Impact of a probiotic-based hospital sanitation on antimicrobial resistance and HAI-associated antimicrobial consumption and costs: a multicenter study
Open accessAbstract
PURPOSE: Antimicrobial resistance (AMR) is one of the major threats to human health, and the high frequency of resistant pathogens in the hospital environment can contribute to the transmission of difficult-to-treat health care-associated infections (HAIs). We recently reported that, compared with conventional chemical cleaning, the use of a microbial-based sanitation strategy (Probiotic Cleaning Hygiene System [PCHS]) was associated with remodulation of hospital microbiota and reduction of HAI incidence. Here, we aimed to analyze the impact of PCHS on AMR and related effects, such as HAI-associated antimicrobial drug consumption and costs. PATIENTS AND METHODS: Five Italian hospitals, enrolled in a multicenter study where conventional sanitation methods were replaced with PCHS, were included in the analysis. The study period included a 6-month observation for each sanitation type. Surface microbiota AMR was analyzed using microarray, nested PCR, antibiogram, and microdilution tests. Drug consumption data and related costs were obtained from the medical records of all hospitalized patients affected by HAIs. RESULTS: <0.01). Functional assays confirmed the molecular data, demonstrating a 33%-100% decrease of resistant strains depending on the antibiotic type. Antimicrobial drug consumption associated with HAI onset showed a global 60.3% decrease, with a 75.4% decrease of the associated costs. CONCLUSION: The spread of AMR in the hospital environment can be limited by the use of sanitation methods to remodulate the hospital microbiota, leading to lower antimicrobial consumption and costs. This approach might be considered as part of broader infection prevention and control strategies.
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PCHS results in a >50% decrease in HAI incidence.
“This type of sanitation has been shown to reduce surface pathogens 80% more than chemical disinfectants without selecting resistant strains but rather decreasing the prevalence of preexisting AMR up to 99.9%, resulting in a > 50% decrease in HAI incidence [8, 29–35].”
From Profiling the resistome and virulome of Bacillus strains used for probiotic-based sanitation: a multicenter WGS analysis (2025) · cites this paper as [33]
PCHS reduces surface pathogens 80% more than chemical disinfectants.
“This type of sanitation has been shown to reduce surface pathogens 80% more than chemical disinfectants without selecting resistant strains but rather decreasing the prevalence of preexisting AMR up to 99.9%, resulting in a > 50% decrease in HAI incidence [8, 29–35].”
From Profiling the resistome and virulome of Bacillus strains used for probiotic-based sanitation: a multicenter WGS analysis (2025) · cites this paper as [33]
PCHS does not select resistant strains but decreases the prevalence of preexisting AMR up to 99.9%.
“This type of sanitation has been shown to reduce surface pathogens 80% more than chemical disinfectants without selecting resistant strains but rather decreasing the prevalence of preexisting AMR up to 99.9%, resulting in a > 50% decrease in HAI incidence [8, 29–35].”
From Profiling the resistome and virulome of Bacillus strains used for probiotic-based sanitation: a multicenter WGS analysis (2025) · cites this paper as [33]
PBS systems were recently proposed based on studies showing ability to provide stable decreases in pathogens and AMR, accompanied in most cases by significant reduction in associated HAIs.
“systems based on the use of probiotics as sanitizers (probiotic-based sanitation, PBS) were recently proposed on the basis of studies showing the ability of PBS to provide stable decreases in pathogens and AMR, accompanied in most cases by a significant reduction in associated HAIs [29, 33, 34, 37, 38, 87–92].”
From Profiling the resistome and virulome of Bacillus strains used for probiotic-based sanitation: a multicenter WGS analysis (2025) · cites this paper as [33]
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References 21 · Cited by 77
- Authors
- Caselli, E., Arnoldo, L., Rognoni, C., D'Accolti, M., Soffritti, I., Lanzoni, L., Bisi, M., Volta, A., Tarricone, R., Brusaferro, S., & Mazzacane, S.
- Affiliations
- University of Ferrara (IT)
- University of Udine (IT)
- Bocconi University (IT)
- Corresponding author
- Caselli, Elisabetta
- ORCID
- Venue
- Infection and Drug Resistance
- Publisher
- Informa UK Limited
- Published
- 2019-02
- Volume
- Volume 12
- Pages
- 501-510
- ISSN
- 1178-6973 (ISSN-L)
- PMC
- PMC6398408
- OpenAlex
- W2917826539
- Cited by
- 77
- References
- 21
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 10 · 2023: 17 · 2022: 12 · 2021: 4 · 2020: 8 · 2019: 8
- FWCI
- 6.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Infection and Drug Resistance (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Archivio istituzionale della Ricerca - Bocconi (submittedVersion, cc-by-nc)
- Institutional Research Information System (University of Udine) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Keywords
- antimicrobial resistance, nosocomial infections, antimicrobial use, health care costs, infection control, hospital environment
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