(CNN) -- In February 2016, infectious disease epidemiologist Steffanie Strathdee held her dying husband's hand, watching as he lost a grueling fight against a deadly superbug.
After months of ups and downs, doctors had just told her that her husband, Tom Patterson, was too full of bacteria to live.
"And I have this conversation that no one ever wants to have with their loved one," Strathdee told an audience recently at Life Itself, a health and wellness event presented in collaboration with CNN.
"I said, 'Honey, we're running out of time. I need to know if you want to live. I don't even know if you can hear me, but if you can hear me and want to live, please squeeze my hand.' And I waited and waited," he continued, his voice breaking. "And all of a sudden, he squeezed really hard. And I thought, 'Oh, that's great!' And then I thought, 'Oh god! What am I going to do?'"
Strathdee would place cold cloths on her husband's forehead during his prolonged illness to try to curb his numerous fevers.
What he did next could be described as miraculous. First, Strathdee found an obscure treatment that offered a glimmer of hope: fighting superbugs with bacteriophages, viruses created by nature to eat bacteria.
He then convinced bacteriophage scientists across the country to hunt and peck in the molecular haystacks of sewage, swamps, ponds, ships' bilges, and other prime breeding grounds for bacteria and their viral opponents. The impossible goal: to quickly find the few bacteriophages, exquisitely unique, capable of fighting a specific strain of antibiotic-resistant bacteria that are literally eating her husband alive.
Next, the U.S. Food and Drug Administration (FDA) had to give the green light to this untested cocktail of hope, and scientists had to purify the mixture so that it wouldn't be deadly.
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However, just three weeks later, Strathdee watched as doctors injected the mixture intravenously into her husband's body, saving his life.
His journey is an example of relentless perseverance and incredible luck. It's a brilliant tribute to the immense kindness of strangers. And it's a story that could save countless lives from the growing threat of antibiotic-resistant superbugs, maybe even your own.
"It is estimated that by 2050, 10 million people a year, or one person every three seconds, will die from a superbug infection," Strathdee told the Life Itself audience.
"We've been trapped for two and a half years in this terrible situation where the viruses have been the bad guys," he said. "I am here to tell you that the enemy of my enemy may be my friend. Viruses can be the medicine."
A terrifying holiday
During a Thanksgiving cruise on the Nile in 2015, Patterson was suddenly struck down by severe stomach cramps. When a clinic in Egypt couldn't help his worsening symptoms, Patterson was flown to Germany, where doctors discovered a grapefruit-sized abdominal abscess filled with Acinetobacter baumannii, a virulent bacterium resistant to almost all antibiotics.
Found in the sands of the Middle East, the bacteria made its way into the wounds of U.S. troops hit by roadside bombs during the Iraq War, earning it the nickname "Iraqibacter."
"Veterans were getting shrapnel in their legs and bodies from improvised explosive device explosions and were evacuated home for convalescence," Strathdee told CNN, referring to improvised explosive devices. "Unfortunately, they carried their superbug with them. Sadly, many of them survived the bomb blasts but died from this deadly bacteria."
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Today, Acinetobacter baumannii tops the World Health Organization's list of dangerous pathogens for which new antibiotics are urgently needed.
"It's kind of a bacterial kleptomaniac. It's really good at stealing antimicrobial resistance genes from other bacteria," Strathdee told Life Itself attendees. "I began to realize that my husband was much sicker than I thought and that modern medicine had run out of antibiotics to treat him."
With the bacteria growing uncontrollably inside him, Patterson was soon medically transferred to the couple's hometown of San Diego, where he was a professor of psychiatry and Strathdee was the associate dean for global health sciences at the University of California, San Diego.
"Tom was on a roller coaster — he would get better for a few days and then deteriorate and be very sick," said Dr. Robert "Chip" Schooley, a leading infectious disease specialist at the University of California, San Diego who was a longtime friend and colleague. As the weeks turned into months, "Tom began to develop multi-organ failure. He was so sick that we could lose him any day."
Patterson's body was systemically infected by a virulent, drug-resistant bacterium that also infected troops in the Iraq War, earning the pathogen the nickname "Iraqibacter."
