Table 2 Characteristics of cleaning regimes stratified by advantages (pro) and disadvantages (contra) as discussed during the workshop. Results presented here represent consensus of all workshop participants
From: Can probiotics trigger a paradigm shift for cleaning healthcare environments? A narrative review
Topic | Detergents (Soap and water) | Disinfectants | Probiotics |
|---|---|---|---|
Environmental safety / sustainability | Some products (not all) can be biodegradable, sustainable and environmental friendly (PRO / CONTRA) | Not biodegradable, not environmental friendly, not sustainable (CONTRA) | Biodegradable, environmental friendly, sustainable (PRO) |
Occupational safety | No dangerous substance, usually harmless for occupational health, allergies possible (PRO) | Dangerous substance, potentially harmful for occupational health, allergies possible (CONTRA) | No dangerous substance, harmless for occupational health, allergies possible (PRO) |
Is the method well established? | Very well established (PRO) | Very well established, critical values for reduction / elimination of microorganisms available (PRO) | Not well established, future studies and standardization needed (CONTRA) |
Regulations | Meet current regulations / recommendations / national and international guidelines (PRO) | Meet current regulations / recommendations / national and international guidelines (PRO) | Do not meet current regulations / recommendations / national and international guidelines, new regulations necessary, currently only available in Europe (CONTRA) |
Costs | Low costs (PRO) | High costs (CONTRA) | Higher costs, potentially additional costs by quality control measures and monitoring of potential side effects (CONTRA) |
Antiseptic / antimicrobial resistances | No effect on antiseptic / antimicrobial resistances to be expected (PRO/CONTRA) | Has the potential to increase antiseptic / antimicrobial resistances (CONTRA) | Might prevent antimicrobial resistance (PRO) |
Longterm cleaning effect | No long-lasting cleaning effect (CONTRA) | No long-lasting cleaning effect (CONTRA) | Longer lasting effects for days, more effective in removal of organic pollution on surfaces (PRO) |
Quality control / monitoring | Quality control and monitoring activities established, no additional activities are necessary (PRO) | Quality control and monitoring activities established, no additional activities are necessary (PRO) | Quality control and monitoring necessary (might generate additional costs) (CONTRA) |
Risk of contamination | Moderate risk of contamination by other bacteria, e.g. with Gram-negatives (PRO) | Very low risk of contamination by other bacteria, e.g. with Gram-negatives (PRO) | Risk of contamination by other bacteria due to prebiotics (e.g. inulin), e.g. with Gram-negatives (CONTRA) |
Effect on the diversity of the hospital microbiome | No negative effect on the diversity of the hospital microbiome (PRO) | Reduces diversity of the hospital microbiome (CONTRA) | May reduce the biological diversity of the hospital microbiome, but shifts the balance towards beneficial microorganisms (PRO) |
Universal applicability | Not adequate for rooms that needs to be sterile (e.g. operating theatre) (CONTRA) | Adequate for rooms that needs to be sterile (e.g. operating theatre) (PRO) | Not adequate for rooms that needs to be sterile (e.g. operating theatre) (CONTRA) |
Additional risks by living organisms | None (PRO) | None (PRO) | Potential of living organisms to take up genes (e.g. antimicrobial resistance genes). Available data show high genetic stability and lack of infectious risk in hospitalized patients but they need further confirmation. (CONTRA) |