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Published on: August 19, 2021
Bacteriophage Therapy as a Promising Alternative for Antibiotic-Resistant Enterococcus faecium: Advances and
Laura Ribes-Martínez1,2,3, Maria-Carmen Muñoz-Egea1,2, Jose Yuste3,4,5
1Clinical Microbiology Department, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain.
Abstract:
Enterococcus faecium is a Gram-positive bacterium increasingly identified as a critical nosocomial pathogen that poses significant treatment challenges due to its resistance to multiple antibiotics, particularly vancomycin-resistant E. faecium (VRE) strains. The urgent need for alternative therapeutic strategies has renewed interest in bacteriophage (phage) therapy, given phages specificity and bactericidal potential. This review explores the advancements in phage therapy against antibiotic-resistant E. faecium, including phage morphological diversity, genomic characteristics, and infection mechanisms. The efficacy of phage therapy in in vitro, ex vivo, and in vivo models and the compassionate use in clinical settings are evaluated, highlighting the promising outcomes of phage-antibiotic synergies and biofilm disruption. Key challenges and future research directions are discussed, with a focus on improving therapeutic efficacy and overcoming bacterial resistance. This review emphasizes the potential of phage therapy as a viable solution for managing multidrug-resistant E. faecium infections and underscores the importance of future investigations to enhance clinical applications.
Insights
Bacteriophage therapy shows promise against vancomycin-resistant Enterococcus faecium infections. This approach offers a potential alternative to antibiotics, effectively targeting resistant bacterial strains and biofilms.
Area of Science:
- Microbiology
- Infectious Diseases
- Biotechnology
Background:
- Enterococcus faecium is a significant nosocomial pathogen.
- Antibiotic resistance, especially vancomycin resistance (VRE), presents major treatment challenges.
- Phage therapy is being explored as an alternative therapeutic strategy.
Purpose of the Study:
- To review advancements in bacteriophage therapy against antibiotic-resistant E. faecium.
- To evaluate the efficacy of phage therapy in various models and clinical settings.
- To discuss challenges and future directions for phage therapy.
Main Methods:
- Review of literature on phage morphology, genomics, and infection mechanisms.
- Evaluation of in vitro, ex vivo, and in vivo studies on phage therapy efficacy.
- Analysis of clinical case reports and compassionate use data.
Main Results:
- Phage therapy demonstrates specificity and bactericidal potential against E. faecium.
- Promising outcomes observed with phage-antibiotic synergies and biofilm disruption.
- Successful compassionate use cases highlight clinical potential.
Conclusions:
- Phage therapy is a viable alternative for managing multidrug-resistant E. faecium infections.
- Further research is crucial to optimize therapeutic efficacy and overcome bacterial resistance.
- Enhancing clinical applications requires continued investigation into phage-host interactions.
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