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.