Since antibiotics and antimicrobial drugs were first available some 70 years ago, they have saved countless lives and are often referred to as one of modern medicine's greatest achievements. However, in the past few years, disease-causing microorganisms have become resistant to drug therapy and have emerged as a serious threat to wounded soldiers as well as the general public. Multidrug-resistant (MDR) infections, which frequently develop after battlefield trauma, are particularly devastating in Wounded Warriors suffering from burns, blast, and bone injuries. These infections cause negative outcomes for the Soldier and often lead to bone infection, limb losses, and possible death. In addition, bacteria that infect combat-related wounds could easily be spread to other patients and staff in both military and civilian medical facilities.

The emergence of new MDR-infections demands the need to discover new antimicrobials. This need has become increasingly urgent, as pharmaceutical companies do not have many antibiotics in development. One biological-based microbial control strategy that might be used to treat MDR infections is the use of predatory bacteria. Bdellovibrio and Micavibrio are bacteria ubiquitous to many natural environments. Unlike most bacteria, these organisms survive by feeding exclusively on other bacteria. In a previous Department of Defense-supported study, we found that predatory bacteria are able to attack many pathogens that are associated with human infection, including MDR bacteria isolated from Wounded Warriors. Although our study validated that predatory bacteria have the potential to control wound infections, many questions still remain. The goal of this proposal is to identify any risks that might be associated with the use of predatory bacteria to treat wound infections in patients. The long-term goal of our research is to develop a safe and potent probiotic topical product that could be used by medical caregivers to significantly reduce the incidence and severity of wound-related infections, which in turn will reduce the transmission of nosocomial bacteria in military hospitals, prevent the transmission of MDR bacteria in civilian hospitals, and ultimately provide medical caregivers with a new, effective antimicrobial that is urgently needed to treat bacteria that no longer respond to "conventional" therapeutics. We believe that the data obtained throughout this study will answer key questions and concerns regarding the safety and efficacy of predatory bacteria therapy and will be the cornerstone for future work aimed at the development of a U.S. Food and Drug Administration-regulated product.