Looking for a needle in a haystack
After that reassuring handshake from her husband, Strathdee got to work. Searching the internet, I had already come across a study by a researcher in Tbilisi, Georgia on the use of bacteriophages for the treatment of drug-resistant bacteria.
A phone call later, Strathdee discovered that bacteriophage treatment was well established in former Soviet bloc countries, but had long since been dismissed as "fringe science" in the West.
"Bacteriophages are everywhere. There are 10 million trillion trillion, or 10 to the power of 31, bacteriophages thought to be on the planet," Strathdee said. "They're in the soil, they're in the water, they're in our oceans, and they're the gatekeepers that keep the number of bacteria in check. But you have to find the right bacteriophage to kill the bacteria causing the problem."
Encouraged by her newfound knowledge, Strathdee began reaching out to scientists working with bacteriophages: "I wrote emails out of the blue to complete strangers, begging them to help me," she said in Life Itself.
One of the unknowns who responded quickly was Texas A&M University biochemist Ryland Young. He has been working with bacteriophages for almost 45 years.
"You know the word persuasive? There's no one as persuasive as Steffanie," said Young, a professor of biochemistry and biophysics who directs the lab at the university's Center for Bacteriophage Technology. "We left it all. Without exaggeration, people were literally working 24 hours a day, examining 100 different environmental samples to find just a couple of new bacteriophages."
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While the Texas lab was burning its eyelashes, Schooley was trying to get FDA approval to inject the bacteriophage cocktail into Patterson. Because bacteriophage therapy has not undergone clinical trials in the United States, each case of "compassionate use" required a fair amount of documentation. It's a process that can consume precious time.
But the woman who answered the phone at the FDA said, "No problem. This is what he needs, and we can fix it,'" Schooley recalls. "And then he told me he had friends in the Navy who might as well find some bacteriophages for us."
In fact, the U.S. Navy's Medical Research Center had banks of bacteriophages collected from seaports around the world. Scientists at the center began looking for a match, "and it didn't take long for them to find a few bacteriophages that appeared to be active against the bacteria," Strathdee said.
Drs. Robert "Chip" Schooley (left) and Randy Taplitz after injecting Patterson with the first round of bacteriophages at UC San Diego Medical Center.
Back in Texas, Young and his team had also been lucky. They found four promising bacteriophages that wiped out Patterson's antibiotic-resistant bacteria in a test tube. Now the hard part began: figuring out how to separate the victorious bacteriophages from the remaining soup of bacterial toxins.
"You put a virus particle in a culture, go home to eat, and if you're lucky, you come back with a big, churning, liquid mess of dead bacterial parts among billions and billions of viruses," Young said. "You want to inject those virus particles into the human bloodstream, but you start with a bacterial goo that's just awful. You wouldn't want that to be injected into your body."
Purifying bacteriopages to be administered intravenously was a process that no one had yet perfected in the U.S., Schooley said, "but both the Navy and Texas A&M got to work and, using different approaches, figured out how to clean the bacteriophages to the point where they could be safely administered."
More hurdles: Texas A&M's legal staff expressed concern about future lawsuits. "I remember the lawyer saying to me, 'Let's see if I understand. You want to send unapproved viruses from this lab to inject into a person who is likely to die.' And I said, 'yes, that's it,'" Young said.
"But Stephanie literally had the speed dial numbers of the chancellor and all the people involved in human experimentation at UC San Diego. After she called them, they basically called their counterparts at A&M, and all of a sudden they all started working together," Young added.
"It was like the parting of the Red Sea: all the paperwork and doubts disappeared."
"It was just miraculous."
The purified cocktail from Young's lab was the first to arrive in San Diego. Strathdee watched as doctors injected the Texas bacteriophages into the pus-filled abscesses of Patterson's abdomen before calming down for the agonizing wait.
"We started with the abscesses because we didn't know what would happen and we didn't want to kill him," Schooley said. "We didn't see any negative side effects; in fact, Tom seemed to stabilize a little bit, so we continued therapy every two hours."
Two days later, the Navy cocktail arrived. Those bacteriopphages were injected into Patterson's bloodstream to deal with the bacteria that had spread to the rest of his body.
