Abedon Stephen T
Department of Microbiology, The Ohio State University, Mansfield, OH 44906, USA.
Viruses. 2025 Aug 8;17(8):1094. doi: 10.3390/v17081094.
Treatments for bacterial infections can be less effective due to toxicities, bacterial tolerance, or genetic resistance to antibacterial agents. The emphasis here is on combating genetic bacterial resistance to bacteriophages. Commonly described simply as phages, bacteriophages are the viruses of bacteria. As phage therapies, they are one of the oldest clinical treatments for bacterial infections. Thwarting bacterial evolution of resistance to phages, particularly during phage treatments, typically involves targeting more than one bacterial characteristic. This can be achieved serially, involving phage substitution after bacterial resistance has become problematic, something that is used especially during more personalized therapies. Substitution phages can be sourced in various ways. This includes as autophages, from phage banks, or via phage training-all as considered here-as well as through phage engineering. An alternative approach is preventing bacterial mutations from occurring at all. In addition, there is simultaneous targeting of multiple bacterial characteristics. These latter strategies include all of the following: using phages that target bacterial fitness or virulence determinants, employing individual phages that recognize multiple receptors, using phage cocktails, or applying phages in combination with antibiotics. This review discusses these different approaches for combating treatment resistance, highlighting various pros and cons.
由于毒性、细菌耐受性或对抗菌剂的遗传抗性，细菌感染的治疗可能效果较差。这里的重点是对抗细菌对噬菌体的遗传抗性。噬菌体通常简称为噬菌体，是细菌的病毒。作为噬菌体疗法，它们是治疗细菌感染最古老的临床方法之一。阻止细菌对噬菌体产生抗性的进化，特别是在噬菌体治疗期间，通常需要针对不止一种细菌特征。这可以通过连续的方式实现，即在细菌抗性出现问题后进行噬菌体替换，这在更个性化的治疗中尤为常用。替换噬菌体可以通过多种方式获得。这包括作为自噬噬菌体、从噬菌体库中获取、通过噬菌体训练（这里都有考虑）以及通过噬菌体工程。另一种方法是完全防止细菌发生突变。此外，还有同时针对多种细菌特征的方法。这些后一种策略包括以下所有方法：使用靶向细菌适应性或毒力决定因素的噬菌体、使用识别多种受体的单个噬菌体、使用噬菌体鸡尾酒或联合使用噬菌体与抗生素。本综述讨论了这些对抗治疗抗性的不同方法，突出了各种优缺点。
