as a vehicle for advertising to the world its openness.”

Saudi Arabia bought the English Premier league club Newcastle United in 2021 through a three-party consortium, with PIF being the largest stakeholder. The move proved controversial, as Amnesty International and other human rights defenders worried it would overshadow the kingdom’s human rights violations.

Ronaldo’s work with Saudi Arabia is already being criticized by rights groups who are urging the soccer player to “draw attention to human rights issues” in Saudi Arabia.

“Saudi Arabia has an image problem,” especially since Khashoggi’s killing, says Reiche. But the kingdom’s recent investments in sports and entertainment are “not about sportswashing but about developing the country, social change and opening up to the world.”

Saudi Arabia is reportedly weighing a 2030 World Cup bid with Egypt and Greece, but the kingdom’s tourism ministry noted in November that it has not yet submitted an official bid. Chadwick believes that Ronaldo’s deal with Al Nassr, however, may help boost the kingdom’s bid should it choose it pursue it.

Another way Saudi Arabia may benefit from Ronaldo’s acquisition is that it will be able to improve commercial performance, says Chadwick, especially if this collaboration attracts further international talent.

“It is important to see Ronaldo not just as a geopolitical instrument,” said Chadwick, “There is still a commercial component to him and to the purpose he is expected to serve in Saudi Arabia.”

What Ronaldo’s move to Saudi Arabia shows is that the kingdom aspires “to be seen as being the best” and that it wants to be perceived as a “contender and a legitimate member of the international football community,” said Chadwick.

UAE FM meets Syria’s Assad in Damascus in further sign of thawing ties

Syrian President Bashar al-Assad received the United Arab Emirates Foreign Minister Sheikh Abdullah bin Zayed in Damascus on Wednesday in the latest sign of thawing relations between Assad and the Gulf state. The meeting addressed developments in Syria and the wider Middle East, according to UAE state news agency WAM.

  • Background: It was Abdullah bin Zayed’s first visit since a November 2021 meeting with Assad that led to the resumption of relations. Months later, in March 2022, Assad visited the UAE, his first visit to an Arab state since the start of Syria’s civil war.
  • Why it matters: A number of Assad’s former foes have been trying to mend fences with his regime. Last week, talks between the Syrian and Turkish defense ministers were held in Moscow in the highest-level encounter reported between the estranged sides since the war in Syria began. The regional rapprochement is yet to improve the lives of average Syrians. Syria is still under Western sanctions.

Turkish President Erdogan says he could meet with Assad

Turkish President Recep Tayyip Erdogan said in a speech on Thursday that he could meet the Syrian leader “to establish peace.”

  • Background: Erdogan’s comments came after the Moscow talks between the two nations’ defense ministers and intelligence chiefs. “Following this meeting… we will bring our foreign ministers together. And after that, as leaders, we will come together,” Erdogan said on Thursday.
  • Why it matters: The meeting would mark a dramatic shift in Turkey’s decade-long stance on Syria, where Ankara was the prime supporter of political and armed factions fighting to topple Assad. The Turkish military maintains a presence across the Syrian border and within northern Syria, where it backs Syrian opposition forces. Erdogan has also pledged to launch yet another incursion into northern Syria, aiming at creating a 30-km (20-mile) deep “safe zone” that would be emptied of Kurdish fighters.

Iran shuts down French cultural center over Charlie Hebdo’s Khamenei cartoons

Iran announced on Thursday it had ended the activities of a Tehran-based French research institute, in reaction to cartoons mocking Ayatollah Ali Khamenei and fellow Shia Muslim clerics published by French satirical magazine Charlie Hebdo this week.

  • Background: Iran summoned the French ambassador to Tehran on Wednesday to protest cartoons published by satirical magazine Charlie Hebdo. More than 30 cartoons poking fun at Iran’s supreme leader were published by the magazine on Wednesday, in a show of support for the Iranian people who have been protesting the Islamic Republic’s government and its policies.
  • Why it matters: French-Iranian relations have deteriorated significantly since protests broke out in Iran late last year. Paris has publicly supported the protests and spoken out against Iran’s response to them. French Foreign Minister Catherine Colonna criticized Iran’s freedom of press and judicial independence on Thursday, saying “press freedom exists, contrary to what is going on in Iran and… it is exercised under the supervision of a judge in an independent judiciary – and there too it’s something that Iran knows little of.”

The prized legacy of iconic Egyptian singer Umm Kulthum re-emerged this year when Rolling Stone magazine featured her in its “200 Greatest Singers of All Time.”

Ranking 61st, Umm Kulthum was the only Arab artist to make it to the list, with the magazine saying that she “has no real equivalent among singers in the West.”

Born in a small village northeast of the Egyptian capital Cairo, Umm Kulthum rose to unmatched fame as she came to represent “the soul of the pan-Arab world,” the music magazine said.

“Her potent contralto, which could blur gender in its lower register, conveyed breathtaking emotional range in complex songs that, across theme and wildly-ornamented variations, could easily last an hour, as she worked crowds like a fiery preacher,” it wrote.

Nicknamed “the lady of Arab singing,” her music featured both classical Arabic poetry as well as colloquial songs still adored by younger generations. Her most famous pieces include “Inta Uumri” (you are my life), “Alf Leila Weileila” (a thousand and one nights), “Amal Hayati” (hope of my life) and “Daret al-Ayyam” (the days have come around). Some of her songs have been remixed to modern beats that have made their way to Middle Eastern nightclubs.

The singer remains an unmatched voice across the Arab World and her music can still be heard in many traditional coffee shops in Old Cairo’s neighborhoods and other parts of the Arab world.

Umm Kulthum’s death in 1975 brought millions of mourners to the streets of Cairo.

By Nadeen Ebrahim

Women athletes aim their air rifles while competing in a local shooting championship in Yemen's Houthi rebel-held capital Sanaa on January 3.



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