Department of Biochemistry and Biomedical Sciences and M.G. DeGroote Institute for Infectious Disease Research, McMaster University, Ontario, Canada.
Ann N Y Acad Sci. 2021 Jul;1496(1):23-34. doi: 10.1111/nyas.14533. Epub 2020 Nov 11.
Antibiotic resistance has reached dangerously high levels throughout the world. A growing number of bacteria pose an urgent, serious, and concerning threat to public health. Few new antibiotics are available to clinicians and only few are in development, highlighting the need for new strategies to overcome the antibiotic resistance crisis. Combining existing antibiotics with phages, viruses the infect bacteria, is an attractive and promising alternative to standalone therapies. Phage-antibiotic combinations have been shown to suppress the emergence of resistance in bacteria, and sometimes even reverse it. Here, we discuss the mechanisms by which phage-antibiotic combinations reduce resistance evolution, and the potential limitations these mechanisms have in steering microbial resistance evolution in a desirable direction. We also emphasize the importance of gaining a better understanding of mechanisms behind physiological and evolutionary phage-antibiotic interactions in complex in-patient environments.
抗生素耐药性在全球范围内已经达到了危险的高水平。越来越多的细菌对公众健康构成了紧迫、严重和令人担忧的威胁。临床医生可用的新抗生素寥寥无几，而且正在开发的也很少，这凸显了需要新的策略来克服抗生素耐药性危机。将现有的抗生素与噬菌体（感染细菌的病毒）结合使用，是一种有吸引力和有前途的替代单独治疗的方法。噬菌体-抗生素联合已被证明可以抑制细菌耐药性的出现，有时甚至可以逆转耐药性。在这里，我们讨论了噬菌体-抗生素联合减少耐药性进化的机制，以及这些机制在引导微生物朝着理想方向进化方面的潜在局限性。我们还强调了在复杂的住院环境中，更好地理解生理和进化噬菌体-抗生素相互作用背后的机制的重要性。
