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Background: Contamination of healthcare surfaces contributes to Healthcare-associated infections (HAIs)\udtransmission, representing a global concern. Conventional chemicals-based sanitation shows limitations in\udcontrolling surface contamination and related HAIs onset, and can select multi-resistant pathogen species. Recently,\uda sanitizing procedure involving probiotic-based detergents was shown to decrease surface pathogens up to 90%\udmore than conventional disinfectants, without selecting resistant species. This study aims to analyse the influence of\uda probiotic-based sanitizing intervention on HAIs incidence and typology.\udDesign: Seven Italian hospitals representative of all Italian geographical areas will be recruited for participation in\uda multicentre, prospective, randomised, pre-post interventional study, analysing simultaneously for a consecutive 18-\udmonths period both microbial surface contamination and HAIs occurrence. The intervention will consist in the\udsubstitution of the conventional cleaning procedure (chlorine-based) with a probiotic-based one. In the preintervention\udphase, hospitals will maintain conventional sanitizing procedures; in the post-intervention phase, the\udprobiotic-based sanitation will be applied, allowing a buffer period for the stabilization of the new method.\udThe participating hospitals will be randomly allocated in the following groups: no-intervention (one hospital),\udintervention-1st group (three hospitals) and intervention-2nd group (three hospitals), entering the study with a 5-\udmonths delay.\udDuring the whole study period, all patients admitted to the recruited hospital wards will be continuously surveyed\udfor HAI occurrence. Meanwhile, surface bioburden will be monitored monthly by both biological and molecular\udassays.\udDiscussion: This study will be the first to provide robust data on the impact of sanitation procedures on\udhealthcare associated infections onset and typology, as no previously reported studies evaluates simultaneously and\udcontinuously for a period of 18 months both the environmental surface bioburden, its resistome and the healthcare\udassociated infections onset.\udResults: The results generated from this study might be important for the development of future guidelines to\udmodulate environmental microbiota and to ameliorate hospital environmental cleaning, implementing prevention\udstrategies to reduce HAIs onset

Influence of Sanitizing Methods on Healthcare-Associated Infections Onset: A Multicentre, Randomized, Controlled Pre-Post Interventional Study