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Putting a human face on antibiotic resistance Date: 03/26/18

Chris Dall

Reporter Chris Dall, a reporter for CIDRAP News wrote “To Save a Life, Doctors Turn to Bacteria-Killing Viruses,” which won third place in the 2017 AHCJ Awards for Excellence in Health Care Journalism. (CIDRAP is the Center for Infectious Disease Research and Policy at the University of Minnesota.) The story vividly illustrates a potential new avenue for treating antibiotic-resistant bacteria. Here, Dall explains more about how he wrote the story.

By Chris Dall

As a reporter covering antibiotic resistance and stewardship for the online infectious diseases news site CIDRAP News, I spend a lot of time reading, and writing about, scientific studies. And as many science writers know, scientific studies aren't always the most interesting reading. The language is complex and careful, there are often a lot of numbers, and the central point isn't always clear. I frequently have to read a study two to three times before I fully understand it, and even then it's not always clear.

But a paper published online in the journal Antimicrobial Agents and Chemotherapy on Aug. 14, 2017, was a little different. My editor assigned me to write a short summary of the study because it involved bacteriophages – bacteria-killing viruses that the scientific community has known about for several decades but have recently garnered increased interest as antibiotic resistance has emerged and the development of new antibiotics has stalled. The paper was a case study that described the use of bacteriophage therapy to treat a patient with a life-threatening, multidrug-resistant bacterial infection.

While the study was dense and complicated, it was clear that there was an intriguing narrative contained within; a 68-year-old man had suffered a bout of gallstone pancreatitis while on vacation in Egypt, then had developed a severe infection and had to be medevaced to Germany before being flown home to California. His condition continued to deteriorate, the infection wasn't responding to last-resort antibiotics and started to spread, organs began to fail, and he slipped into a coma. With no antibiotic options left, the doctors submitted an application to the Food and Drug Administration to treat the infection with bacteriophages. Forty-eight hours after the first "cocktail" of bacteriophages was administered, a turning point was observed.

Even though I only wrote a short summary of the paper initially, I knew I wanted to revisit the case at some point. Most of the people I interview are researchers or physicians, and at that point I'd not had the opportunity to speak with a patient. This was a chance to put a human face on antibiotic resistance. I figured if I wanted to tell this story in more detail, I would need to speak to the patient.

A few weeks later, I reached out to the lead author of the paper, Dr. Robert Schooley, who was the treating physician on the case. I, of course, wanted to get his perspective on the case, but I was also hoping that he might be able to get in touch with the patient. And frankly, I didn't know if this would be possible. Would he be willing to give me the patient's name or contact information? Would HIPAA rules prevent him from doing so?

As it turns out, Schooley is a close friend of the patient, Tom Patterson, and the two had just had coffee together. He gave me Patterson's email address. He also told me to speak with Patterson's wife, Steffanie Strathdee, since she was the person who had really pushed for the doctors to try bacteriophage therapy. Also, since Patterson was in a coma for much of the time in the hospital, he has very little recollection of what happened.

During a 45-minute phone conversation, Strathdee and Patterson (mostly Strathdee) told me the whole story, from the initial gallstone attack to Patterson's eventual release from the hospital; Strathdee also filled me in on how she had learned about bacteriophage therapy and her efforts to find bacteriophage researchers who would help her. It helped that Patterson and Strathdee are both scientists and realize that his treatment and recovery is scientifically interesting. They also understand that they have a very compelling personal story to tell about an important global health issue. In fact, they're in the process of writing a book about it.

I asked Strathdee for contact information for the bacteriophage researchers, knowing that I would need to speak to them so I could understand, and explain to readers, how exactly bacteriophages work. That led to an hour-long conversation with Ryland Young, director of Texas A&M's Center for Phage Technology, who took me step-by-step through the process of finding bacteriophages that work against specific bacterial pathogens, growing them, and purifying them. This interview was really essential, because it helped me explain the process and illustrate how much work went into the effort to save a single life.

In the end, I think I lucked out on this story in a lot of ways. It was a great story that was waiting to be told, the central characters were articulate and eager to tell their story, and the scientists involved were strong communicators who could explain a complicated process in a way that I was able to understand. I just needed to put it all together in a compelling package.

My hope is to find more stories like this, because I think that putting a human face on antibiotic resistance is important for getting the wider public to understand the severity of the issue. One writer who is doing this is journalist Maryn McKenna, whose recent book, "Big Chicken," tells the story of how antibiotic overuse in poultry production not only affects the food we eat but also has consequences for our health. I would suggest that anyone interested in learning about antibiotic resistance, and covering it, start with her work.

Chris Dall is a news reporter for CIDRAP News, focusing on antimicrobial resistance and stewardship. Chris has written about health and medicine for the online health news startup PresentNation and worked for several years as a news producer at Minnesota Public Radio. He has a master's degree in journalism from Emerson College in Boston.