Mishra A, Juneja D. Decolonizing the gut from multidrug-resistant bacteria: Current strategies and future perspectives. World J Methodol 2026; 16(1): 108646 [DOI: 10.5662/wjm.v16.i1.108646]
Corresponding Author of This Article
Deven Juneja, MD, Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
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Critical Care Medicine
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Opinion 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/
Mar 20, 2026 (publication date) through Feb 10, 2026
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Publication Name
World Journal of Methodology
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2222-0682
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Mishra A, Juneja D. Decolonizing the gut from multidrug-resistant bacteria: Current strategies and future perspectives. World J Methodol 2026; 16(1): 108646 [DOI: 10.5662/wjm.v16.i1.108646]
World J Methodol. Mar 20, 2026; 16(1): 108646 Published online Mar 20, 2026. doi: 10.5662/wjm.v16.i1.108646
Decolonizing the gut from multidrug-resistant bacteria: Current strategies and future perspectives
Anjali Mishra, Deven Juneja
Anjali Mishra, Department of Critical Care Medicine, Holy Family Hospital, New Delhi 110025, India
Deven Juneja, Institute of Critical Care Medicine, Max Super Speciality Hospital, New Delhi 110017, India
Author contributions: Mishra A and Juneja D performed the data accusation, wrote and reviewed the manuscript.
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: Deven Juneja, MD, Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Received: April 21, 2025 Revised: May 21, 2025 Accepted: August 20, 2025 Published online: March 20, 2026 Processing time: 297 Days and 4.2 Hours
Abstract
The rise of multidrug-resistant organisms (MDROs) represents a serious global health crisis, with the gastrointestinal tract serving as a major reservoir for these pathogens. This review highlights the burden of gut colonization by MDROs, its role in spreading antimicrobial resistance, and explores current and emerging strategies for decolonization. Various non-antibiotic approaches such as probiotics, prebiotics, bacterial consortia, selective digestive decontamination, faecal microbiota transplantation, bacteriophage therapy, and Clustered Regularly Interspersed Short Palindromic Repeats—CRISPR-associated protein systems along with dietary interventions have been assessed for their potential to restore microbial balance and reduce MDRO carriage. While promising results have emerged from early studies and animal models, most interventions remain investigational. Rigorous clinical trials, standardized protocols, and safety assessments are essential before these approaches can be integrated into routine practice for MDRO management.
Core Tip: Asymptomatic colonization of the gastrointestinal tract by extended-spectrum β-lactamase or carbapenamase-producing enterobacterales poses a substantial risk of infections caused by these resistant bacteria. Furthermore, this colonization carries a significant risk of transmitting these organisms to other patients and the broader community. Emerging interventions such as faecal microbiota transplantation, phage therapy, engineered probiotics, and Clustered Regularly Interspersed Short Palindromic Repeats—CRISPR-associated protein systems offer new hope for precise and sustainable decolonization. Additionally, dietary interventions and immune modulation may serve as supportive strategies to enhance the resilience of the host microbiota. However, many of these approaches are still in the nascent stage, and their long-term efficacy, safety, and regulatory approval remain barriers to routine clinical application.
