Comparative impact of bacteriophage disinfection on hospital microbiota and multidrug-resistant organisms in critical care units.

BACKGROUNDS: Currently used disinfection methods for multidrug-resistant organisms (MDROs) in intensive care units (ICUs) have limitations. This study evaluated the efficacy of bacteriophage disinfection compared to traditional methods.

METHODS

Initially, 30 ICU rooms housing patients with cultured MDROs were included between 2020-2022 (yielding 630 initial swabs). After applying exclusion criteria for unmatched environmental strains, 373 relevant ICU surface samples from 29 rooms were analyzed. Disinfection methods were categorized into three groups: sodium hypochlorite (bleach), bleach with ultraviolet C (UVC) light, and MDRO-targeting bacteriophages. The environmental bacteria in ICU rooms were compared across groups, and the eradication rates of high-risk pathogens and MDROs were analyzed.

RESULTS

Among 373 ICU surface samples, 339 yielded positive bacterial cultures. Staphylococcus spp. and Enterococcus spp. were the most commonly isolated bacteria. High-risk bacteria accounted for 23.3% of isolates, with MDROs comprising 14.7%. After disinfection, the eradication rate of MDROs was 88.2% in the bleach plus UVC group, 85.7% in the bacteriophage group, and 52.9% in the bleach-only group (p = 0.023). The bleach plus UVC and bacteriophage groups significantly reduced high-risk pathogens (p < 0.001) compared to the bleach-only group.

CONCLUSIONS

While bleach with UVC is highly effective, bacteriophage disinfection achieves comparable MDRO eradication while potentially preserving non-MDRO culturable bacteria in critical care settings.