CRISPR-Cas systems as precision antimicrobials: Reversing the tide of antimicrobial resistance

Abstract

Highlights • CRISPR-Cas systems enable programmable, sequence-specific elimination of antimicrobial resistance genes.• Diverse Cas effectors (Cas9, Cas3, Cas12a, Cas13, Cas14) and delivery platforms (phages, plasmids, nanoparticles, OMVs) expand therapeutic versatility.• CRISPRi offers reversible resistance suppression, while AI-guided design and toxin-antitoxin systems enhance efficacy and safety.• In vivo models confirm significant reduction of resistant pathogens, supporting clinical translational potential.• Key challenges remain in off-target effects, manufacturing, and regulatory approval for human use.