Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative Species

Biocidal agents used for disinfection are usually not suspected to enhance cross-resistance to antibiotics. The aim of this review was therefore to evaluate the effect of 13 biocidal agents at sublethal concentrations on antibiotic resistance in Gram-negative species. A medline search was performed...

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Main Author: Günter Kampf
Format: Article
Language:English
Published: MDPI AG 2018-12-01
Series:Antibiotics
Subjects:
Online Access:https://www.mdpi.com/2079-6382/7/4/110
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author Günter Kampf
author_facet Günter Kampf
author_sort Günter Kampf
collection DOAJ
description Biocidal agents used for disinfection are usually not suspected to enhance cross-resistance to antibiotics. The aim of this review was therefore to evaluate the effect of 13 biocidal agents at sublethal concentrations on antibiotic resistance in Gram-negative species. A medline search was performed for each biocidal agent on antibiotic tolerance, antibiotic resistance, horizontal gene transfer, and efflux pump. In cells adapted to benzalkonium chloride a new resistance was most frequently found to ampicillin (eight species), cefotaxime (six species), and sulfamethoxazole (three species), some of them with relevance for healthcare-associated infections such as <i>Enterobacter cloacae</i> or <i>Escherichia coli</i>. With chlorhexidine a new resistance was often found to ceftazidime, sulfamethoxazole and imipenem (eight species each) as well as cefotaxime and tetracycline (seven species each). Cross-resistance to antibiotics was also found with triclosan, octenidine, sodium hypochlorite, and didecyldimethylammonium chloride. No cross-resistance to antibiotics has been described after low level exposure to ethanol, propanol, peracetic acid, polyhexanide, povidone iodine, glutaraldehyde, and hydrogen peroxide. Taking into account that some biocidal agents used in disinfectants have no health benefit (e.g., in alcohol-based hand rubs) but may cause antibiotic resistance it is obvious to prefer products without them.
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spelling doaj.art-0d5e189e2db54586aafc5e9bc92a9bc62022-12-22T00:35:10ZengMDPI AGAntibiotics2079-63822018-12-017411010.3390/antibiotics7040110antibiotics7040110Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative SpeciesGünter Kampf0University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, 17475 Greifswald, GermanyBiocidal agents used for disinfection are usually not suspected to enhance cross-resistance to antibiotics. The aim of this review was therefore to evaluate the effect of 13 biocidal agents at sublethal concentrations on antibiotic resistance in Gram-negative species. A medline search was performed for each biocidal agent on antibiotic tolerance, antibiotic resistance, horizontal gene transfer, and efflux pump. In cells adapted to benzalkonium chloride a new resistance was most frequently found to ampicillin (eight species), cefotaxime (six species), and sulfamethoxazole (three species), some of them with relevance for healthcare-associated infections such as <i>Enterobacter cloacae</i> or <i>Escherichia coli</i>. With chlorhexidine a new resistance was often found to ceftazidime, sulfamethoxazole and imipenem (eight species each) as well as cefotaxime and tetracycline (seven species each). Cross-resistance to antibiotics was also found with triclosan, octenidine, sodium hypochlorite, and didecyldimethylammonium chloride. No cross-resistance to antibiotics has been described after low level exposure to ethanol, propanol, peracetic acid, polyhexanide, povidone iodine, glutaraldehyde, and hydrogen peroxide. Taking into account that some biocidal agents used in disinfectants have no health benefit (e.g., in alcohol-based hand rubs) but may cause antibiotic resistance it is obvious to prefer products without them.https://www.mdpi.com/2079-6382/7/4/110biocidecross-resistancecross-toleranceantibioticsantiseptic stewardship
spellingShingle Günter Kampf
Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative Species
Antibiotics
biocide
cross-resistance
cross-tolerance
antibiotics
antiseptic stewardship
title Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative Species
title_full Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative Species
title_fullStr Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative Species
title_full_unstemmed Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative Species
title_short Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative Species
title_sort biocidal agents used for disinfection can enhance antibiotic resistance in gram negative species
topic biocide
cross-resistance
cross-tolerance
antibiotics
antiseptic stewardship
url https://www.mdpi.com/2079-6382/7/4/110
work_keys_str_mv AT gunterkampf biocidalagentsusedfordisinfectioncanenhanceantibioticresistanceingramnegativespecies