Multidrug-Resistant and Highly Virulent Strains of <i>Burkholderia Cepacia Complex</i> – Phage Therapy as a Potential Treatment Option for Infections

Abstract The Burkholderia cepacia complex (Bcc) consists of multiple opportunistic pathogens capable of causing serious infections, especially in individuals with cystic fibrosis (CF). Some patients may develop “cepacia syndrome,” a rapidly worsening and often deadly complication. Treatment is difficult because Bcc naturally resists many antibiotic classes and can form biofilms, which help it persist and shield bacteria from the immune system. These issues have made traditional antibiotic treatments mostly ineffective, highlighting the urgent need for alternative solutions. Phage therapy has shown promise as a potential strategy, but its use against Bcc remains limited. Isolating strictly lytic phages is challenging because most available Burkholderia phages are temperate and have narrow host ranges. So far, only a few phages with activity against clinically relevant isolates have been identified. Evidence from compassionate use cases indicates that phage therapy can be safe and well-tolerated, but solid clinical data are still missing. Important gaps in knowledge include the limited availability of phages, the need for standardized protocols, and the optimization of delivery methods, such as aerosolization for lung infections. Solving these issues will be crucial for making phage therapy a practical treatment option for multidrug-resistant Bcc infections.