Phages as antimicrobials against multi-drug resistant bacteria

Area of Science:

• Microbiology
• Antimicrobial Resistance
• Biotechnology

Background:

• Multi-drug resistant bacteria (MDR) present a significant global health threat, driven by horizontal gene transfer (HGT) of resistance genes.
• Antibiotic treatments are increasingly ineffective against MDR infections, necessitating alternative therapeutic strategies.
• Bacteriophage therapy, using viruses that infect bacteria, is a key alternative approach.

Purpose of the Study:

• To review the current applications and limitations of whole bacteriophages as antimicrobial agents.
• To explore the potential of phage-derived enzymes, such as endolysins and depolymerases, as novel antimicrobial tools.
• To compare the advantages and challenges of whole phage therapy versus phage-derived enzyme therapy.

Main Methods:

• A narrative review of 40 studies was conducted.
• Studies focused on the use of whole bacteriophages and phage-derived enzymes (endolysins, depolymerases).
• Applications in human medicine, veterinary medicine, and the food industry were considered.

Main Results:

• Whole phages demonstrate high specificity and efficacy against bacteria but face limitations including HGT contribution, resistance emergence, narrow host range, immunogenicity, and regulatory hurdles.
• Phage-derived enzymes show promise with a lower risk of bacterial resistance and reduced immune response.
• These enzymes may benefit from existing regulatory frameworks for biologics or enzymes.

Conclusions:

• Phage-derived enzymes offer a compelling alternative to whole phage therapy due to their improved safety profile and regulatory advantages.
• Further research into endolysins and depolymerases could lead to novel treatments against multi-drug resistant bacteria.
• These enzymes represent a viable strategy to address the challenge of antimicrobial resistance.