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Published on: June 7, 2017
A critical assessment of microbial-based antimicrobial sanitizing of inanimate surfaces in healthcare settings
Sabina Fijan1, Peter Kürti2, Urška Rozman1
1Faculty of Health Sciences, University of Maribor, Maribor, Slovenia.
Abstract:
The global rise in antimicrobial resistance (AMR) poses a significant public health threat, especially in healthcare settings, where controlling the spread of antimicrobial genes is crucial. While person-to-person transmission remains the primary route for healthcare-associated infections (HAIs), hospital surfaces serve as key reservoirs for antimicrobial-resistant microorganisms. Regular cleaning and disinfection of these surfaces are essential. Microbial-based products for sanitizing hospital surfaces have emerged as promising tools to combat HAIs and AMR. However, a review of 32 publications found inconsistencies and potential risks. A total of 15 publications included hospital-based trials, while the rest were either in vitro or in situ assays, reviews, book chapters, or commentaries. In most of the hospital-based studies, specific strains of applied microorganisms were not identified, and the term "probiotic" was inaccurately used. These products mainly featured spores from Bacillus and Priestia genera, which was mainly hypothesized to work through competitive exclusion. Most hospital-based studies have shown that the application of microbial-based products resulted in a significant reduction in pathogens on surfaces, thereby contributing to a decrease in the incidence of healthcare-associated infections (HAIs). Further research is however needed to understand the effectiveness, mechanisms of action, and safety of microbial-based sanitizing agents. Strain-level identification is crucial for safety assessments, yet many reviewed products lacked this information. Consequently, there is a need for rigorous safety evaluations within existing regulatory frameworks to ensure the efficacy and safety of microbial-based cleaning products in healthcare settings.
Insights
Microbial-based sanitizers show promise for reducing pathogens on hospital surfaces and lowering healthcare-associated infections (HAIs). However, more research is needed to ensure their effectiveness and safety, especially regarding microbial strain identification.
Area of Science:
- Microbiology
- Public Health
- Infectious Diseases
Background:
- Antimicrobial resistance (AMR) is a growing global health threat, particularly in healthcare settings.
- Hospital surfaces act as reservoirs for antimicrobial-resistant microorganisms, contributing to healthcare-associated infections (HAIs).
- Current cleaning and disinfection methods are essential, but novel approaches are being explored.
Purpose of the Study:
- To review the efficacy and safety of microbial-based products for sanitizing hospital surfaces.
- To assess the current evidence regarding the use of these products in combating HAIs and AMR.
- To identify gaps in research and highlight the need for rigorous safety evaluations.
Main Methods:
- A comprehensive literature review of 32 publications was conducted.
- Studies included hospital-based trials, in vitro assays, in situ assays, reviews, book chapters, and commentaries.
- Analysis focused on the application, effectiveness, and reported safety of microbial-based sanitizing agents.
Main Results:
- Most hospital-based studies indicated a significant reduction in surface pathogens and a decrease in HAIs following the application of microbial-based products.
- Products primarily utilized spores from Bacillus and Priestia genera, often relying on competitive exclusion.
- Inconsistencies were found, including the inaccurate use of the term "probiotic" and a lack of specific microbial strain identification in many studies.
Conclusions:
- Microbial-based sanitizing agents show potential for reducing HAIs and AMR in healthcare environments.
- Further research is critical to elucidate mechanisms of action, confirm effectiveness, and ensure safety.
- Rigorous safety evaluations, including strain-level identification and adherence to regulatory frameworks, are essential before widespread adoption.
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