bims-fagtap Biomed News
on Phage therapies and applications
Issue of 2025–07–27
six papers selected by
Luca Bolliger, lxBio



  1. Cell Surf. 2025 Dec;14 100149
      A persistent increase in antimicrobial resistance presents a significant danger to global public health. The application of bactericidal phages that do not interfere with the body's natural flora becomes a promising approach to alternative treatments. This section offers an in-depth examination of the use of bacteriophage therapy in both laboratory and human trials for the treatment of specific bacterial infections. The benefits and hurdles of increasing the use of bacteriophages as a supplemental or alternative treatment for bacterial infections resistant to antibiotics are examined. The use of highly adaptable bacteriophage populations, combined with antibiotic chemical compounds, as molecular tools to combat rapidly evolving pathogenic bacteria in the host environment, presents significant virologic complexities. Pre-clinical studies, isolated clinical reports and a few randomized clinical trials have demonstrated that bacteriophages can be effective for treating bacterial infections that are resistant to multiple drugs. The capability of certain bacteriophages to reverse antibiotic resistance, as well as resistance to human complement and other bacteriophages seems to be a significant benefit of bacteriophage therapy, despite the predictable appearance of bacteriophage-resistant strains. Bacteriophages or specific products derived from them can improve antimicrobial effectiveness by decreasing bacteria's harmful properties through changes to fundamental bacterial structures, mainly their cell walls and membranes. Despite several ongoing issues regarding their practical use, it seems that bacteriophage-based treatments combined with antibiotics can serve as an effective solution to addressing the spread of antimicrobial resistance.
    Keywords:  Antibiotics alternative; Antimicrobial resistance; Bacterial pathogens; Bacteriophages; Phage therapy
    DOI:  https://doi.org/10.1016/j.tcsw.2025.100149
  2. Int J Antimicrob Agents. 2025 Jul 22. pii: S0924-8579(25)00134-7. [Epub ahead of print] 107579
       BACKGROUND: Due to the rise in antimicrobial resistance (AMR), there has been an increased interest in phage therapy to treat multi-drug resistant infections. In Australia, phage therapy is predominantly used in small clinical studies or for compassionate use, however, despite its potential expansion in modern medicine, the perception of phage therapy among medical professionals remains largely unknown.
    METHODS: We conducted a national survey of Australian infectious diseases and clinical microbiology advanced trainees and specialists using an online mailing list to assess their knowledge, areas of interest, and concerns around the use of phage therapy in clinical practice in Australia; with 92 eligible respondents.
    RESULTS: Most respondents believed that the current national plan for controlling AMR is inadequate and that phage therapy may be an effective solution; with 87 (97%) indicating that they would consider using phage therapy meeting established guidelines for purity and safety. There was a preference for bespoke therapy, with Gram-negative pathogens highlighted as priority targets. Alongside the phage therapy delivery protocols, therapeutic phage was considered important. Cystic fibrosis (CF), lung-infections, prosthetic device/related infections, and infections among patients following transplantation and/or immunosuppression were highly ranked in terms of priorities for clinical syndromes. Accessibility was highlighted as a barrier to phage therapy, specifically timely access (n=66; 72%) and logistics of phage procurement and administration (n=64; 70%).
    CONCLUSION: These results suggest the support of phage therapy among infectious diseases and clinical microbiology advanced trainees and specialists in Australia, and highlights areas of focus and priority in order to advance phage therapy.
