# Nano-Enabled Delivery of Phage-Based Antibacterials Against ESKAPE Pathogens

**Authors:** Ayman Elbehiry, Eman Marzouk, Adil Abalkhail

PMC · DOI: 10.3390/pharmaceutics18020185 · Pharmaceutics · 2026-01-30

## TL;DR

This paper explores using nanotechnology to improve the delivery of phage-based treatments for drug-resistant bacteria known as ESKAPE pathogens.

## Contribution

The paper introduces a pathogen-aware integration framework linking ESKAPE pathogen barriers to optimal nano-enabled delivery strategies for phage-based therapeutics.

## Key findings

- Nanotechnology can enhance the stability and delivery of phage-based antimicrobials against ESKAPE pathogens.
- Nano-enabled systems improve localization and persistence of biological agents at infection sites.
- A framework is proposed to match delivery strategies with pathogen-specific barriers for better therapeutic outcomes.

## Abstract

Antimicrobial resistance (AMR) remains a major clinical challenge, with Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species (ESKAPE) accounting for a substantial share of multidrug-resistant (MDR) infections worldwide. These organisms undermine antibiotic efficacy through reduced permeability, surface shielding, biofilm formation, and rapid genetic adaptation, mechanisms that primarily restrict effective exposure at infection sites. Bacteriophages, phage-derived enzymes, and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-based antimicrobials provide selective and mechanistically distinct alternatives to conventional antibiotics, but their performance in vivo is often limited by instability in physiological environments, immune neutralization, uneven tissue distribution, and insufficient access to bacteria protected by biofilms or surface-associated barriers. This narrative review examines how nanotechnology-based delivery systems can address these constraints. We first outline the delivery-relevant biological barrier characteristic of ESKAPE pathogens, then summarize the therapeutic potential and inherent limitations of whole phages, phage-derived enzymes, and CRISPR-based antimicrobials when used without formulation. Major nanotechnology platforms for antibacterial delivery are reviewed, followed by analysis of how nano-enabled systems can improve stability, localization, and persistence of these biological agents. A pathogen-aware integration framework is presented that links dominant barriers in each ESKAPE pathogen to the biological modality and nano-enabled delivery strategy most likely to enhance exposure at infection sites. Translational challenges, regulatory considerations, and emerging directions, including responsive delivery systems and personalized approaches, are also discussed. Overall, nano-enabled phage-based therapeutics represent a realistic and adaptable strategy for managing MDR ESKAPE infections. Therapeutic success depends on both continued discovery and engineering of antibacterial agents and effective delivery design.

## Linked entities

- **Species:** Enterococcus faecium (taxon 1352), Staphylococcus aureus (taxon 1280), Klebsiella pneumoniae (taxon 573), Acinetobacter baumannii (taxon 470), Pseudomonas aeruginosa (taxon 287), Enterobacter (taxon 547)

## Full-text entities

- **Diseases:** urinary tract infections (MESH:D014552), cytotoxicity (MESH:D064420), Bone and Wound Infections (MESH:D014946), ESKAPE pathogen infections (MESH:D007239), Pseudomonas infection (MESH:D011552), deaths (MESH:D003643), hospital (MESH:D003428), osteomyelitis (MESH:D010019), bacterial (MESH:D001424), cystic fibrosis (MESH:D003550), AMR (MESH:D060467), diabetic (MESH:D003920), acquired (MESH:D003638), multidrug (MESH:D018088), chronic otitis (MESH:D010031), inflammation (MESH:D007249), lung infections (MESH:D012141), injury to (MESH:D014947), acute diarrhea (MESH:D000208), renal loss (MESH:D006030), pneumonia (MESH:D011014)
- **Chemicals:** R (MESH:D001120), P1 (MESH:C480041), Silica (MESH:D012822), AgNPs (-), poly(lactic-co-glycolic acid) (MESH:D000077182), Lipid (MESH:D008055), lipopolysaccharide (MESH:D008070), Nanogels (MESH:D000080385), Polymer (MESH:D011108), Polysaccharides (MESH:D011134), alginate (MESH:D000464), oxygen (MESH:D010100), Chitosan (MESH:D048271), Gold (MESH:D006046), cholesterol (MESH:D002784), mecA (MESH:C046756), methicillin (MESH:D008712), lipooligosaccharide (MESH:C023023), calcium chloride (MESH:D002122), Ag (MESH:D012834), teichoic acids (MESH:D013682), carbapenem (MESH:D015780)
- **Species:** Homo sapiens (human, species) [taxon 9606], Burkholderia (genus) [taxon 32008], Enterobacter cloacae (species) [taxon 550], Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395], Staphylococcus aureus (species) [taxon 1280], Danio rerio (leopard danio, species) [taxon 7955], Bacteriophage sp. (species) [taxon 38018], Enterococcus faecium (species) [taxon 1352], Acinetobacter baumannii (species) [taxon 470], Enterobacteriaceae (enterobacteria, family) [taxon 543], Enterobacter cloacae complex (species group) [taxon 354276], Klebsiella pneumoniae (species) [taxon 573], Pseudomonas aeruginosa (species) [taxon 287], Mus musculus (house mouse, species) [taxon 10090], Escherichia coli (E. coli, species) [taxon 562], Shigella flexneri (species) [taxon 623], Enterobacterales (order) [taxon 91347], Enterobacter (genus) [taxon 547], Enterococcus faecalis (species) [taxon 1351]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12944560/full.md

## References

172 references — full list in the complete paper: https://tomesphere.com/paper/PMC12944560/full.md

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Source: https://tomesphere.com/paper/PMC12944560