"We believe Tom was the first person to receive intravenous bacteriophage therapy to treat a systemic superbug infection in the United States," Strathdee told CNN.
"And three days later, Tom lifted his head off the pillow to come out of a deep coma and kissed his daughter's hand. It was just miraculous."
Patterson awoke from the coma after receiving an intravenous dose of bacteriophages adapted to his bacteria.
Affected but not shattered
Today, more than six years later, Patterson is happily retired, walking 5 kilometers a day and gardening. The couple has returned to travel the world. But the long illness took its toll: Patterson was diagnosed with diabetes and is now dependent on insulin, has mild heart damage, lost sensation in the soles of his feet and suffers from gut damage that affects his diet.
"He hasn't gone back to surfing because he can't feel the soles of his feet, and he contracted covid-19 in April, which landed him in the hospital because the soles of his lungs are essentially dead," Strathdee said.
"As soon as the infection got to his lungs, he couldn't breathe and I had to rush him to the hospital, so it was terrifying," she said. "It's still high risk for covid, but we won't let that hold us hostage at home. He says, 'I want to get back to a normal life as quickly as possible.'"
To prove it, the couple is once again traveling the world: they recently returned from a 12-day trip to Argentina.
"We traveled with a friend who is an infectious disease doctor, which gave me peace of mind knowing that if something went wrong, we would have an expert on hand," Strathdee said.
"I guess I'm kind of a helicopter wife in that sense. Still, we've traveled to Costa Rica a couple of times, we've been to Africa, and we're planning to go to Chile in January."
"The Perfect Predator" is the couple's account of the struggle to save Patterson's life.
Patterson's case was published in the journal Antimicrobial Agents and Chemotherapy in 2017, leading to new scientific interest in bacteriophage therapy.
"There's been an explosion of clinical trials going on now on phage science around the world and there are phage programs in Canada, the United Kingdom, Australia, Belgium, Sweden, Switzerland, India and China has a new one, so it's really catching on," Strathdee told CNN.
Part of the work focuses on the interaction between phages and antibiotics: When bacteria fight phages, they often shed their outer layer to prevent the enemy from docking and gaining access to kill. When that happens, bacteria can suddenly become vulnerable to antibiotics again.
"We don't think phages will ever completely replace antibiotics, but they will be a good complement to antibiotics. And in fact, they may even make antibiotics work better," Strathdee said.
"We feel like we have to tell our story so that other people can get this treatment more easily."
To this end, the couple published their memoirs: "The Perfect Predator: A Scientist's Race to Save Her Husband From a Deadly Superbug."
Strathdee and Schooley opened the Bacteriophage and Therapeutics Application Innovation Center (IPATH) where they treat or counsel patients suffering from multidrug-resistant infections. And Schooley will soon begin clinical trials with bacteriopages on a deadly antibiotic-resistant bacterium, Pseudomonas aeruginosa, which attacks cystic fibrosis patients.
"More and more students, some of them as young as 12 years old, are reaching out to me," Strathdee said. "There's a little girl in San Francisco who begged her mother to read this book and now she's doing a science project on the synergy between phages and antibiotics, and she's in eighth grade. That excites me."
"And there have been many other labs that have joined: Yale now has a bacteriophage therapy program, Baylor, Brussels... the Australians, Lyon, France, and more," Strathdee told the Life Itself audience.
"The next thing we need is a library of bacteriophages," he continued. "We don't want to have to go from the swamp to bed every time we need bacteriophages, do we? We want to be able to go to a fridge and get characterized and cataloged bacteriophages and customize them for patients."
Strathdee is quick to recognize the many people who helped save her husband's life. But those along the way told CNN that she and Patterson made a difference, and they are still looking for a solution to the growing superbug crisis.
"I think it was a historic accident that could only have happened to Steffanie and Tom," Young said. "They were at UC San Diego, which is one of the top universities in the country. They worked with a brilliant infectious disease doctor who said 'yes' to bacteriophage therapy when most doctors would have said 'no way, I won't'.
"And then there's Steffanie's passion and energy, which is hard to explain until she focuses it on you. It was like a spider's web; she was in the middle and pulling the strings," Young added. "It was meant to be because of her, I think."
Article originally published in July 2022 and expanded in December 2023