    Keywords:  Australia; Infectious diseases; Phage therapy; antimicrobial resistance; physicians; prescribers
    DOI:  https://doi.org/10.1016/j.ijantimicag.2025.107579
  3. Ther Adv Infect Dis. 2025 Jan-Dec;12:12 20499361251356057
      Bacterial infections are a major public health threat, with a substantial global burden of ∼5 million deaths in 2019, of which ∼1.27 million were attributed to antibiotic resistance. The formation of bacterial biofilms has significantly enhanced bacterial resistance to antibiotics. Worse still, it increases overall bacterial pathogenesis, contributing to inflammation and potentially to carcinogenesis in humans. Biofilm is implicated in approximately 65% of all bacterial infections and 78.2% chronic wound infections. Alarmingly, about 100-1000-fold increase in antibiotic concentration is required to eradicate bacteria within biofilms, further compromising the health of already ill-patients. Therefore, it is imperative to explore potential antibiofilm agents, especially ones with novel mechanisms of action, to clinically manage inpatient biofilms. Bacteriophage (phage) use is a promising evolutionary approach but is also challenged with potential resistance. Bacteria have developed several antiphage defense mechanisms, some of which exhibit synergistic antiphage activity. In this review, we provide several lines of evidence supporting the efficacy of phages against antibiotic-resistant clinical biofilm-forming bacteria. Observations reveal that phage enzymes disrupt biofilm structural components (e.g., EPS, pectate, and hyaluronic acid) and pave the way for phage infection of naked bacterial cells. We further provide insights into the recent advancements in phage use against biofilm-associated antibiotic-resistant bacteria in patients. Current knowledge shows that phages are rapidly evolving and counteracting antiphage bacterial mechanisms. Here, future perspectives to enhance phages efficacy against biofilm resistance are provided to establish their clinical antibiofilm application. Enhancing the clinical application of phages against biofilms requires addressing bacterial host biofilm resistance and optimizing strategies accordingly. Beyond phage cocktail and phage genetic engineering, conjugating phages with antimicrobial agents (eg., antimicrobial peptides) offers a compelling strategy to enhance phage antibiofilm efficacy.
    Keywords:  antibiofilm; antibiotic; bacteria; bacteriophage; biofilm; drug resistance; infection; lytic; patients
    DOI:  https://doi.org/10.1177/20499361251356057
  4. Expert Rev Anti Infect Ther. 2025 Jul 25. 1-18
       INTRODUCTION: Diabetic foot ulcers (DFUs) are a significant health concern, often complicated by biofilm formation which delays healing and increases the risk of diabetic foot infections (DFIs). Effective management of complex biofilms is crucial for improving patient outcomes and reducing the risk of amputation and premature death.
    AREAS COVERED: This review summarizes the current state of microbiological research on DFIs, focusing on bacterial populations, biofilm interactions, and their role in antibiotic resistance development, being based on a PubMed search from 1975 to 2025. It also explores recent advances in antimicrobial therapies, including phage therapy, antimicrobial peptides, and other novel treatments.
    EXPERT OPINION: Antimicrobial stewardship, broader access to medical resources, and improved sanitation are essential to diminish the impact of diabetes on healthcare systems. Furthermore, the development of a rapid tool to detect antibiotic-tolerant cells is fundamental to avoid DFIs relapse. The biofilms dynamics and the dual relationship between biofilms and the immune system should be further understood. While traditional antibiotics are essential to treat DFIs, a multi-combinatorial strategy combining conventional compounds with alternative therapies should be more effective to overcome resistance and promote wound healing in DFUs.
    Keywords:  Antimicrobial resistance; antimicrobial peptides; biofilms; biomaterials; chronic wounds; diabetic foot infections; innovative treatments; phage therapy
    DOI:  https://doi.org/10.1080/14787210.2025.2538614
  5. BMC Infect Dis. 2025 Jul 24. 25(1): 940
       BACKGROUND: Non-typhoidal Salmonella (NTS) typically cause self-limiting enterocolitis, but can lead to life-threatening invasive diseases, particularly in sub-Saharan Africa. In Kenya, multidrug-resistant (MDR) NTS strains with increasing non-susceptibility to third-generation cephalosporins pose a growing public health threat. As traditional antimicrobial treatments become less effective, bacteriophages are emerging as a potential alternative. This study aimed to isolate and characterize bacteriophages targeting MDR and extended spectrum-β-lactamase (ESBL)-producing non-typhoidal Salmonella (NTS).
