Revisiting a 100-year-old medical treatment to tackle the growing crisis of antibiotic resistance

Lisa Lock
scientific editor

Robert Egan
associate editor

Every minute, all around us, battles are fought on a microscopic level. (also known as phages) are viruses that infect and kill bacteria. Just like viruses that infect us, these phages seek to steal the resources of the bacteria to replicate and survive.
Phages were independently discovered by .
By the 1920s, d'Hérelle had begun using phages to treat bacterial infections, laying the groundwork for what became known as .
However, the sparked the antibiotic revolution, which soon eclipsed phage therapy and transformed modern medicine, saving millions of lives over the past century.
Now, the rapid rise of antibiotic resistance, also known as antimicrobial resistance (AMR), is threatening to undo past progress.
The World Health Organization (WHO) estimates that .
we may be approaching a post-antibiotic era, where even minor infections could once again become deadly because existing drugs no longer work.
In a new paper in Cell Reports, our research team based at the University of Melbourne and the studied how phages interact with bacteria and how bacteria try to fend them off.
Understanding these steps is key to designing effective phage therapies that don't require antibiotics.
How phages kill bacteria
Phages begin their life cycle by attaching to a bacterial cell and injecting their DNA. Once inside, they hijack the bacterium's cellular machinery to produce copies of themselves.
Eventually, the host cell bursts, releasing new phages that go on to infect other bacteria. Because phages can't reproduce without a host, this relationship is entirely one-sided, offering no benefit to the bacterium.
Therefore, bacteria have developed an impressive arsenal of defenses to survive phage attacks.
One of the most fascinating and well-known defense mechanisms is where bacteria can cleave the phage DNA directly or strip away essential genetic components needed for replication.
Known as the , the technique operates much like a bacterial immune system.
Targets for new antibacterial treatments
Understanding the arms race between phages and bacteria not only deepens our knowledge of how bacteria defend themselves but also opens the door to next-generation treatments.
Our latest work looked at how the bacterial immune system works, finding weaknesses that could be used as targets for phage-based treatments.
Using advanced bacterial genetics, fluorescence microscopy and high-resolution cryo-electron tomography (imaging in 3D), we identified a bacterial "sensor protein" called YjbH.
Bacteria use this protein to defend against phage attack by preventing the phage from infecting neighboring bacterial cells.
It works a bit like containing house pests through extreme quarantine.
Imagine if you notice termites in a part of your house, you would want to restrict it immediately before it spreads everywhere. YjbH operates similarly when it detects invading phage DNA and binds to it.
But simply binding isn't enough; the threat must be contained, or it could replicate and spread throughout the bacterial population, just like a termite spreading through your house.
YjbH rapidly activates cell division machinery by binding to a key cell division protein called FtsE.
This results in constriction of the envelope that surrounds the bacterial cell, which is eventually cut off to isolate the infected part of the cell.
The result is a newly formed compartment that walls off the invading phage DNA.
Crucially, this isolated compartment lacks the resources needed for the virus to replicate, effectively trapping the infection and allowing the rest of the bacterial cell to survive.
suggest that bacteria, despite being single-celled organisms, are capable of a dramatic escape strategy similar to those seen in higher organisms.
Discovery of a unique anti-phage defense system
Just as doctors may amputate an infected limb to save a life, or lizards shed their tails to evade predators, these results show that bacteria can isolate and sacrifice an infected part of themselves to survive a viral attack.
This phenomenon, similar to "bacterial autotomy," marks the first discovery of such an anti-phage defense system.
It reveals that even microbes can perform complex, self-preserving escape responses, once thought to be exclusive to multicellular life.
Now that this defense mechanism has been identified, our next step is to develop different ways to neutralize it.
These could include creating a compound that can be added to the phage therapy, preventing the sensor protein from identifying different phages.
We hope that by reactivating phage therapy, we can contribute to non-antibiotic treatments for infections.
With so many antibiotic-resistant infections emerging, after 100 years, it's time to reconsider the benefits of phage therapy.
More information: Osher Pollak Fiyaksel et al, A bacterial host factor confines phage localization for excluding the infected compartment through cell division, Cell Reports (2025).
Journal information: Cell Reports
Provided by University of Melbourne
This article was first published on Pursuit. Read the original article .