Fighting AMR in the Healthcare Environment: Microbiome-Based Sanitation Approaches and Monitoring Tools
Open accessAbstract
Healthcare-associated infections (HAIs) affect up to 15% of all hospitalized patients, representing a global concern. Major causes include the persistent microbial contamination of hospital environment, and the growing antimicrobial-resistance (AMR) of HAI-associated microbes. The hospital environment represents in fact a reservoir of potential pathogens, continuously spread by healthcare personnel, visiting persons and hospitalized patients. The control of contamination has been so far addressed by the use of chemical-based sanitation procedures, which however have limitations, as testified by the persistence of contamination itself and by the growing AMR of hospital microbes. Here we review the results collected by a microbial-based sanitation system, inspired by the microbiome balance principles, in obtaining more effective control of microbial contamination and AMR. Whatever the sanitation system used, an important aspect of controlling AMR and HAIs relates to the ability to check any variation of a microbial population rapidly and effectively, thus effective monitoring procedures are also described.
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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 [29]
Section 4 (page unavailable) reports that PCHS reduced surface pathogen contamination by up to 90% more than conventional disinfectants, but it does not report the claimed 80% figure. The same section supports the absence of resistant-strain selection and reports a 52% reduction in HAI incidence; it reports up to 99% reduction in a methicillin-resistance marker, not 99.9% reduction in preexisting AMR. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPCHS 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 [29]
Section 4 says PCHS did not select drug-resistant strains and decreased resistance genes in the pre-PCHS surface microbiota. It reports up to a 99% reduction in mecA-driven methicillin resistance, not the claimed 99.9% reduction in preexisting AMR overall. (LLM, conf=0.90)
Experimental — accuracy not yet measuredPCHS 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 [29]
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 [29]
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- Authors
- D’Accolti, M., Soffritti, I., Mazzacane, S., & Caselli, E.
- Affiliations
- University of Ferrara (IT)
- Corresponding author
- Caselli, Elisabetta
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2019-03-27
- Volume
- 20
- Issue
- 7
- Pages
- 1535
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC6479322
- OpenAlex
- W2924668404
- Cited by
- 82
- References
- 76
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 7 · 2023: 24 · 2022: 24 · 2021: 6 · 2020: 3 · 2019: 4
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Physical Sciences › Chemistry › Organic Chemistry › Antimicrobial agents and applications
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
- Keywords
- antimicrobial resistance, nosocomial infections, hospital environmental contamination, microbial contamination control, hospital hygiene
- MeSH terms
- Bacillus, Cross Infection, Drug Resistance, Microbial, Humans, Sanitation, Probiotics, Microbiota
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