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Frontiers in immunology
2025;16 1563450.

Harnessing the human gut microbiota: an emerging frontier in combatting multidrug-resistant bacteria.

Wenwen Ding, Yiwen Cheng, Xia Liu, Zhangcheng Zhu, Lingbin Wu, Jie Gao, Wenhui Lei, Yating Li, Xin Zhou, Jian Wu, Yongtao Gao, Zongxin Ling, Ruilai Jiang
Author Information
  1. Wenwen Ding: Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
  2. Yiwen Cheng: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
  3. Xia Liu: Department of Intensive Care Unit, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
  4. Zhangcheng Zhu: Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.
  5. Lingbin Wu: Department of Intensive Care Unit, Lishui Second People's Hospital, Lishui, Zhejiang, China.
  6. Jie Gao: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
  7. Wenhui Lei: Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China.
  8. Yating Li: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
  9. Xin Zhou: Department of Genetics, Stanford University School of Medicine, Stanford, CA, United States.
  10. Jian Wu: Department of Clinical Laboratory, Suzhou Municipal Hospital, Suzhou, Jiangsu, China.
  11. Yongtao Gao: Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
  12. Zongxin Ling: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
  13. Ruilai Jiang: Department of Intensive Care Unit, Lishui Second People's Hospital, Lishui, Zhejiang, China.
PMID: 40165964 DOI: 10.3389/fimmu.2025.1563450

Abstract

Antimicrobial resistance (AMR) has become a major and escalating global health threat, undermining the effectiveness of current antibiotic and antimicrobial therapies. The rise of multidrug-resistant bacteria has led to increasingly difficult-to-treat infections, resulting in higher morbidity, mortality, and healthcare costs. Tackling this crisis requires the development of novel antimicrobial agents, optimization of current therapeutic strategies, and global initiatives in infection surveillance and control. Recent studies highlight the crucial role of the human gut microbiota in defending against AMR pathogens. A balanced microbiota protects the body through mechanisms such as colonization resistance, positioning it as a key ally in the fight against AMR. In contrast, gut dysbiosis disrupts this defense, thereby facilitating the persistence, colonization, and dissemination of resistant pathogens. This review will explore how gut microbiota influence drug-resistant bacterial infections, its involvement in various types of AMR-related infections, and the potential for novel microbiota-targeted therapies, such as fecal microbiota transplantation, prebiotics, probiotics, phage therapy. Elucidating the interactions between gut microbiota and AMR pathogens will provide critical insights for developing novel therapeutic strategies to prevent and treat AMR infections. While previous reviews have focused on the general impact of the microbiota on human health, this review will specifically look at the latest research on the interactions between the gut microbiota and the evolution and spread of AMR, highlighting potential therapeutic strategies.

Keywords

antimicrobial resistance bacteriophage colonization resistance gut microbiota probiotics

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MeSH Term

Humans
Gastrointestinal Microbiome
Drug Resistance, Multiple, Bacterial
Fecal Microbiota Transplantation
Dysbiosis
Anti-Bacterial Agents
Bacterial Infections
Probiotics
Prebiotics
Bacteria
Animals

Chemicals

Anti-Bacterial Agents
Prebiotics
Journal Article Review
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