Multi-Drug Resistant (MDR) uropathogenic bacteria have increased in number in recent years and the development of new treatment options for the corresponding infections has become a major challenge in the field of medicine. In this respect, recent studies have proposed bacteriophage (phage) therapy as a potential alternative against MDR Urinary Tract Infections (UTI) because the resistance mechanism of phages differs from that of antibiotics and few side effects have been reported for them. Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis are the most common uropathogenic bacteria against which phage therapy has been used. Phages, in addition to lysing bacterial pathogens, can prevent the formation of biofilms. Besides, by inducing or producing polysaccharide depolymerase, phages can easily penetrate into deeper layers of the biofilm and degrade it. Notably, phage therapy has shown good results in inhibiting multiple-species biofilm and this may be an efficient weapon against catheter-associated UTI. However, the narrow range of hosts limits the use of phage therapy. Therefore, the use of phage cocktail and combination therapy can form a highly attractive strategy. However, despite the positive use of these treatments, various studies have reported phage-resistant strains, indicating that phage–host interactions are more complicated and need further research. Furthermore, these investigations are limited and further clinical trials are required to make this treatment widely available for human use. This review highlights phage therapy in the context of treating UTIs and the specific considerations for this application.

中文翻译：

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噬菌体治疗抑制多重耐药尿路致病菌的叙述性综述

近年来，多药耐药（MDR）尿路致病菌的数量不断增加，针对相应感染的新治疗方案的开发已成为医学领域的重大挑战。在这方面，最近的研究提出了噬菌体（噬菌体）疗法作为对抗 MDR 尿路感染 (UTI) 的潜在替代方案，因为噬菌体的耐药机制与抗生素的耐药机制不同，并且几乎没有报道它们的副作用。大肠杆菌、肺炎克雷伯菌和奇异变形杆菌是最常见的泌尿道致病菌，噬菌体疗法已对其进行了治疗。噬菌体除了溶解细菌病原体外，还可以防止生物膜的形成。此外，通过诱导或产生多糖解聚酶，噬菌体可以很容易地渗透到生物膜的更深层并降解它。值得注意的是，噬菌体疗法在抑制多物种生物膜方面显示出良好的效果，这可能是对抗导管相关 UTI 的有效武器。然而，宿主范围狭窄限制了噬菌体疗法的使用。因此，使用噬菌体鸡尾酒和联合疗法可以形成极具吸引力的策略。然而，尽管这些治疗得到了积极的使用，但各种研究报告了噬菌体抗性菌株，表明噬菌体-宿主相互作用更为复杂，需要进一步研究。此外，这些研究是有限的，需要进一步的临床试验才能使这种治疗广泛用于人类。