Bacteriophage Therapy Against Shigella spp.: A Precision Antimicrobial Strategy.

Area of Science:

• Microbiology
• Infectious Diseases
• Gastroenterology

Background:

• Shigellosis causes infectious colitis, complicated by multidrug-resistant strains and antibiotic-induced gut dysbiosis.
• Conventional antibiotics disrupt the gut microbiota, reducing colonization resistance and promoting antimicrobial resistance.
• Precision antimicrobial strategies, like bacteriophage therapy, are gaining interest for their specificity and microbiota-preserving potential.

Purpose of the Study:

• To review the biological rationale, evidence, and challenges of bacteriophage therapy for Shigella infections.
• To highlight the advantages of bacteriophages in targeting specific strains and preserving gut ecology.
• To discuss the translational barriers and future directions for personalized phage therapy.

Main Methods:

• Narrative review of existing literature on bacteriophage therapy for Shigella.
• Evaluation of preclinical data (in vitro, animal models, organoids) and early clinical evidence (Phase 1 trial).
• Analysis of microbiota disruption in shigellosis and the potential of phage therapy to mitigate it.

Main Results:

• Obligately lytic phages offer targeted, self-amplifying activity against planktonic and biofilm Shigella.
• Preclinical and early clinical data demonstrate targeted efficacy and favorable safety of Shigella-specific phages.
• Shigellosis is linked to significant gut ecology disruption, which phage therapy may help restore.

Conclusions:

• Bacteriophage therapy presents a promising, specific alternative to broad-spectrum antibiotics for shigellosis.
• Overcoming barriers like immune response, resistance, and regulatory hurdles is crucial for clinical adoption.
• Personalized phage therapy platforms integrating diagnostics and AI are the future for scalable, precise treatment.