{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:10:02Z","timestamp":1784182202585,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objective<\/jats:title>\n \n This study aimed to evaluate the effect of targeted Carbapenem-resistant\n Klebsiella pneumoniae<\/jats:italic>\n (CR-Kpn) phage aerosol combined with routine disinfection on the decontamination of CR-Kpn in the ICU environment, as well as its incidence rate, drug resistance rate, and antibiotic use.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A prospective two-phase study design was adopted. During the baseline phase (P1), routine terminal disinfection with chlorine-containing agents was performed. In the intervention phase (P2), targeted phage aerosol spray was added to the isolation rooms of CR-Kpn patients. Multivariable models were fitted to isolate the intervention effect, adjusting for patient-days, imipenem use intensity, and carbapenem-resistant\n Acinetobacter baumannii<\/jats:italic>\n (CRAB) incidence density. Outcomes including environmental CR-Kpn detection rate, incidence density, carbapenem resistance rate of\n K. pneumoniae<\/jats:italic>\n , and antibiotic use intensity were compared between the two phases.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Following the combined intervention, the overall detection rate of CR-Kpn in the ICU environment decreased from 17.28% (47\/272) to 0.96% (1\/104), with the detection rate in sink drains dropping from 85.29% (29\/34) to 7.69% (1\/13). Clinical data showed that the incidence density of CR-Kpn significantly decreased from 10.16 cases\/1,000 patient-days to 4.71 cases\/1,000 patient-days (\n p<\/jats:italic>\n \u202f=\u202f0.007), whereas the incidence density of carbapenem-resistant\n A. baumannii<\/jats:italic>\n (CRAB) increased significantly, suggesting the species-specificity of the intervention. Concurrently, the carbapenem resistance rate of\n K. pneumoniae<\/jats:italic>\n decreased from 62.50 to 53.80%, and the use intensity of key antibiotics (tigecycline, polymyxin B, meropenem) significantly declined (reductions of 52.6, 58.5, and 36.6%, respectively;\n p<\/jats:italic>\n \u202f&lt;\u202f0.01 for all).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The combination of phage aerosol and routine disinfection showed potential in controlling CR-Kpn contamination in the ICU environment, reducing its incidence and carbapenem resistance rate, and decreasing the use of related antibiotics. This approach may provide a safe and effective biological disinfection strategy for controlling the spread of CR-Kpn.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1868215","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:39:39Z","timestamp":1784180379000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Targeted phage aerosol for environmental control of CR-Kpn in the ICU: a prospective intervention study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yun","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqin","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijing","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Gui","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhizhuan","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heping","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Healthcare-Associated Infection Management, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Healthcare-Associated Infection Management, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhua","family":"Xu","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yating","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Central Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1089\/hs.2022.0138","article-title":"Viral disinfection of porous fomites utilizing a bacteriophage model and chlorine dioxide gas","volume":"21","author":"Benedict","year":"2023","journal-title":"Health 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