Can probiotic cleaning solutions replace chemical disinfectants?
Culleoka Company’s Natural Based Cleaner, Scale & Scum Remover, and Natural Based Drain, Septic & Sewer, all contain multiple strains of probiotics (beneficial bacteria). This article provides scientific proof of the benefit of using cleaning products that contain probiotics. A study demonstrated that the use of probiotic cleaning is effective in reducing microbial growth in dental settings. Many of our customers in the medical field (veterinarians, doctors, and dentists), use our products in their practices.
During the study, probiotics were used to fight pathogens including, but are not limited to, Staphylococci, Streptococci, Mycobacterium tuberculosis, HIV, hepatitis viruses, and other microbes. Read the article to see the details of the actual study.
This article has been cited by other articles in PMC.
Farah Al-Marzooq,1 Shahad Al Bayat,2 Farah Sayyar,2 Hamdah Ishaq,2 Husain Nasralla,2 Rayan Koutaich,2 and Sausan Al Kawas2
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1Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
2Department of Oral and Craniofacial Health, College of Dental Medicine, University of Sharjah, Sharjah, UAE
Materials and Methods:
The current cleaning protocol of UDHS was evaluated by the surface swabbing of three dental clinics routinely cleaned using regular chemical disinfectants. Then, a new probiotic cleaning solution containing Bacillus subtilis was applied for 3 weeks in a selected clinic. Bacteria were grown onto selective culture media for colony counting from surfaces cleaned with probiotic solution compared to those obtained from the same surfaces cleaned with the regular chemical solutions. Isolates identity was confirmed by biochemical tests or polymerase chain reaction.
There was a significant reduction of the bacterial counts of various bacterial species (Staphylococci, Streptococci, and Gram-negative rods) from almost all the surfaces in the dental clinic after the application of the probiotic solution compared to the same surfaces cleaned with the regular chemical solutions. However, the antibiotic resistance rates were not significantly reduced within the short period of 3 weeks of using the new probiotic cleaning product.
This study demonstrated that the use of probiotic cleaning is effective in reducing microbial growth in dental settings. This approach may be tested further to examine the long-term effect and to evaluate the opportunity of applying this novel biotechnology as part of the infection control routine in dental settings instead of the chemical disinfectants which are known to cause serious health problems. This is the first study testing the application of probiotic-based solution in dental settings.
Microbes contaminating the environment of dental clinics represent a major source of transmission of healthcare-associated infections. In the dental clinics, infections can be acquired through the aerosols, blood, saliva, and respiratory secretions. Organisms residing in the oral cavity or respiratory tract can be transmitted during dental practice. These pathogens include, but are not limited to, Staphylococci, Streptococci, Mycobacterium tuberculosis, HIV, hepatitis viruses, and other microbes. Therefore, proper implementation of strict infection control measures is critical for both patients and dentists’ safety.
As part of the routine infection control measures, cleaning of the surfaces in the dental clinic is recommended before and after treating each patient. The use of regular chemical cleaning products has adverse health effects, especially on those exposed to the chemical disinfectants very frequently, including nurses and dentists spending long hours in the clinics and being exposed to the chemical disinfectants through inhalation or direct contact with the skin or eyes. Continuous use of regular chemical disinfectants and detergents in cleaning the dental clinics may not remove all the pathogens completely. In addition, the persistent use of disinfectants may lead to the selection of drug resistant organisms “superbugs” in the environment.
Recently, an innovative approach, based on biotechnology cleaning products has been adopted to eliminate the growth of several pathogens contaminating hospital surfaces. These biotechnology cleaning products contain probiotic bacteria, mostly from the Bacillus family. Bacillus subtilis is one of the commonly used Bacillus species in probiotic cleaning. It is a Gram-positive, rod-shaped bacterium, producing heat-resistant spores, and commonly found in the soil. These nonpathogenic bacteria are considered as a GRAS (generally recognized as safe) organism as they do not deemed to cause human diseases, with no impact on plants or animals. B. subtilis can produce antimicrobial components active against many dangerous pathogenic bacteria.[6,7] Due to their safety and activity on pathogens, biotechnology products have been used in hospitals. Many studies have been conducted on the efficacy of probiotic sanitation, specifically using strains from the Bacillus family, demonstrating a significant reduction in microbial contamination with a stable effect over time.[1,8] These studies were conducted in medical hospitals; however, probiotic cleaning in dental clinics was not investigated previously.
The growth of nosocomial pathogens on different surfaces of the dental clinics has been documented in many studies, whereby ordinary chemical disinfectants were used to clean different surfaces.[9,10] In our study, we aimed to test the antibacterial effect of a probiotic solution on the pathogens in different parts of a dental clinic at a University Dental Hospital in Sharjah (UDHS), UAE, compared to regular chemical disinfectants being used in routine infection control guidelines at the same hospital.
Go to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178676/ to see the Materials and methods of the study. (Scientific details)
New alternatives to the chemical disinfectants are biotechnology cleaning products containing environment-friendly probiotic bacteria. B. subtilis is one of the commonly used species in probiotic cleaning. They are nonpathogenic, ubiquitous in nature as they are found in soil, water, vegetables, and in human gut. These spore-forming bacteria are suitable for addition to eco-sustainable detergents, as the spores can stay viable in the concentrated cleansers and can produce the vegetative bacteria when diluted in water and seeded on surfaces.
