Prophylactic Phage Aerosols for Nosocomial Infection Control in an Extracorporeal Membrane Oxygenation Unit: A 4-Year Prospective Study of Temporospatially Designed Phage Cocktails.

IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES
Chun-Chieh Tseng, Li-Kuang Chen, Hsiu-Tzu Chu, Yi-Ting Chen, Hui-Li Jiang, Hui-Hua Yang, Chin-Cheng Chang, Sankhla Debangana, Lee-Mei Ponge, Min-Xiu Li, Ying-Hao Chin, Jui-Chih Chang
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引用次数: 0

Abstract

Phage-based decontamination has rarely been explored in real-world settings, particularly in the environments of patients undergoing extracorporeal membrane oxygenation (ECMO). This four-year prospective study aimed to evaluate the effectiveness of aerosolized phage cocktails tailored to combat target antibiotic-resistant species of Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia. The decontamination procedure with phage aerosols was proactively implemented before the admission of ECMO patients based on a thorough analysis of phage typing results from bacterial species isolated from prospective patient areas during the preceding two months. The phage cocktail formulation design also accounted for phage resistance development, phage families, and plaque characteristics. Throughout the study, 85 ECMO patients were monitored, with the environments of 22 patients undergoing phage decontamination. Fifty phage cocktails were prepared to target the identified species. Respiratory infections were most common among ECMO patients, accounting for 71.4%. The ECMO duration for patients infected with the targeted species was significantly longer than that for noninfected patients (p = 0.019), with peak infection incidence occurring between 3-7 days of ECMO treatment (67.1 per 1000 ECMO days). Notably, none of the patients in phage-treated environments contracted infections from the targeted species. However, the overall incidence of bacterial infections did not significantly correlate with phage decontamination efforts, as phages are effective only against their specific hosts. This study demonstrates the potential of prophylactic phage decontamination to prevent specific infections, aligning with One Health principles by offering a sustainable alternative to antibiotics, potentially significantly reducing antibiotic use.

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来源期刊
CiteScore
21.60
自引率
0.90%
发文量
176
审稿时长
36 days
期刊介绍: The International Journal of Antimicrobial Agents is a peer-reviewed publication offering comprehensive and current reference information on the physical, pharmacological, in vitro, and clinical properties of individual antimicrobial agents, covering antiviral, antiparasitic, antibacterial, and antifungal agents. The journal not only communicates new trends and developments through authoritative review articles but also addresses the critical issue of antimicrobial resistance, both in hospital and community settings. Published content includes solicited reviews by leading experts and high-quality original research papers in the specified fields.
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