Preoptimized phage cocktail for use in aerosols against nosocomial transmission of carbapenem-resistant Acinetobacter baumannii: A 3-year prospective intervention study

Chen, Li‐Kuang; Chang, Jui-Chih; Chu, Hsiu-Tzu; Chen, Yi-Ting; Jiang, Huili; Wang, Lih-Shinn; Teh, Soon-Hian; Yang, Huihua; Chen, Dar-Sen; Chang, Chin Chen; Sankhla, Debangana; Tseng, Chun-Chieh

doi:10.1016/j.ecoenv.2022.113476

Cited by 9 publications

(10 citation statements)

References 44 publications

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“…The use of phages as environmental sanitizers has been considered an alternative approach to removing bacterial contamination from the environment. Among the techniques reported, the use of phages as environmental sanitizers successfully decreased the rates of CRAB infection in ICUs ( Ho et al, 2016 ; Chen et al, 2022 ). Steam technology ( Oztoprak et al, 2019 ), terminal cleaning with sodium troclosene ( Dickstein et al, 2021 ), installation of heat and moisture exchangers ( Thatrimontrichai et al, 2020 ), ultraviolet-C, and aerosolized hydrogen peroxide ( Kelly et al, 2021 ) have been successfully applied in environmental disinfection.…”

Section: Strategies and Advicementioning

confidence: 99%

Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit

et al. 2022

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Carbapenem-resistant Acinetobacter baumannii (CRAB) has become one of the leading causes of healthcare-associated infections globally, particularly in intensive care units (ICUs). Cross-transmission of microorganisms between patients and the hospital environment may play a crucial role in ICU-acquired CRAB colonization and infection. The control and treatment of CRAB infection in ICUs have been recognized as a global challenge because of its multiple-drug resistance. The main concern is that CRAB infections can be disastrous for ICU patients if currently existing limited therapeutic alternatives fail in the future. Therefore, the colonization, infection, transmission, and resistance mechanisms of CRAB in ICUs need to be systematically studied. To provide a basis for prevention and control countermeasures for CRAB infection in ICUs, we present an overview of research on CRAB in ICUs, summarize clinical infections and environmental reservoirs, discuss the drug resistance mechanism and homology of CRAB in ICUs, and evaluate contemporary treatment and control strategies.

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Section: Strategies and Advicementioning

confidence: 99%

Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit

et al. 2022

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“…Even if resistant bacteria appear during phage therapy, bacteria will be targeted by new phages that are added in the course of treatment. This strategy keeps the population density of bacteria at a low level for a long time and curbs the emergence of resistant bacteria [ 216 ].…”

Section: Phage Therapy For Drug-resistant a Baumanniimentioning

confidence: 99%

Acinetobacter Baumannii Phages: Past, Present and Future

et al. 2023

Viruses

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Acinetobacter baumannii (A. baumannii) is one of the most common clinical pathogens and a typical multi-drug resistant (MDR) bacterium. With the increase of drug-resistant A. baumannii infections, it is urgent to find some new treatment strategies, such as phage therapy. In this paper, we described the different drug resistances of A. baumannii and some basic properties of A. baumannii phages, analyzed the interaction between phages and their hosts, and focused on A. baumannii phage therapies. Finally, we discussed the chance and challenge of phage therapy. This paper aims to provide a more comprehensive understanding of A. baumannii phages and theoretical support for the clinical application of A. baumannii phages.

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“…Notably, they are also active against HAI-associated pathogens persistently contaminating hospital surfaces, including MDR bacteria such as Pseudomonas aeruginosa [ 34 ], and methicillin-resistant Staphylococcus aureus (MRSA) [ 35 ]. Nevertheless, the potential use of lytic phages as environmental sanitizers in hospitals has been rarely investigated in the field, despite the promising results obtained in a few published studies that report the effective use of aerosolized phage cocktails for room terminal cleaning as an efficient procedure to control carbapenem-resistant Acinetobacter baumannii (CRAB) contamination and associated infections [ 36 , 37 ]. One study by us showed that phages could effectively eliminate several bacteria isolated from hospitals, including Gram-positive, Gram-negative, and MDR strains, and that they could be added to PCHS without losing activity [ 38 ].…”

Section: Introductionmentioning

confidence: 99%

Potential Use of a Combined Bacteriophage–Probiotic Sanitation System to Control Microbial Contamination and AMR in Healthcare Settings: A Pre-Post Intervention Study

D’Accolti

Soffritti

Bini

et al. 2023

IJMS

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Microbial contamination in the hospital environment is a major concern for public health, since it significantly contributes to the onset of healthcare-associated infections (HAIs), which are further complicated by the alarming level of antimicrobial resistance (AMR) of HAI-associated pathogens. Chemical disinfection to control bioburden has a temporary effect and can favor the selection of resistant pathogens, as observed during the COVID-19 pandemic. Instead, probiotic-based sanitation (probiotic cleaning hygiene system, PCHS) was reported to stably abate pathogens, AMR, and HAIs. PCHS action is not rapid nor specific, being based on competitive exclusion, but the addition of lytic bacteriophages that quickly and specifically kill selected bacteria was shown to improve PCHS effectiveness. This study aimed to investigate the effect of such combined probiotic–phage sanitation (PCHSφ) in two Italian hospitals, targeting staphylococcal contamination. The results showed that PCHSφ could provide a significantly higher removal of staphylococci, including resistant strains, compared with disinfectants (−76%, p < 0.05) and PCHS alone (−50%, p < 0.05). Extraordinary sporadic chlorine disinfection appeared compatible with PCHSφ, while frequent routine chlorine usage inactivated the probiotic/phage components, preventing PCHSφ action. The collected data highlight the potential of a biological sanitation for better control of the infectious risk in healthcare facilities, without worsening pollution and AMR concerns.

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Preoptimized phage cocktail for use in aerosols against nosocomial transmission of carbapenem-resistant Acinetobacter baumannii: A 3-year prospective intervention study

Cited by 9 publications

References 44 publications

Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit

Carbapenem-resistant Acinetobacter baumannii: A challenge in the intensive care unit

Acinetobacter Baumannii Phages: Past, Present and Future

Potential Use of a Combined Bacteriophage–Probiotic Sanitation System to Control Microbial Contamination and AMR in Healthcare Settings: A Pre-Post Intervention Study

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