Decolonizing the gut from multidrug-resistant bacteria: Current strategies and future perspectives

Area of Science:

• Microbiology
• Public Health
• Gastroenterology

Background:

• The gastrointestinal tract is a significant reservoir for multidrug-resistant organisms (MDROs).
• Gut colonization by MDROs contributes to the global crisis of antimicrobial resistance.
• Effective strategies are needed to manage and reduce MDRO carriage in the gut.

Purpose of the Study:

• To review the burden of gut MDRO colonization.
• To explore current and emerging non-antibiotic decolonization strategies.
• To assess the potential of these strategies in combating antimicrobial resistance.

Main Methods:

• Literature review of non-antibiotic interventions for MDRO decolonization.
• Assessment of approaches including probiotics, prebiotics, fecal microbiota transplantation, and CRISPR-Cas systems.
• Evaluation of dietary interventions and selective digestive decontamination.

Main Results:

• Promising results observed in early studies and animal models for various decolonization strategies.
• Non-antibiotic approaches aim to restore gut microbial balance and reduce MDRO carriage.
• Most interventions are still investigational and require further validation.

Conclusions:

• Non-antibiotic strategies show potential for managing gut MDRO colonization.
• Rigorous clinical trials and safety assessments are crucial for clinical integration.
• Standardized protocols are essential for the routine use of these novel approaches in MDRO management.