Could we fight healthcare-associated infections and antimicrobial resistance with probiotic-based sanitation? Commentary.

Healthcare-associated infections (HAI) affect every year about 4 million hospitalized patients in the EU, causing over 33 000 deaths as a direct consequence and over 1.1 billion € associated costs. Besides the persistent microbial contamination of the hospital environment, a major cause is the rampant antimicrobial resistance (AMR) of the HAI-associated pathogens. The hospital environment itself is in fact a reservoir of resistant pathogens, apparently not sufficiently controlled by conventional chemical-based sanitation. A recently published study, the SAN-ICA study, performed in Italy, suggests that the fight against AMR may involve probiotic-based sanitation approaches, as they might stably reduce AMR surface pathogens, finally reducing HAI incidence. Here we discuss the reported results and argue that their use may provide a novel approach which deserves exploration.