Meta-analysis of preclinical evidence supporting phage therapy against Stenotrophomonas maltophilia.

AIM: To systematically and quantitatively assess the efficacy of phage therapy against multidrug-resistant Stenotrophomonas maltophilia in preclinical models.

MATERIALS AND

METHODS

A systematic search of PubMed, Scopus, ScienceDirect, Google Scholar, and Wiley Online Library was conducted for preclinical studies on phage therapy against established S. maltophilia infections with survival outcomes. Data were pooled using a fixed-effects model, with subgroup and sensitivity analyses.

PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier is CRD420251059693.

RESULTS

Among 6,277 references, six studies met the inclusion criteria; one study was excluded after sensitivity analysis. The overall pooled Odds Ratio (OR) for phage therapy efficacy was 21.10 (95% CI: 9.09-49.02; p < 0.001). Subgroup analysis by Multiplicity of Infection (MOI) showed dose-dependent effects, with the highest efficacy at MOI = 100 (OR =143.68, 95% CI: 11.95-1726.78; p < 0.001) followed by MOI = 10 (OR =60.13, 95% CI: 6.29-575.09; p < 0.001). Burst size analysis indicated larger burst sizes increased effect magnitude, with the highest at 41.67 (OR =31.27, 95% CI: 7.32-133.49; p < 0.001).

CONCLUSION

Phage therapy shows strong preclinical efficacy against multidrug-resistant S. maltophilia. It represents a rapid, targeted, and antibiotic-sparing approach, supporting future antimicrobial stewardship efforts and informing the design of clinical applications.