How can the gut microbiome be targeted to fight multidrug-resistant organisms?

Blair Merrick, Nicolas Benech, Benjamin Davido, Ed Kuijper, Lena M Biehl, Silvia Corcione

Journal: The Lancet. Microbe 2025;6(8):101063

PMID: 39983749

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Abstract

The rise of antimicrobial resistance presents a challenge to public health, undermines the efficacy of antibiotics, and compromises the management of infectious diseases. Gut colonisation by multidrug-resistant organisms, such as multidrug-resistant Enterobacterales and vancomycin-resistant enterococci, is associated with increased morbidity and mortality rates, as well as health-care costs. Of late, the role of the gut microbiome in combating colonisation by multidrug-resistant organisms, which could precede invasive infection, has garnered interest. Innovative interventions, including faecal microbiota transplantation, probiotics, phage therapy, and bacterial consortia, represent potential preventive or therapeutic options to counteract colonisation by multidrug-resistant organisms. In this Personal View, we have synthesised the current findings on these interventions and elucidated their potential as solutions to the crisis of antimicrobial resistance.

Address: Infectious Diseases Department, Raymond-Poincaré University Hospital, AP-HP, Paris-Saclay University, Garches, France. Electronic address: [email protected].; Clinical Infection and Diagnostics Research Group, Guy's and St Thomas' NHS Foundation Trust and King's College, London, UK.; Center for Microbiota Analysis and Therapeutics, Leiden University Center for Infectious Disease, Leiden University Medical Center, Leiden, Netherlands.; Hepato-Gastroenterology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Lyon GEM Microbiota Study Group, Lyon, France; Claude Bernard Lyon 1 University, Centre de Recherche en Cancérologie de Lyon (CRCL), Lyon, France.; Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Bonn-Cologne, Cologne, Germany.; Department of Medical Sciences, University of Turin, Torino, Italy; Tufts University School of Medicine, Boston, MA, USA.

DOI: 10.1016/j.lanmic.2024.101063

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MeSH Terms: Gastrointestinal Microbiome, Humans, Drug Resistance, Multiple, Bacterial, Anti-Bacterial Agents, Probiotics, Fecal Microbiota Transplantation, Phage Therapy, Bacterial Infections, Bacteria, Vancomycin-Resistant Enterococci