Journal Article

Pathogen-pathogen interactions during co-infections

Sal-Man, Neta, Ferreira, Rosana Barreto Rocha, Antunes, Luis Caetano Martha

2025

Overview

For over a century, bacterial infections have been studied through the lens of the one-microbe, one-disease paradigm. However, it is now clear that multi-pathogen infections are common, and many infectious diseases are inherently polymicrobial. These complex infections can involve a variety of pathogens, including viruses, bacteria, fungi, and parasites, with polyviral and viral-bacterial interactions being the most extensively studied. In this review, we focus on polybacterial infections, providing an in-depth analysis of the diverse strategies bacteria employ to thrive in co-infection scenarios. We examine the mechanisms of bacterial competition, competition avoidance through spatial or temporal separation, and cooperation. Given the association of polymicrobial infections with more severe clinical outcomes and heightened antibiotic tolerance, we also explore novel therapeutic targets to treat these increasingly common and complex infections. Although our review summarizes current knowledge, the vast scope of this phenomenon suggests that many more mechanisms remain undiscovered and warrant further investigation.

• Publisher: Oxford University Press
• Subject: Animals / Antibiotic tolerance / Antibiotics / Bacteria / Bacteria - pathogenicity / Bacterial diseases / Bacterial infections / Bacterial Infections - microbiology / Catheters / Clinical outcomes / Coinfection - microbiology / Coinfection - virology / Competition / Cooperation / Cystic fibrosis / E coli / Gram-positive bacteria / Gum disease / Host-Pathogen Interactions / Humans / Immunology / Infectious diseases / Knowledge management / Microbial Interactions / Parasites / Pathogens / Pressure ulcers / Review / Staphylococcus infections / Streptococcus infections / Therapeutic targets / Urinary tract infections / Virulence