Abstract
Southeast Asia (SEA) can be considered a hotspot of antimicrobial resistance (AMR) worldwide. As recent surveillance efforts in the region reported the emergence of multidrug-resistant (MDR) pathogens, the pursuit of therapeutic alternatives against AMR becomes a matter of utmost importance. Phage therapy, or the use of bacterial viruses called bacteriophages to kill bacterial pathogens, is among the standout therapeutic prospects. This narrative review highlights the current understanding of phages and strategies for a phage revolution in SEA. We define phage revolution as the radical use of phage therapy in infectious disease treatment against MDR infections, considering the scientific and regulatory standpoints of the region. We present a three-phase strategy to encourage a phage revolution in the SEA clinical setting, which involves: (1) enhancing phage discovery and characterization efforts, (2) creating and implementing laboratory protocols and clinical guidelines for the evaluation of phage activity, and (3) adapting regulatory standards for therapeutic phage formulations. We hope that this review will open avenues for scientific and policy-based discussions on phage therapy in SEA and eventually lead the way to its fullest potential in countering the threat of MDR pathogens in the region and worldwide.
Highlights
A recent report identified Southeast Asia (SEA) as a global epicenter of antimicrobial resistance and emerging infectious diseases evolution (Chua et al, 2021)
An extension of this study showed that the same nanoparticle controlled the bacterial colonization of avian pathogenic E. coli in chicken and decreased the symptoms of colibacillosis (Kaikabo et al, 2017)
1The original paper of Krylov et al (2015) described second-generation phage therapy products as mixtures of previously characterized lytic phages or combination of lytic and pseudo-temperate phages. As it may have no clear distinction with the first generation in terms of the actual product to be used in therapies, we proposed a new definition for this generation to refer to the current characteristics described in the table
Summary
A recent report identified Southeast Asia (SEA) as a global epicenter of antimicrobial resistance and emerging infectious diseases evolution (Chua et al, 2021). In terms of bioengineering phages for therapeutic applications, SEA scientists reported the use of phages for targeted gene therapy (Namdee et al, 2018; Przystal et al, 2019; Chongchai et al, 2021) and adaptation of nanomaterial-based phage delivery systems (Adamu Ahmad et al, 2016; Kaikabo et al, 2017).
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