title: Impact of a Probiotic-Based Cleaning Intervention on the Microbiota Ecosystem of the Hospital Surfaces: Focus on the Resistome Remodulation.
abstract: BACKGROUND
  Contamination of hospital surfaces by clinically-relevant pathogens represents a major concern in healthcare facilities, due to its impact on transmission of healthcare-associated infections (HAIs) and to the growing drug resistance of HAI-associated pathogens. Routinely used chemical disinfectants show limitations in controlling pathogen contamination, due to their inefficacy in preventing recontamination and selection of resistant strains. Recently we observed that an innovative approach, based on a cleanser added with spores of non-pathogenic probiotic Bacilli, was effective in stably counteracting the growth of several pathogens contaminating hospital surfaces.
  
  
  METHODS
  Here, we wanted to study the impact of the Bacillus-based cleanser on the drug-resistance features of the healthcare pathogens population. In parallel, the ability of cleanser-derived Bacilli to infect hospitalized patients was also investigated.
  
  
  RESULTS
  Collected data showed that Bacilli spores can germinate on dry inanimate surfaces, generating the bacterial vegetative forms which counteract the growth of pathogens and effectively substitute for them on treated surfaces. Strikingly, this procedure did not select resistant species, but conversely induced an evident decrease of antibiotic resistance genes in the contaminating microbial population. Also importantly, all the six HAI-positive patients hosted in the treated areas resulted negative for probiotic Bacilli, thus adding evidences to their safety-to-use.
  
  
  CONCLUSIONS
  These results indicate that this probiotic-based procedure is active not only in controlling surface microbial contamination but also in lowering drug-resistant species, suggesting that it may have relevant clinical and therapeutical implications for the management of HAIs.
authors.affiliation: Section of Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.|CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Caselli
authors.affiliation: Section of Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.|CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: D'Accolti
authors.affiliation: CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.|Architecture and Urban Planning (XXX cycle), Department of Architecture, University of Ferrara, Ferrara, Italy.
authors.forename: Alberta
authors.initials: A
authors.lastname: Vandini
authors.affiliation: CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Lanzoni
authors.affiliation: CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.|Architecture and Urban Planning (XXX cycle), Department of Architecture, University of Ferrara, Ferrara, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Camerada
authors.affiliation: CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Coccagna
authors.affiliation: Section of Biochemistry and Molecular Biology, Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Branchini
authors.affiliation: Department of Infection Prevention Control and Risk Management, S. Anna University Hospital, Ferrara, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Antonioli
authors.affiliation: CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Balboni
authors.affiliation: Section of Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.|CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Di Luca
authors.affiliation: CIAS Interdepartmental Research Center for pollution control in high sterility rooms, University of Ferrara, Ferrara, Italy.
authors.forename: Sante
authors.initials: S
authors.lastname: Mazzacane
mesh_terms: D001407:Bacillus / Q000235:genetics / Q000302:isolation & purification; D003428:Cross Infection / Q000382:microbiology; D003902:Detergents / Q000494:pharmacology; D004352:Drug Resistance, Microbial / Q000187:drug effects* / Q000235:genetics; D017753:Ecosystem; D020869:Gene Expression Profiling; D005798:Genes, Bacterial; D006761:Hospitals; D006801:Humans; D006920:Hygiene; D046228:Microarray Analysis; D064307:Microbiota / Q000187:drug effects* / Q000235:genetics; D019936:Probiotics / Q000494:pharmacology*; D013171:Spores, Bacterial / Q000187:drug effects
chemical_list: D003902:Detergents