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Peer-reviewedCC BY 4.0Infection

Exploring the next “phage” of treating non-tuberculous mycobacterial infections

  • Max Kevane-Campbell1,2,3
  • Raja Idris1,2
  • Silvia Würstle1
  • Simone Lieberknecht1
  • Maria J. G. T. Vehreschild1
  • Thomas A. Wichelhaus2,3
  • Nils Wetzstein1,2,4
4 affiliations
  1. 1Department II of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
  2. 2Mycobacterial Infection Research Unit (MIRU), Goethe University Frankfurt, Frankfurt am Main, Germany
  3. 3Institute for Medical Microbiology and Infection Control, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany
  4. 4Molecular and Experimental Mycobacteriology, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
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Abstract

Non-tuberculous mycobacteria (NTM) can present a serious clinical threat due to their resistance to conventional antibiotics and their ability to cause persistent infections. As antimicrobial resistance (AMR) represents one of the most significant global health threats, mycobacteriophages (MPs)—viruses that specifically target mycobacterial species—are emerging as a promising therapeutic addition or alternative. This review explores the biological characteristics, therapeutic mechanisms, and clinical potential of MPs, with a primary focus on their use against NTM infections. Based on data from in vitro studies, animal models, and human compassionate-use cases, we highlight the mycobactericidal efficacy of MPs as well as their potential to complement antibiotic treatment regimens. However, there are key challenges that need to be addressed to implement MPs as therapeutics—such as limited host range, immune response interference, MP resistance, and intracellular delivery barriers. The implementation of MP banks, standardized regulatory protocols, and approved clinical trials is highly essential for MP therapy to transition smoothly into the healthcare sectors. By carrying out coordinated scientific, regulatory, and clinical efforts, MP-based therapy holds a promising potential in combating antibiotic-resistant NTM infections.

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Cite

BibTeXRIS
BibTeX
@article{kevanecampbell2026exploring,
  title = {{Exploring the next “phage” of treating non-tuberculous mycobacterial infections}},
  author = {Max Kevane-Campbell and Raja Idris and Silvia Würstle and Simone Lieberknecht and Maria J. G. T. Vehreschild and Thomas A. Wichelhaus and Nils Wetzstein},
  journal = {Infection},
  year = {2026},
  month = jun,
  doi = {10.1007/s15010-026-02818-7},
  url = {https://doi.org/10.1007/s15010-026-02818-7},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Exploring the next “phage” of treating non-tuberculous mycobacterial infections
AU  - Max Kevane-Campbell
AU  - Raja Idris
AU  - Silvia Würstle
AU  - Simone Lieberknecht
AU  - Maria J. G. T. Vehreschild
AU  - Thomas A. Wichelhaus
AU  - Nils Wetzstein
PY  - 2026
DA  - 2026/06/01
JO  - Infection
DO  - 10.1007/s15010-026-02818-7
UR  - https://doi.org/10.1007/s15010-026-02818-7
AB  - Non-tuberculous mycobacteria (NTM) can present a serious clinical threat due to their resistance to conventional antibiotics and their ability to cause persistent infections. As antimicrobial resistance (AMR) represents one of the most significant global health threats, mycobacteriophages (MPs)—viruses that specifically target mycobacterial species—are emerging as a promising therapeutic addition or alternative. This review explores the biological characteristics, therapeutic mechanisms, and clinical potential of MPs, with a primary focus on their use against NTM infections. Based on data from in vitro studies, animal models, and human compassionate-use cases, we highlight the mycobactericidal efficacy of MPs as well as their potential to complement antibiotic treatment regimens. However, there are key challenges that need to be addressed to implement MPs as therapeutics—such as limited host range, immune response interference, MP resistance, and intracellular delivery barriers. The implementation of MP banks, standardized regulatory protocols, and approved clinical trials is highly essential for MP therapy to transition smoothly into the healthcare sectors. By carrying out coordinated scientific, regulatory, and clinical efforts, MP-based therapy holds a promising potential in combating antibiotic-resistant NTM infections.
SN  - 0300-8126
SN  - 1439-0973
ER  -