How Do You Kill a Superbug?

Hi everyone, welcome to Cold-Knowledge Blind Box.

Today we're opening a blind box about viruses and bacteria. It's the story of a fight on the edge of life and death, the birth of a medical miracle, and a true story about love and perseverance.

It all started with what seemed like an ordinary trip, one that ended up drawing humanity into the ultimate battle against a superbug.

At the end of 2015, Tom Patterson, a retired American, and his wife, Stephanie, had just finished visiting the Egyptian pyramids when Patterson fell ill. He felt severe abdominal pain and vomited violently, and his condition deteriorated quickly. Three days later, he went into toxic shock. Patterson had been infected with a superbug.

This was obviously not the curse of the pharaohs, but it did have something to do with the pyramids, a famous tourist destination. Every day, thousands of tourists from all over the world visit the pyramids. Bacteria gather there and are carried by people to every corner of the planet.

Patterson was urgently flown back to the United States. His condition was so serious that the American medical community had no choice but to reopen "Pandora's box" and fight the most dangerous enemy with the oldest method.

Then, on Patterson's body, a life-and-death "battle of the species" began. This case may well change how humans treat superbugs.

At the end of October 2015, Patterson was taken back to the University of California, San Diego School of Medicine. He and his wife, Stephanie, were both medical experts at this university, so he was able to receive the best possible care here.

But by then, Patterson had become delirious. The bacteria inside him belonged to one of the most formidable kinds in the world: Acinetobacter baumannii. It had developed resistance to almost every antibiotic humans had, and had evolved into a "superbug."

Watching her husband, who had been by her side for many years, approach death day by day, Stephanie was frantic with worry. Every day she discussed treatment plans with the doctors.

One day, during a conference call, the doctors thought Stephanie had already hung up, so they began discussing Patterson's "final arrangements." Someone said, "Maybe someone should tell Stephanie that Patterson is about to die, so she can face reality sooner."

Stephanie was thunderstruck when she heard this. She broke down, shouting into the phone: "No! I will save Patterson no matter what. I will not give up!"

Bacteria are among the oldest forms of life on Earth, appearing about 3.7 billion years ago. They are prokaryotes, with no cell nucleus, and their structure is relatively simple. Humans, animals, plants and fungi, on the other hand, are eukaryotes, with nuclei and complex structures.

The total number of bacteria is about 1.5 × 10³⁰, far more than the total of all animal and plant cells on Earth combined. They are everywhere, in the air, in water and in food. About 80% of bacteria are harmless to humans, and some are even beneficial, but some cause all sorts of diseases: tetanus, typhoid, syphilis, food poisoning, cholera and more.

Humanity's fight with bacteria took a turn only in 1929. The British bacteriologist Alexander Fleming, while studying Staphylococcus aureus, accidentally discovered that a mold, penicillium, could kill bacteria. That led humans to invent the world's first antibiotic, penicillin. Afterward, various broad-spectrum antibiotics were developed one after another.

But bacteria did not simply "give up." Through extremely fast reproduction and frequent genetic mutation, they rapidly evolved resistance to antibiotics. Ninety years later, superbugs once again left humanity with no answer.

This is the predicament Stephanie faced: Patterson had no medicine left that could treat him.

She thought it over again and again, and finally made up her mind. She went to the bedside, took Patterson's hand and asked, "Darling, do you still want to live? I have one last option. It might save you, or it might not, but I need your permission. Do you agree to let me try an unconventional treatment? If you do, please squeeze my hand."

At first there was no reaction. But a few seconds later, she suddenly felt her hand being squeezed. She asked again, and Patterson once more held her hand tightly.

Stephanie decided to use an ancient but highly promising method she had learned early in her career to fight the bacteria: phage therapy.

Bacteria are prokaryotes, and humans are eukaryotes. But there is another, even more mysterious form of life on Earth: viruses. Viruses may have appeared even earlier than bacteria. In 1899, the Dutch microbiologist Martinus Beijerinck first named viruses.

In the early 20th century, the British scientist Frederick Twort discovered a virus that specifically infects bacteria, called the bacteriophage, or phage for short. This marked the birth of modern virology.

A phage looks like a tiny robot. Its head has an icosahedral structure, containing DNA or RNA genetic material inside. It injects its genetic information into the bacterium through a hollow "tail spike," thereby killing the bacterium.

It's estimated that the number of phages on Earth is about 10 to the 31st power, an order of magnitude more than bacteria.

Whether viruses count as life is still debated. Most scientists think viruses do not have the characteristics of life. They cannot reproduce on their own, and they have no metabolism, yet they single-mindedly devote themselves to "copying themselves."

Stephanie went into action. She contacted the Naval Medical Research Center in Maryland and Texas A&M University, asking them to provide phages that target Acinetobacter baumannii. At the same time, she quickly contacted the U.S. Food and Drug Administration (FDA) to apply for an unprecedented experimental treatment.

She signed a life-or-death waiver, taking on all the risks.

Before long, the FDA approved the plan. Experts from around the world, including from Switzerland, Belgium, Poland, Croatia, India and other countries, sent over usable phage samples.

The experiment began at the UC San Diego School of Medicine.

A phage attaches to a bacterium through its tail structure, then injects its DNA into the bacterium. The infected bacterium is forced to manufacture a large number of new phages. In the end, the bacterium bursts and dies, and the new phages are released to infect the next target.

This is a process of "viruses hunting bacteria."

Forty-eight hours after the phage injection, Patterson slowly opened his eyes, his vital signs gradually recovered, and the superbugs in his body dropped sharply.

He had come back from the gates of death.

Patterson survived thanks to a calm, brave wife who loved him deeply. Afterward, Stephanie asked him whether he had heard her calling while he was unconscious. Patterson said he had heard it, but he didn't understand exactly what she said. He only knew one thing: he had to hold on to her hand.

This miracle was made possible by phages. But does that mean phages can already be used for medical treatment? No.

Bacteria attack humans, and phages, being viruses, attack both humans and bacteria.

The purpose of a virus is very simple: to copy its own genetic material and pass it down from generation to generation.

Studying viruses doesn't only help medical development. It could even solve the puzzles of "the origin of life" and "why life exists in the universe."

Patterson's case became the first case in North America in which a superbug was successfully treated with phages. This breakthrough is bound to push medical researchers around the world toward more research and practice in phage therapy.

But the problems that come with it are also real. Phages are viruses after all. Could they exchange genes with humans? Could they bring unknown consequences in the future? Nobody knows.

Perhaps, in fighting one demon, we have unleashed another great demon.

Is this a blessing or a curse? Or perhaps everything has already been arranged by our genes?

Alright, that's where today's show ends. In our next episode, we'll open the next cold-knowledge blind box!

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