Isolation of Lytic Bacteriophages Against Multidrug-Resistant Klebsiella pneumoniae From Hospital Sewage

Abstract

Klebsiella pneumoniae is a leading cause of hospital-acquired infection, and strains resistant to many antibiotic classes, including carbapenems, have narrowed the options available to clinicians. Lytic bacteriophages, the viruses that infect and burst bacteria, are being revisited as a complement to antibiotics, and hospital sewage is often proposed as a rich place to find them because it concentrates the bacteria they prey on. This narrative review asks what the published literature says about isolating lytic phages against multidrug-resistant K. pneumoniae from hospital sewage, how candidate phages are characterised, and how much weight the reported findings can carry. It draws on work on the organism and its resistance, on phage biology and enrichment methods, on animal and clinical experience with phage preparations, and on the ecology of hospital wastewater, and it reports no new laboratory or patient data. Isolation is technically straightforward, but narrow host range, capsule dependence, rapid emergence of bacterial resistance and incomplete characterisation limit what a single isolate can offer. Most supportive evidence comes from cell culture and animal models. The review sets out a practical appraisal framework and the gaps that future studies should close.