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Introduction of Probiotic-Based Sanitation in the Emergency Ward of a Children's Hospital During the COVID-19
Irene Soffritti1,2, Maria D'Accolti1,2, Carolina Cason3
1Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, and LTTA, University of Ferrara, Ferrara, 44121, Italy.
Insights
Probiotic-based sanitation (PCHS) significantly reduced hospital pathogens and resistance genes in a pediatric emergency room. This approach effectively controlled microbial contamination without exacerbating antimicrobial resistance (AMR) concerns.
Area of Science:
- Microbiology
- Infectious Diseases
- Environmental Health
Background:
- Antimicrobial resistance (AMR) is a major public health threat, potentially worsened by disinfectant use during pandemics.
- Healthcare-associated infections (HAIs) are a significant risk in hospitals, especially for children in pediatric wards.
- Controlling microbial contamination is critical to prevent HAIs and limit pathogen spread.
Purpose of the Study:
- To evaluate the efficacy of probiotic-based sanitation (PCHS) in a pediatric hospital's emergency room during the COVID-19 pandemic.
- To assess PCHS's impact on environmental bioburden, pathogen levels, and antimicrobial resistance.
- To determine if PCHS can control viral spread without increasing AMR.
Main Methods:
- Replaced conventional chemical disinfection with PCHS for two months in the emergency room.
- Monitored microbial contamination using culture-based methods and molecular assays (16S rRNA NGS, microarrays).
- Assessed SARS-CoV-2 presence via PCR and characterized the environmental resistome.
Main Results:
- PCHS led to a stable 80% reduction in surface pathogens compared to chemical disinfection.
- Observed up to a 2-log decrease in resistance genes with PCHS usage.
- Reintroducing chemical disinfection reversed the positive effects of PCHS; SARS-CoV-2 was not detected.
Conclusions:
- PCHS is an effective strategy for reducing pathogens and antimicrobial resistance in hospital environments.
- This sanitation method can control viral spread without negatively impacting the AMR landscape.
- PCHS offers a viable alternative for microbial control during public health emergencies.
Background:
Antimicrobial resistance (AMR) represents a major threat to public health, especially in the hospital environment, and the massive use of disinfectants to prevent COVID-19 transmission might intensify this risk, possibly leading to future AMR pandemics. However, the control of microbial contamination is crucial in hospitals, since hospital microbiomes can cause healthcare-associated infections (HAIs), which are particularly frequent and severe in pediatric wards due to children having high susceptibility.
Aim:
We have previously reported that probiotic-based sanitation (PCHS) could stably decrease pathogens and their AMR in the hospital environment, reduce associated HAIs in adult hospitals, and inactivate enveloped viruses. Here, we aimed to test the effect of PCHS in the emergency room (ER) of a children's hospital during the COVID-19 pandemic.
Methods:
Conventional chemical disinfection was replaced by PCHS for 2 months during routine ER sanitation; the level of environmental bioburden was characterized before and at 2, 4, and 9 weeks after the introduction of PCHS. Microbial contamination was monitored simultaneously by conventional culture-based CFU count and molecular assays, including 16S rRNA NGS for bacteriome characterization and microarrays for the assessment of the resistome of the contaminating population. The presence of SARS-CoV-2 was also monitored by PCR.
Results And Conclusions:
PCHS usage was associated with a stable 80% decrease in surface pathogens compared to levels detected for chemical disinfection (P < 0.01), accompanied by an up to 2 log decrease in resistance genes (Pc < 0.01). The effects were reversed when reintroducing chemical disinfection, which counteracted the action of the PCHS. SARS-CoV-2 was not detectable in both the pre-PCHS and PCHS periods. As the control of microbial contamination is a major issue, especially during pandemic emergencies, collected data suggest that PCHS may be successfully used to control virus spread without simultaneous worsening of the AMR concern.
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