The rising rate of multidrug resistance (MDR) among bacteria is a real threat to public health across the globe, necessitating novel solutions that are beyond pharmacological approaches. The appearance of Bdellovibrio bacteriovorus as a predatory Gram-negative bacterium has become an alternative source to treat antibiotic-resistant infections, especially in cases of respiratory tract infections by pathogenic organisms like Klebsiella pneumoniae and Pseudomonas aeruginosa . In vivo studies demonstrate that intranasal administration of Bdellovibrio bacteriovorus reduces Klebsiella pneumoniae lung burden by more than 3 log 10 in rat models, while in vitro studies report significant disruption of P. aeruginosa biofilms and reduced epithelial invasion. The targeting of Gram-negative bacteria by this bacterium is the key to success, as this bacterium can prey upon Gram-negative bacteria and biofilm-forming bacteria. Nonetheless, Gram-positive bacteria have not been fully utilized in the application of Bdellovibrio bacteriovorus . In this review, our study aims to discuss antibiotic resistance, the Bdellovibrio life cycle, Bdellovibrio bacteriovorus against Gram-negative and Gram-positive bacteria, its shortcomings, and the way it could be applied, most especially against respiratory infections. However, important limitations remain, including incomplete eradication of prey populations, transient phenotypic resistance, and the absence of long-term or human clinical safety data. This review highlights the potential of B. bacteriovorus as an active antibacterial agent and draws attention to its clinical use to solve the current MDR respiratory infections.
Kanwal et al. (Fri,) studied this question.