The use of living bacteria either as therapeutic agents or drug carriers has shown great potential in treating a multitude of intractable diseases. However, cells are often fragile to unfriendly environmental stressors and limited by inadequately therapeutic responses, leading to unwanted cell death and a decline in treatment efficacy. Surface decoration of bacteria has emerged as a simple yet useful strategy that not only confers bacteria with extra capacity to resist environmental threats but also endows them with exogenous characteristics that are neither inherent nor naturally achievable. In this review, we systematically introduce the advancements of physicochemical and biological technologies for surface modification of bacteria, especially the single-cell surface decoration strategies of individual bacteria. We highlight the recent progress on surface decoration that aims to improve the bioavailability and efficacy of therapeutic bacterial agents and also to achieve enhanced and targeted delivery of conventional drugs. The promises along with challenges of surface-decorated bacteria as drug delivery systems for applications in cancer therapy, intestinal disease treatment, bioimaging, and diagnosis are further discussed with respect to future clinical translation. This review offers an overview of the advances of decorated bacteria for drug delivery applications and would contribute to the development of the next generation of advanced bacterial-based therapies.

使用活细菌作为治疗剂或药物载体已显示出治疗多种疑难病症的巨大潜力。然而，细胞通常对不友好的环境压力源很脆弱，并且受到不充分的治疗反应的限制，导致不希望的细胞死亡和治疗效果下降。细菌的表面装饰已成为一种简单而有用的策略，它不仅赋予细菌额外的抵抗环境威胁的能力，而且还赋予它们既不是固有的也不是自然可获得的外源性特征。在这篇综述中，我们系统地介绍了细菌表面修饰的物理化学和生物学技术的进展，特别是单个细菌的单细胞表面修饰策略。我们强调了表面装饰的最新进展，旨在提高治疗性细菌药物的生物利用度和功效，并实现常规药物的增强和靶向输送。关于未来的临床转化，进一步讨论了表面装饰细菌作为药物输送系统在癌症治疗、肠道疾病治疗、生物成像和诊断中应用的前景和挑战。这篇综述概述了用于药物输送应用的装饰细菌的进展，并将有助于开发下一代先进的基于细菌的疗法。关于未来的临床转化，进一步讨论了表面装饰细菌作为药物输送系统在癌症治疗、肠道疾病治疗、生物成像和诊断中应用的前景和挑战。这篇综述概述了用于药物输送应用的装饰细菌的进展，并将有助于开发下一代先进的基于细菌的疗法。关于未来的临床转化，进一步讨论了表面装饰细菌作为药物输送系统在癌症治疗、肠道疾病治疗、生物成像和诊断中应用的前景和挑战。这篇综述概述了用于药物输送应用的装饰细菌的进展，并将有助于开发下一代先进的基于细菌的疗法。