Work

Phage therapy for multidrug-resistant Serratia marcescens infection: mechanisms, preclinical evidence, and translational challenges

Year: 2026

Type: article

Abstract: Multidrug-resistant and carbapenem-resistant Serratia marcescens ( S. marcescens ) infections are increasingly difficult to treat because of intrinsic and acquired antimicrobial-resistance mechanisms, limited therapeutic options, and the organism’s capacity to persist within biofilms. Phage therapy has therefore emerged as a potential precision antimicrobial strategy against refractory S. marcescens infections. This narrative review critically examines the molecular basis, preclinical development, and translational potential of phage therapy targeting multidrug-resistant S. marcescens . Particular emphasis is placed on phage adsorption and receptor recognition, bacterial anti-phage defense systems, capsule- and biofilm-associated resistance, phage-encoded depolymerases, host-range limitations, phage screening and cocktail design, phage–antibiotic interactions, and available preclinical and clinical evidence. Current findings support the biological plausibility of this approach, particularly when strictly lytic phages are matched to the infecting clinical isolate and delivered locally in combination with antibiotics. However, the clinical evidence remains limited primarily to individual compassionate-use reports, and the therapeutic contribution of phages cannot be clearly distinguished from that of concomitant antibiotics, drainage procedures, or supportive care. Additional barriers include the emergence of phage resistance, variable pharmacokinetics, immune-mediated phage clearance, limited standardized susceptibility testing, and manufacturing and regulatory challenges. Future research should prioritize receptor-informed phage selection, representative clinical isolate panels, rationally designed phage cocktails, standardized pharmacokinetic and pharmacodynamic evaluation, and prospective controlled clinical studies. Precision phage therapy, engineered phages, curated phage libraries, and harmonized regulatory pathways may ultimately facilitate the transition of phage therapy from an individualized salvage intervention to a reproducible treatment strategy for multidrug-resistant S. marcescens infections.

Source: Frontiers in Microbiology

DOI: 10.3389/fmicb.2026.1959850

Authors: Shengting Zhang, Huili Tao, Sha Zhao, Yunlin Wei

Institution: Kunming University of Science and Technology

Language: English

Topic: Bacteriophages and microbial interactions

Subfield: Ecology

Field: Environmental Science

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801