Antimicrobial Resistance in Pseudomonas aeruginosa and the Emerging Role of Phage Therapy

Antimicrobial resistance has emerged as a significant global issue in combating bacterial diseases. Pseudomonas aeruginosa is one of the major opportunistic bacteria that cause acute, chronic, and nosocomial infections. The WHO has indicated P. aeruginosa as a member of ESKAPE group due to its high resistance rate to multiple existing treatments. The rapid rises in bacterial strains that are extensively drug-resistant (XDR), pan-drug-resistant (PDR), and multidrug-resistant (MDR) significantly increases the morbidity and mortality rates. In response to the escalating challenge of antimicrobial resistance (AMR), phage therapy has emerged as a promising alternative to the regular antibiotics. Lytic phages are specific viruses that infect and lyse bacterial cells, offering targeted antibacterial activity while minimizing disruption of normal microbiota. Recent progresses in specific bacteriophage isolation, optimized phage cocktail formulation, and combination therapy with antibiotics have demonstrated significant therapeutic potential in both laboratory and clinical studies. This review provides an overview of the current molecular mechanisms of antimicrobial resistance in P. aeruginosa and discusses the therapeutic potential of bacteriophages, highlighting their advantages, limitations, and future perspectives as an alternative therapy.