When Antibiotics Fail, Living Viruses Can Treat Infection

By Keith Gillogly

Bacteriophages, or simply phages, are naturally occurring viruses that selectively target and infect bacteria to replicate. Using bacteriophage therapy to treat infections dates back to the beginning of the 20th century but was gradually overtaken by antibiotics. Now, it’s reemerging as a viable solution for difficult-to-treat bacterial infections.

Patrick O. Kenney, MD, clinical assistant professor of pediatrics at the Jacobs School of Medicine and Biomedical Sciences, led development of the phage therapy used. According to Kenney, this is the first time a phage has been developed at UB and then applied to a patient. He believes it’s also the first time phage therapy has been successfully used in Buffalo.  

On Feb. 19, the patient received the initial phage dose intraoperatively while undergoing surgical replacement of prosthetic hip hardware components at Buffalo General Hospital, Kenney says. He was then given twice daily phage doses for the first few days post-surgery, followed by weekly treatments for six weeks coupled with antibiotics.

The patient had been living with his infection for some three years, contributing to hip pain, decreased mobility, and hospital visits. Medical teams had repeatedly tried antibiotics. “But the infection just wouldn’t budge,” Kenney says.

Within 24 hours of the phage application, the MRSA bacteria was gone, Kenney says.  He adds that the patient hasn’t had any ill effects related to the phage, and the joint has remained free of MRSA bacteria. The patient continues to receive follow-up care to ensure the treatment’s lasting effectiveness.

While a first for Buffalo, Kenney says that phage therapy has already been used on a few patients in surrounding areas such as Rochester and Syracuse. The patient continues to be treated by Seth R. Glassman, MD, clinical assistant professor of medicine, and the surgery was led by Sridhar R. Rachala, MD, clinical assistant professor of orthopaedics, both of whom supported the use of phage therapy. 

The process of finding, purifying, sterilizing, testing, and finally applying a suitable phage takes time. Kenney received the patient bacteria sample in the fall of 2024 and first isolated the suitable phage in early 2025. He completed quality control testing this past summer and received FDA approval at the end of October.

A perhaps surprising but key ingredient to developing this novel phage therapy was wastewater. The logic is simple: Bacteria feed on sewage and phages feed on bacteria. Where bacteria abound, so do phages.

Kenney and his research colleague cultivated the MRSA bacteria sample on plates and then added drops of wastewater sourced from 20 different sites throughout the region. In a sample obtained from Lackawanna, macroscopic circular clearings began to form on the plate, indicating presence of a specific phage targeting the MRSA bacteria.

Kenney had to next genetically sequence the phage, known as M963, to look for genes linked to antibiotic resistance. “This particular one had a super tiny genome, no bad genes. It was a beautiful phage,” Kenney says.

In medicine, viruses are an age-old culprit. But this understanding ignores a much larger reality. Across the world, every day, everywhere, scores of bacteria multiply only to be cut down by phages. “It’s the largest predator-prey relationship in the world,” Kenney says.

Yet phages are incredibly picky eaters. Of the billions of types of phages, each one targets only a highly specific subset of bacteria. In the natural world, they’re a sort of microbial equalizer. When tailored for therapeutic use, they’re the worst enemy of pathogenic bacteria.

“We hear about it all the time about how we have all of these beneficial bacteria living inside of us. We have just as many beneficial phages living inside of us,” Kenney says. “And they live in concert with our bacteria.”

According to the World Health Organization, the world faces an antibiotics pipeline and access crisis, with inadequate research and development in the face of rising levels of resistance. Therefore, alternatives like phage therapy are gaining traction.  

Currently, patients treated with phage therapy are often one-off cases, Kenney says, owing in part to the time needed to identify, cultivate, and evaluate new phages. This means critically ill patients aren’t often good candidates. 

But this could change. Health care teams could someday have a bank of many different phages at their disposal, tailored and ready to administer to patients. Getting there will take research and resources.

When Kenney began studying phages at UB in 2021, he recalls maybe one other phage researcher at the university; now there are several across the health sciences schools. 

While ambitious, he hopes to someday see a dedicated phage research center established in Buffalo. There are only five or six such centers across the U.S., he estimates.

“There’s a lot of interest in basic and translational phage research here at UB,” Kenney says. “And the potential is vast.”