In this study, we have applied one of the probiotic biotechnology cleaning solutions on different surfaces in a selected dental clinic for 3 weeks. Despite the short duration of this study, we noticed significant reduction in the microbial counts on most of the tested surfaces. Our results are in agreement with recent reports indicating that probiotic-based sanitation had stronger effect on surface pathogens compared to conventional disinfectants. It is worth mentioning that previous studies were all done in medical-surgical hospitals.[1,8] To the best of our knowledge, application of cleaning solution with probiotic bacteria in a dental hospital or clinic was not reported before our study.
The probiotic cleaning solution was effective against various bacterial species (Staphylococci, Streptococci, and Gram-negative rods), which were significantly reduced from almost all the surfaces in the dental clinic after the application of the cleaning product. It is not surprising to detect bacteria of oral origin in the dental clinic environment which are probably disseminated from the aerosol generated during different dental procedures. After contaminating the environment, transmission of these bacteria can occur through contact with contaminated surfaces such as door handles, benches, towels, and taps. Some of these bacteria represent serious risk to human health. methicillin-resistant S. aureus (MRSA) is a pathogenic bacteria causing wide range of infections ranging from skin infections to life-threatening pneumonia and sepsis. Some studies reported the oral carriage of S. aureus, sometimes MRSA, in healthy children and adults as well as in patients with oral diseases such as periodontitis, gingivitis, failing dental implants, and patients with acrylic dentures. Staphylococci from different species were also isolated from the oral cavity of immunocompromised patients like elderly and children with hematological malignancies and patients with rheumatoid arthritis. We have detected several Gram-negative pathogens, including K. pneumoniae, Pseudomonas, and E. coli, in different parts of the dental clinic. Some of these bacteria can exist as colonizers in the oral cavity;[19,20] however, many of them are potentially pathogenic and responsible for various types of infections, especially nosocomial infections. Probiotic cleaning is a promising approach for the eradication of these bacteria to minimize their health risks.
In general, we did not detect any significant difference in the antibiotic resistance rates of strains isolated from the surfaces cleaned with the regular cleaning solution compared to probiotic cleaning solution. Some studies reported reduction in the antibiotic resistant bacteria after the application of probiotic-based cleaning products, but this effect probably needs long duration of application as reported in a study done in a hospital in Italy, whereby the Bacillus- based probiotic product was applied for several months. After this long duration, significant decrease in the antibiotic resistance genes was evident in the bacteria isolated from the surfaces cleaned with the probiotic product compared to the original bacteria that were existing while the same surfaces were cleaned using chemical disinfectants.
We found that probiotic cleaning is better than using chemical disinfectants which usually eliminate surface pathogens immediately; however, they are ineffective in preventing recontamination and pathogens regrowth occurring within a few hours after cleaning. Another disadvantage of using chemical disinfectants is that they enhance the selection of antibiotic-resistant strains. It has been reported that long exposure of K. pneumoniae to chlorhexidine-containing disinfectants led to the development of resistance to multiple commonly used antibiotics due to the development of mutations in these bacteria.
The effectiveness of probiotic cleaning and the reduction in bacterial count were mostly related to the mechanism of action of the probiotic bacteria “B. subtilis” in the biotechnology cleaning solution, as it can reach to hidden areas that are hard to clean. Probiotic bacteria are able to disturb biofilms that function as a shelter for other pathogens; thus, facilitate their killing and elimination from hard to reach areas. In addition, they are able to kill other bacteria by competing with them for the space and nutrients.[8,24] Thus, the replacement of the pathogenic bacteria by B. subtilis in the cleaning product was observed obviously on HiCrome UTI Agar which allowed the growth of B. subtilis in addition to Gram-negative bacteria. Based on several studies, B. subtilis is well known for the ability to produce multiple compounds with antimicrobial properties. For example, bacteriocins, lantibiotics (peptide antibiotics), and lantibiotic-like peptides.[23,24] It is possible that the antimicrobial compounds produced by the B. subtilis present in the probiotic cleaning product may also contribute to the killing effect observed in our study.
The application of probiotic cleaning solution was found effective in limiting bacterial growth in different parts of the dental clinic. They are eco-friendly; thus, they can reduce the exposure to chemical disinfectants and will reduce the selection of resistant bacteria. It is necessary to establish a new biosafety protocol in dental clinics which includes adequate disinfection of surfaces by appropriate cleaning products. The information obtained from this study can be used to develop proper interventions to improve cleaning and disinfection practices in dental institutions.
Financial support and sponsorship
The study was financially supported by University of Sharjah, wound healing and oral diagnosis research group grant number 150307.
Conflicts of interest
There are no conflicts of interest.
The authors would like to thank Innu Science, Middle East, Dubai, for supplying the novel probiotic cleaning solution used in the study. The authors would like to thank Mr. Steve Teasdale (Innu Science, Canada) and Mr. Ali Mohri (Innu Science, Middle East, Dubai) for sharing insights on the potential of the application of the probiotic-based biotechnology cleaning solution used in our experiments.
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