    METHODS: Environmental samples were collected from seven sites in Nairobi City County, Kenya. Four NTS bacterial strains were used for phage enrichment, screening, and purification via spot tests and plaque assays. Phage efficacy was assessed in vitro by testing host range and efficiency of plating (EOP) against 12 Salmonella strains isolated in Kenya over different years. Ten selected broad-host-range phages were evaluated for thermal and pH stability and their ability to disrupt pre-formed NTS biofilms. Phage genomes were sequenced using the Illumina sequencing platform, and analyzed with bioinformatics tools to screen for antimicrobial resistance (AMR), lysogeny, virulence, and allergenic genes. The morphological characteristics of four representative phages were examined using Transmission Electron Microscopy.
    RESULTS: Thirty-one phages were isolated, with host ranges varying from lysing one strains to all 12 strains. Ten phages lysed more than 80% of the Salmonella strains and were selected for further characterization. Most phages exhibited high production EOP on at least one bacterial strain, except KE26 and KE28. All phages were stable from - 80 °C to 40 °C and pH 5 to 11, with noticeable but statistically insignificant biofilm disruption. Genome sizes ranged from 23,215 bp to 159,981 bp, and were free of known AMR, lysogeny, or virulence genes. Allergenicity screening identified no allergenic hits across most phages, with exception of KE23, which showed potential allergenic regions in its tail fiber and endolysin proteins. All phages belonged to class Caudoviricetes, with KE23, KE26, and KE28 exhibiting a myovirus-like morphotype, and KE15 displaying a siphovirus morphotype.
    CONCLUSION: This study identified phages with desirable safety and stability profiles for potential usage against MDR and ESBL-producing NTS infections. Further in vivo studies are recommended to evaluate their therapeutic potential.
    IMPORTANCE: Non-typhoidal Salmonella (NTS) typically cause self-limiting enterocolitis but can lead to life-threatening invasive diseases. In Kenya, multidrug-resistant (MDR) NTS strains with increasing nonsusceptibility to third-generation cephalosporins have been reported, posing a significant public health concern that requires urgent attention. Bacteriophages are increasingly being considered as an alternative treatment for MDR bacterial infections because of the growing ineffectiveness of conventional antibiotics. Our study reports the isolation and characterization of lytic Salmonella phages devoid of detectable antimicrobial resistance (AMR) genes, lysogeny potential, allergens or virulence factors. These attributes position them as promising candidates for therapeutic interventions against MDR NTS infections. These findings highlight the potential of our study phages as a therapy for drug-resistant NTS and underscore the need for further investigation into their clinical application against MDR strains.
    Keywords:  And phage; Multidrug-resistant; Non-typhoidal Salmonella
    DOI:  https://doi.org/10.1186/s12879-025-11325-3
  6. Curr Issues Mol Biol. 2025 May 07. pii: 335. [Epub ahead of print]47(5):
      This study aims to isolate and characterize the lytic phage XC1 targeting Acinetobacter nosocomialis and systematically analyze its biological properties and genomic structure, providing theoretical support for developing novel treatments against antibiotic-resistant infections. Phage XC1 was isolated and purified from lake water. Its morphology, optimal multiplicity of infection (MOI), thermal stability, and pH tolerance were analyzed. Genomic sequencing and functional annotation were performed to identify its lysis-associated genes. Phage XC1 demonstrated a short latent period (20 min) and high burst size (310 plaque-forming units per cell, PFU/cell). It remained stable under temperatures of 50-60 °C and at pH 7, indicating good environmental stability. Genomic analysis revealed a 45,324 bp genome with a GC content of 38.21%, including 84 open reading frames (ORFs), without any lysogenic, virulence, or antibiotic-resistance genes, confirming its safety. Average Nucleotide Identity (ANI) analysis shows that the ANI values between phage XC1 and other phages range from 80% to 95%. As the ANI value between strains of the same species is typically ≥95%, this suggests that phage XC1 may be a previously undiscovered new phage. Classified within the genus Obolenskvirus (class Caudoviricetes), phage XC1 is a virulent bacteriophage with rapid lytic activity and extreme environmental tolerance. Its therapeutic potential against multidrug-resistant infections, either as a monotherapy or in synergy with antibiotics, warrants further investigation.
    Keywords:  Acinetobacter nosocomialis; phage genome; phage therapy
    DOI:  https://doi.org/10.3390/cimb47050335