Limitations of surface disinfection
Contaminated environmental surfaces act as reservoirs of microorganisms (Hota B, 2004), which include several health-related pathogens (disease-causing microorganisms). As a result, contaminated surfaces can influence the incidence of infections in healthcare settings. It is one of the most common complications in health care facilities worldwide (Allegranzi B, 2010, Cookson B, 2013, Suetens C, 2013). Proper surface disinfection is recommended as the primary procedure for infection prevention (Rutala WA 1996, Sehulster L 2003, Mangram AJ 1999). However, the commonly used chemical disinfection methods have several disadvantages in controlling pathogens:
- Limited effects of the biocidal product (Vandini A, 2014);
- Rapid bacterial re-contamination of treated surfaces (occurs after 30 minutes) (Elisabetta Casell, 2017);
- Development of drug-resistant microorganisms (although to date this has only been demonstrated in vitro) (Vandini A, 2014, Wand, 2017);
- Environmental pollution (Vandini A, 2014);
- Possible hypersensitivity of patients, staff and cleaners to chemical cleaners (Vandini A, 2014);
- Resistance to widely used antiseptics and disinfectants (Frabetti A, 2009, Bock, 2016);
- Both harmful (bad) and beneficial (good) microorganisms are killed (University of Ghent, 2007).
For these reasons, the importance of cleaning procedures to control the presence of pathogenic bacteria indicates the need for a new and sustainable strategy.
The use of probiotics is a new approach and a viable strategy
A promising strategy was first proposed by Falag and Macris in 2009. The basis of this strategy is the use of non-pathogenic microorganisms – probiotics (eg B. subtilis, B. pumilus and B. megaterium, etc.). Probiotic bacteria are spores of Bacillus spp, which are considered harmless microorganisms because, unlike disinfectants, they do not act as biocides. Probiotics are organic, easy to use and biodegradable. Detergents for probiotic microorganisms are based on the concept of “microbial control”, which no longer seeks to obtain a sterile environment, but instead creates a stable and healthy microbial community that provides a hygienically stable environment. Based on the principle of competitive exclusion (Gause’s Law) (Hibbing ME, 2010), probiotics are able to anchor and colonize cleaned surfaces to counteract the proliferation of other bacterial species (occupy area and consume all available food sources without allowing pathogenic bacteria to grow) (Gatesoupe FJ, 1999) , La Fauci 2015).
Research in health care institutions
Alberta Vandini in a study in 2014 compared the microbiological cleaning method with conventional cleaning methods. The study was conducted for 24 weeks in three independent hospitals (one in Belgium and two in Italy). About 20,000 test samples were collected from the surfaces to be cleaned.
The results of a study conducted in 2000 showed that microbial cleaning reduced the amount of pathogens associated with healthcare facilities by 50 to 89%. This effect was achieved after 3-4 weeks and the pathogen levels decreased steadily. While many questions remain about the true mechanisms, this study suggests that microbial cleaning is a more effective and sustainable alternative to dry cleaning and non-specific disinfection in healthcare settings.
Based on the results obtained, we can state that probiotics are effective and innovative products for environmental management. Probiotic-based cleaning strategies can greatly accelerate efforts to reduce the risk of infections in medical facilities, social care homes, and homes, thereby significantly improving health sustainability and providing a viable “green” alternative to the chemical disinfectants used to date.
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