Multidrug resistance, diagnostic challenges, and treatment gaps in Pandoraea infections: A review

Waiel S. Halabi; Sulaiman Bani Abdel-Rahman; Hala Altarawneh; Rawan Altalhi; Loui A. Ismaeel; Khulud A. Alhazmi; Ohood S. Alharbi; Malaz Gazzaz; Sarah Almuhayya; Turki M. Alharthi; Bandar Hasan Saleh; Nabeel Hussain Alhussainy; Abdulaziz Alsaedi; Hatoon A. Niyazi; Hanouf A. Niyazi; Noha A. Juma; Mona Abdulrahman; Karem Ibrahem

doi:10.17305/bb.2025.13126

Authors

Waiel S. Halabi Department of Optometry, Faculty of Applied Medical Sciences, University of Jeddah, Jeddah, Saudi Arabia https://orcid.org/0000-0002-6198-5566
Sulaiman Bani Abdel-Rahman Department of Microbiology and Pathology, Faculty of Medicine, Mutah University, Al-Karak, Jordan
Hala Altarawneh Department of Microbiology and Pathology, Faculty of Medicine, Mutah University, Al-Karak, Jordan
Rawan Altalhi Department of Biological Sciences, College of Science, University of Jeddah, Jeddah, Saudi Arabia
Loui A. Ismaeel Department of Nursing, School of Applied Medical Sciences, University of Jeddah, Jeddah, Saudi Arabia
Khulud A. Alhazmi Department of Microbiology and Parasitology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
Ohood S. Alharbi Department of Microbiology and Parasitology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
Malaz Gazzaz Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
Sarah Almuhayya Department of Clinical Laboratory Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
Turki M. Alharthi Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
Bandar Hasan Saleh Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Clinical Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Nabeel Hussain Alhussainy Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Abdulaziz Alsaedi Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Hatoon A. Niyazi Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Clinical Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Hanouf A. Niyazi Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Noha A. Juma Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Mona Abdulrahman Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Karem Ibrahem Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Clinical Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

DOI:

https://doi.org/10.17305/bb.2025.13126

Keywords:

Pandoraea spp, multidrug-resistant pathogens, bacteriophages, antimicrobial peptides, combination antibiotic therapies

Abstract

Pandoraea species are emerging multidrug-resistant pathogens increasingly associated with respiratory tract infections, particularly in cystic fibrosis patients. Despite their growing clinical relevance, these bacteria are underrepresented in the scientific literature. This review aims to consolidate existing evidence regarding Pandoraea species as emerging multidrug-resistant pathogens, with a focus on their taxonomy, diagnostic methodologies, antimicrobial resistance mechanisms, and treatment challenges. By identifying gaps in current therapeutic strategies and the limited clinical outcome data, this review underscores the necessity of advancing research into innovative interventions, such as bacteriophages, antimicrobial peptides, and combination therapies, to enhance patient management and infection control. A comprehensive literature search was conducted using PubMed and Google Scholar, employing relevant keywords to identify case reports, clinical studies, and in vitro research related to Pandoraea infections, resistance mechanisms, and therapeutic strategies. Our findings reveal a significant lack of comprehensive data on therapeutic approaches, particularly concerning bacteriophages, antimicrobial peptides, and combination antibiotic therapies. Furthermore, clinical data on treatment efficacy remain sparse, with the majority of evidence stemming from in vitro studies rather than real-world clinical settings. This review emphasizes the urgent need for further research to address these knowledge deficits and to develop effective therapeutic interventions against Pandoraea infections.