A battle unfolds within hospital walls that is invisible to the naked eye, yet could prove life-changing for thousands of patients. It's not just a battle for recovery, but also for survival in a world where invisible enemies—bacteria—have gained new strength. Modern medicine faces a daily challenge that was largely theoretical just a few decades ago: the widespread spread of hospital-acquired infections (HAIs) caused by multidrug-resistant microorganisms.

Traditional methods, particularly antibiotic therapy, are increasingly proving powerless against these "superbugs" that have adapted to aggressive treatment and hospital conditions. Against this backdrop, one little-known but extremely promising method of fighting infections— phage therapy —is attracting increasing attention. The use of bacteriophages—viruses that kill exclusively pathogenic bacteria—is becoming more than just a scientific curiosity, but a real and practical tool for infection control. This is a return to an idea that originated in the first half of the 20th century, but is now taking on new significance in the era of antibiotic resistance.

In this article, we'll explore why phages could be the key to safer hospitals, how they're being used in today's environment, and why Ukraine could become a pioneer in implementing this biotechnological approach.

Resistant Infections in Hospitals: A 21st Century Challenge

In intensive care units, surgical units, neonatology units, and wards for immunocompromised patients, hospital-acquired infections are a real and serious risk. They are caused by bacteria that have survived in sterile environments, adapted to disinfectants, and developed resistance to antibiotics. Among the most common pathogens are Pseudomonas aeruginosa , Klebsiella pneumoniae , Acinetobacter baumannii , and Staphylococcus aureus . Many of these are multidrug-resistant—that is, they are resistant to most existing medications. In such settings, traditional antibiotic therapy is often ineffective.

This isn't just a minor inconvenience for medical professionals. It's a factor that prolongs hospital stays, increases treatment costs, and, most importantly, puts patients' lives at risk. Children, the elderly, cancer patients, and people with severe chronic illnesses are particularly vulnerable.

Bacteriophages against hospital-acquired infections

Phage therapy in hospitals is not a new discovery, but a once-forgotten alternative. Since the 1920s, bacteriophages have been actively used to treat infections, including in the former USSR, including Ukraine. With the development of antibiotics, interest in phages waned, but today, when antibiotic resistance has become a global threat, these viruses are making a comeback—and with compelling arguments.

Bacteriophages are used in hospital settings for both the treatment and prevention of nosocomial infections. They are used as solutions for wound treatment, instillation into drainage systems, inhalation, and for sanitation of the nasopharynx or intestines. One of the main advantages of phages is their high specificity. This means they attack only a specific pathogen without disrupting the body's overall bacterial balance. Unlike antibiotics, these beneficial viruses do not cause dysbiosis, allergies, or toxic effects. They can be combined with other treatment methods, and, if necessary, the phage "cocktail" can be modified based on the results of bacteriological analysis.

Preventing outbreaks with phages

The ability to prevent hospital-acquired outbreaks is one of the advantages of phage therapy. Many European hospitals already use phage disinfection to reduce the risk of pathogen transmission from medical staff to patients. Risk areas, such as operating rooms, intensive care units, catheters, and ventilation tubes, are also disinfected. The use of bacteriophages for prophylactic purposes helps reduce the overall level of colonization by nosocomial pathogens, minimize the risk of chronic carriage, and prevent outbreak escalation. Phages have also demonstrated high efficacy in combating biofilms —bacterial growths that form on the surfaces of medical devices and are largely resistant to antibiotics. Biofilms are often a source of reinfection.

Why hasn't phage therapy been widely implemented yet?

Despite impressive results, phage therapy is still not part of standard protocols in most hospitals. This is due to the complexity of production, the need for precise pathogen identification, and a lack of widespread awareness among medical professionals and healthcare administrators. Bacteriophages are not a "magic pill" that can be used for every infection. They require individualized selection and microbiological diagnostics. But this personalized approach is the future of medicine, which is moving toward precision and safety.

Prospects: Phages as part of infection control

Infection control isn't just about hand washing and instrument sterility; it's a multi-layered strategy that requires innovative solutions. Incorporating phages into the infection control system could be a game-changer. Instead of dealing with the consequences, it's about early prevention. Imagine a hospital that treats and actively prevents infections using biological control agents. Bacteriophages could be the very tool that brings pathogens back under control.

Ukraine has all the prerequisites to become a leader in this field—we have scientific schools, the production of phage preparations, and tangible clinical results. We only need to bring these practices to the national level and support them with regulations. The fight against hospital-acquired infections requires weapons that can adapt and act precisely. Bacteriophages in hospitals are a viable alternative to traditional antibiotic therapy. They could be key to reducing mortality, shortening hospital stays, and improving patient safety. Phage therapy remains underutilized, but it has the potential to become the main line of defense against bacteria within healthcare facilities.