Localized Hotspot Management: Hand-Held Phage Aerosols as a Complementary Strategy for Carbapenem-Resistant Acinetobacter baumannii Infection Control in Healthcare Settings

局部热点管理:手持式噬菌体气溶胶作为医疗机构中碳青霉烯耐药鲍曼不动杆菌感染控制的补充策略

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Abstract

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) remains a major challenge in healthcare settings due to its persistence on inanimate surfaces and resistance to conventional cleaning methods. Bacteriophages (phages) represent a promising biocontrol option owing to their high specificity and lytic activity. Methods: This study evaluated the use of a personal hand-held vibrating mesh nebulizer (VMN) as a rapid and localized delivery platform for phage aerosols. Using two lytic phages (ϕ2, Podovirus; ϕ11, Myovirus), we assessed phage stability under different storage conditions, viability during VMN operation, and surface decontamination efficacy under varying spray parameters. Results: In saline, both phages showed optimal long-term stability at 4 °C, whereas storage at -20 °C resulted in a progressive reduction in infectivity exceeding 3 logs over the storage period. VMN aerosolization did not compromise viability. A 3 min spray achieved >99.9% surface reduction: ϕ2 was effective at 1 × 10(7) PFU/mL, whereas ϕ11 required 1 × 10(8) PFU/mL. Importantly, residual ϕ2 activity persisted for at least 24 h, preventing detectable recolonization under the assay conditions, while ϕ11 protection was limited to 6 h. Conclusions: These findings establish the hand-held sprayer as a practical, low-cost, and flexible approach to deliver viable phage aerosols, providing an effective complement to large-scale disinfection systems and offering a targeted strategy to enhance infection control in healthcare environments.

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