Steffanie Strathdee and her husband Thomas Patterson were on a “bucket list” vacation in Egypt in 2015, when he suddenly became ill with what they thought was food poisoning. It was the beginning of a life-and-death battle with Acinetobacter baumannii, a superbug resistant to all antibiotics.
Desperate to find a cure after more than a dozen antibiotics had failed, Strathdee, an infectious disease epidemiologist at the University of California, San Diego, School of Medicine, stumbled upon phage therapy: a mostly forgotten treatment discovered 100 years ago that uses viruses to kill lethal bacteria. Would it work for Thomas? The medical journey is chronicled in the couple’s new book, “The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug.”
Strathdee, 52, and Patterson, 72, shared their story in an interview with TODAY.
Patterson: One of the scary things is that even when you’re healthy, you never know what’s going to happen. On Nov. 28, 2015, we were on the Nile on a ship. It was the last night of our vacation and we were in Luxor right across from the Valley of the Kings. We had a wonderful moonlit dinner and were looking forward to a wonderful day of exploring.
I woke up just violently nauseous, sick, throwing up. I continued to do that all night long and the next morning. A local doctor thought I could be cured simply by giving me some antibiotics. But I continued to become sicker and sicker.
On Dec. 4, I was medevaced to Munich, Germany, where they discovered I had passed a gallstone. I wasn’t aware I had gallstones — I had no symptoms. It had gotten lodged in my bile duct and a big cyst had resulted from that, which I had for probably some time. It was as large as a football at that point. They tested this fluid and discovered that I had this very deadly infection. I was medevaced back to San Diego, California, on Dec. 14.
Strathdee: The gallstone caused this abscess to form before we went to Egypt. But the superbug was genetically sequenced and was found to be an Egyptian strain. So his body was a vessel for this superbug that found a lovely home inside this walled off abscess where it could multiply under the radar.
Acinetobacter baumannii is a bacterium that, until the last couple of decades, was considered to be pretty wimpy. However, it has a very clever ability to steal antibiotic resistance genes from other bacteria — I call it a bacterial kleptomaniac. It ends up not being killed like other bacteria are when you take antibiotics. In fact, once these other bacteria are killed, it moves into that space and takes it over. We were throwing some pretty heavy antibiotics at Tom’s bacterial infection and this organism was just saying, “Bring it on.”
We don’t know how Tom got the bug and we’ll never know. We just know that it was an Egyptian strain. It’s not a very commonly acquired bacterium in the U.S. It’s very common in the Middle East.
It would sometimes get into his blood stream, so he would develop sepsis, or septic shock. There’s a 50 percent death rate for each episode and Tom had seven cases of septic shock that we could count. He was delirious, he was losing weight and he could not keep anything down so he was on a feeding tube. He lost 100 pounds over the course of his illness. Right before we administered the phage therapy, it was thought he was within hours of dying.
After the doctors told us that they’d run out of solutions, I went to the internet to look for alternative treatments. I found phage therapy was one option.
Phages are viruses that have naturally evolved to attack bacteria. It’s like nature’s own alternative to antibiotics. You have a miniature Godzilla, the bacteria, and we’re sending in a miniature King Kong to attack it. It’s mainstream in parts of the former Soviet Union and in Poland, where it’s been used for decades. When phages were discovered 100 years ago, they were used to treat bacterial infections, but then when penicillin came on the scene, it was considered to be a wonder drug. And of course it was, for a time. Bacteriophages were also considered finicky because they had to be matched to the bacterial infection.
We always thought of viruses as the enemy, but this time, we were using viruses to be our friend. It’s like the enemy of my enemy is my friend.
I approached the head of infectious diseases at our university hospital. He said, “If you can find phages that match Tom’s bacterial infection, I will contact the FDA and get approval to use them for compassionate use.”
In February 2016, I begged for help and a researcher from Texas A&M responded. We would need to send him Tom’s bacterial culture and he looked for phages in his lab that would match it. He also looked at environmental samples, which essentially meant sewage because wherever you find a lot of bacteria, you find the phages that prey upon them. Luckily, they were able to find four phages that attacked his bacteria. Colleagues from the Navy also found phages that matched Tom’s bacteria and agreed to help.
Tom and I are both AIDS researchers and we always thought of viruses as the enemy, but this time, we were using viruses to be our friend. It’s like the enemy of my enemy is my friend.
Patterson: I was in a coma and I was hallucinating at that point that I was a snake. While you’re in a coma, you actually do hear and then misinterpret what you’re hearing. In this case, I was a snake. When Steff was trying to decide whether or not she was going to look for alternative remedies, she asked me to squeeze her hand if I wanted to live. I had to figure out how to squeeze her hand without any arms since I was a snake, and I decided I had to wrap my snake body around her hand and squeeze.
Strathdee: I wasn’t sure if he could hear me. His eyebrows were twitching that day so I thought maybe he could. I said, “Honey, I know you’re fighting really hard and you’re really tired. It’s OK if you want to let go. But if you decide that you want to live, please squeeze my hand and I’ll leave no stone unturned.” I waited about a minute and all of a sudden, he squeezed my hand very hard. It seemed that in that period of time, he was trying to figure out how to squeeze. It wasn’t a matter of him not hearing me. The phage therapy began on March 15, 2016; he woke up on March 20.
You have a miniature Godzilla, the bacteria, and we’re sending in a miniature King Kong to attack it.
Patterson: I do remember that when I came out of the coma, I saw my daughter standing over me and I raised my head off the pillow and took her hand and kissed it. That was a magical moment.
I was in the hospital for nine months, until August 2016. I had to go through a lot of rehabilitation to get back the muscle strength. I had to learn to talk, to swallow. I was in a wheelchair for a while. We had PTSD.
Now I’m up and about. We just came back from a vacation in Costa Rica, where we enjoyed bird watching and some hiking. Life is good.
Strathdee: One of the reasons we wrote this book is to make it easier for other people to get phage therapy. Even though it’s still experimental, we now have the Center for Innovative Phage Applications and Therapeutics at UC San Diego. It’s the first dedicated phage therapy center in North America.
The next step is to move this to clinical trials to see if phage therapy works at a broader scale with a larger number of people. If it does, that’s the kind of evidence the Food and Drug Administration needs to decide whether or not to approve and license it alongside antibiotics as an alternative.
Patterson: I’m very privileged that so many people put so much energy and effort into saving my life. I was extraordinarily lucky. We have a growing crisis of superbugs coming — antibiotic resistance is becoming a bigger and bigger problem. I represent evidence-based hope that this is really going to be a part of the solution.