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06 November 2019 : Clinical Research  

Lytic Bacteriophage Screening Strategies for Multidrug-Resistant Bloodstream Infections in a Burn Intensive Care Unit

Zichen Yang1ABCE, Yunlong Shi1B, Cheng Zhang1AB, Xiaoqiang Luo1BC, Yu Chen1C, Yizhi Peng1DEFG*, Yali Gong1ACDE

DOI: 10.12659/MSM.917706

Med Sci Monit 2019; 25:8352-8362


BACKGROUND: Increasing antibiotic resistance and multidrug resistance (MDR) in patients with bloodstream infection (BSI) has resulted in treatment using bacteriophage. This study aimed to identify Gram-negative bacilli and Gram-positive cocci and antibiotic resistance in patients with BSI in a burn intensive care unit (BICU). The environment, including sewage systems, were investigated for the presence of lytic bacteriophage.

MATERIAL AND METHODS: Between January 2011 to December 2017, 486 patients with BSI were admitted to the BICU. Blood culture identified the main infectious organisms. Bacterial screening tests for antibiotic resistance included the D test and the modified Hodge test (MHT). Lytic bacteriophage was isolated from the environment.

RESULTS: In 486 patients with BSI, the main causative organisms were Gram-negative bacilli (64.6%), Gram-positive cocci (27.7%), and fungi (7.7%). The main pathogenic organisms that showed multidrug resistance (MDR) were Acinetobacter baumannii (26.0%), Staphylococcus aureus (16.8%), and Pseudomonas aeruginosa (14.2%). Bacteriophage was mainly isolated from Gram-negative bacilli. Screening of hospital and residential sewage systems identified increased levels of bacteriophage in hospital sewage.

CONCLUSIONS: The causative organisms of BSI and the presence of MDR in a hospital BICU were not typical, which supports the need for routine bacterial monitoring. Hospital sewage provides a potential source of bacteriophage for the treatment of MDR pathogenic bacteria.

Keywords: Antibiotics, Antitubercular, Bacterial Infections, Bacteriophages, Burn Units, Acinetobacter baumannii, Anti-Bacterial Agents, Bacteremia, Communicable Diseases, Cross Infection, Drug Resistance, Multiple, Bacterial, Intensive Care Units, Mass Screening, Microbial Sensitivity Tests, Pseudomonas, Pseudomonas Infections, Staphylococcal Infections, Staphylococcus aureus

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DOI: 10.12659/MSM.943911

Med Sci Monit 2024; 30:e943911


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750