Role of Inanimate Objects in Nosocomial Infections and their Prevention by Specific Bacteriophage Treatment in Intensive Care Unit

Author(s): Rahul Katiyar, Arvind Bhalekar,*, Shekhar Verma, Alakh Narayan Singh, Gopal Nath, Ravi Kumar Verma, Rajeev Kumar Dubey

Abstract: Intensive care unit (ICU) acquired infections are challenging health care problems worldwide, especially multidrug-resistant (MDR) pathogens. In ICUs, inanimate surfaces and equipment e.g. stethoscopes, medical charts, ultrasound machine, bedrails etc may be contaminated by bacteria and MDR pathogens. Cross-transmission of microorganisms from inanimate surfaces may have a major role in ICU acquired infections and colonization. Contamination can happen from healthcare worker’s hands or by patients themselves which are able to survive several months on dry surfaces. The practice of phage therapy, which uses bacterial viruses to treat bacterial infections, has been used for almost a century. Further, the decline in the effectiveness of antibiotics (i.e. drug resistance) has generated renewed interest in revisiting this practice. Conventionally, bacteriophage therapy reckons on the use of naturally occurring bacteriophage to infect and lyse bacteria at the site of infection. In the present study, bacteriophages were used as an adjuvant disinfectant for environmental cleaning and the efficacy of a phage aerosol on nosocomial transmission in ICUs was evaluated. The relevant clinical samples from patients admitted during first six months of study along with swab samples from environment and inanimate objects from ICU were collected for culture isolation. During next six months, Klebsiella pneumoniae specific phages were applied on the surface and common objects present in ICU. After this, spraying of phages was continued fortnightly for six months. The specimens from patients and environment were processed for culture isolation. The result showed significant reduction in isolation rate of Klebsiella pneumoniae from inanimate objects after Klebsiella pneumoniae specific phage spray. Furthermore, the effect of this reduction on inanimate objects leads to reduced isolation rate from patient’s samples also. These observations showed definitive role of phage therapy of inanimate objects in ICU and in reduction of incidence of infections.

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