Vaou N, Zavras N, Fessatou S, Voidarou CC, Vrioni G, Tsakris A, Vaos G. Microbiota decolonization of bacterial pathogens in pediatric surgery-related intestinal disorders: Insights on current strategies and future outlook. World J Clin Pediatr 2025; 14(4): 107722 [DOI: 10.5409/wjcp.v14.i4.107722]
Corresponding Author of This Article
Natalia Vaou, BSc (Hons)-UK, BSc, MSc, PhDc, Research Fellow, Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 M. Asias, Athens 11527, Greece. nvaou@hotmail.com
Research Domain of This Article
Pediatrics
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Review
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 9, 2025 (publication date) through Nov 2, 2025
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Journal Information of This Article
Publication Name
World Journal of Clinical Pediatrics
ISSN
2219-2808
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Vaou N, Zavras N, Fessatou S, Voidarou CC, Vrioni G, Tsakris A, Vaos G. Microbiota decolonization of bacterial pathogens in pediatric surgery-related intestinal disorders: Insights on current strategies and future outlook. World J Clin Pediatr 2025; 14(4): 107722 [DOI: 10.5409/wjcp.v14.i4.107722]
Natalia Vaou, Georgia Vrioni, Athanasios Tsakris, Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
Nikolaos Zavras, George Vaos, Department of Pediatric Surgery, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
Smaragdi Fessatou, 3rd Department of Pediatrics, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens 12462, Greece
Chrysoula Chrysa Voidarou, Department of Agriculture, School of Agriculture, University of Ioannina, Arta 47100, Greece
Co-corresponding authors: Natalia Vaou and Nikolaos Zavras.
Author contributions: Vaou N and Zavras N contributed equally to the conceptualization, design, writing-original draft preparation, writing-review and editing of the manuscript; Fessatou S performed the literature search and analyzed the data; Voidarou C, Vrioni G, and Tsakris A have significantly contributed to the writing of the manuscript by providing supervision and intellectual input; Vaos G supervised the writing of the original draft and critically revised and edited the manuscript. All authors have read and agreed to the published version of the manuscript. Our research consists of two main topics. The role of microbiota decolonization of bacterial pathogens and its impact on treating intestinal disorders affecting infants and children. Therefore, the collaboration of researchers involved in the research of microbiota decolonization and pediatric surgical intestinal disorders were necessary. Vaou N as a Research Fellow in Microbiology (Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece) and Zavras N as Professor of Pediatric Surgery (Emeritus Professor, Department of Pediatric Surgery, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece) substantially participated in the completion of the manuscript. They equally contributed to the conceptualization, design, writing-original draft preparation, writing-review, and editing of the manuscript. Therefore, they should be considered co-corresponding authors, as they have made significant contributions by guiding the study at all stages of its progress.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Natalia Vaou, BSc (Hons)-UK, BSc, MSc, PhDc, Research Fellow, Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 M. Asias, Athens 11527, Greece. nvaou@hotmail.com
Received: March 28, 2025 Revised: April 29, 2025 Accepted: August 1, 2025 Published online: December 9, 2025 Processing time: 217 Days and 19.8 Hours
Abstract
The significance of gut microbiota (GM) in human health is being increasingly researched. An imbalance in GM composition, known as dysbiosis, is linked to various and other health issues. In addition, antibiotics are the primary and most significant factors leading to major changes in the composition and function of the GM, which may result in colonization by antimicrobial-resistant (AMR) pathogens. Therefore, alternative antibiotic strategies for combating AMR pathogens are urgently needed. This narrative review highlights current knowledge regarding various pertinent strategies for decolonizing bacterial pathogens from GM and emphasizes decolonization therapies’ critical role in pediatric surgical disorders. Strategies such as decontamination of the digestive tract utilizing antibiotics, the use of probiotics, and particularly fecal microbiota transplantation have introduced new options for clinical treatment. These treatments show the potential to restore GM balance and have demonstrated advantages for intestinal disorders related to pediatric surgery, including inflammatory bowel disease, neonatal necrotizing enterocolitis, Hirschsprung-associated enterocolitis, and short bowel syndrome. Despite GM therapeutics, recent strategies are still in their developmental phase and exhibit challenges that need further research. Thus, potential future directions for GM-targeted decolonization therapies are under consideration. Innovative alternative strategies to combat AMR though GM modulation in disorders related to pediatric surgery appear to be promising and should continue to be prioritized for further research and development.
Core Tip: Optimizing gut microbiota composition is a promising strategy for decolonizing bacterial pathogens in pediatric surgery-related intestinal disorders. The decolonization of bacterial pathogens in this condition is crucial for reducing complications and improving recovering. Current approaches include selective digestive decontamination, probiotics, and fecal microbiota transplantation. Future strategies should focus on microbiota-targeted precision therapies, including phage therapy and clustered regularly interspaced short palindromic repeat-based gene editing among others, to enhance pathogen eradication while preserving beneficial gut flora.
