Infection and Drug Resistance (Mar 2022)
Introduction of Probiotic-Based Sanitation in the Emergency Ward of a Children’s Hospital During the COVID-19 Pandemic
Abstract
Irene Soffritti,1,2 Maria D’Accolti,1,2 Carolina Cason,3 Luca Lanzoni,2 Matteo Bisi,2 Antonella Volta,2 Giuseppina Campisciano,3 Sante Mazzacane,2 Francesca Bini,1,2 Eleonora Mazziga,1 Paola Toscani,4 Elisabetta Caselli,1,2,* Manola Comar3,5,* 1Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, and LTTA, University of Ferrara, Ferrara, 44121, Italy; 2CIAS Research Center, University of Ferrara, Ferrara, 44122, Italy; 3Department of Advanced Translational Microbiology, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, Trieste, 34137, Italy; 4Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, Trieste, 34137, Italy; 5Department of Medical Sciences, University of Trieste, Trieste, 34149, Italy*These authors contributed equally to this workCorrespondence: Elisabetta Caselli, Section of Microbiology, Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, via Luigi Borsari 46, Ferrara, 44121, Italy, Tel +39 0532 455387, Fax +39 0532 974470, Email [email protected]: 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.Keywords: drug resistance, cross infection, biological monitoring, COVID-19, probiotics
