Current Updates from the Long-Standing Phage Research Centers in Georgia, Poland, and Russia

The George Eliava Institute of Bacteriophages, Microbiology and Virology (IBMV) in Tbilisi, Georgia; the Hirszfeld Institute of Immunology and Experimental Therapy in Wroclaw, Poland; and various centers and companies in Russia, together, have a long history of clinical phage therapy use. With a revived interest in phage therapy, attention has turned to these long-standing centers and their wealth of hands-on experience. The Eliava Institute has been the leader in bacteriophage research and therapy since Soviet times. In accord with the growing antibiotic crisis, some of the important ongoing research at the Eliava Institute has focused on pathogens such as Acinetobacter, MRSA, and Pseudomonas. Genetic characterization of Georgian cocktails has supported their safety in clinical use. More recently, Georgian clinical research has focused on chronic wound, urological, and lung infections. The Eliava Phage Therapy Center is central to coordinating the expertise of Eliava scientists with the increasing demand for treatment of antibiotic-resistant infections with phage. The Hirszfeld Institute’s research has focused on expansion of their rich phage collection and development of optimized phage preparations including starting a collection of plasmid- and prophage-free hosts for phage stock preparation. Polish research has given some potential insight into important aspects of clinical tolerability, immunogenicity, and treatment of antibiotic-resistant infections. The Phage Therapy Unit of the Hirszfeld Institute has provided an in-depth analysis of clinical results through extensive observational studies. Bacteriophage preparations are registered medicines in Russia. Their use in clinical practice is well established, but there is no single center there dedicated to phage therapy. Multiple studies from different institutions focus on prophylactic use of phage for chronic conditions in the areas of ENT, gynecology, and urology. All of the research correlates with a positive tendency for phage therapy safety and efficacy. As there is an overwhelming need for effective alternatives to antibiotics, an important distinguishing aspect of phage therapy as just such an alternative is this ongoing and historical clinical use of phage therapy in these three countries, as reviewed in this chapter.