Biocidal Resistance in Clinically Relevant Microbial Species: A Major Public Health Risk

Abstract

Antimicrobial resistance is one of the greatest dangers to public health of the 21st century, threatening the treatment and prevention of infectious diseases globally. Disinfection, the elimination of microbial species via the application of biocidal chemicals, is essential to control infectious diseases and safeguard animal and human health. In an era of antimicrobial resistance and emerging disease, the effective application of biocidal control measures is vital to protect public health. The COVID-19 pandemic is an example of the increasing demand for effective biocidal solutions to reduce and eliminate disease transmission. However, there is increasing recognition into the relationship between biocide use and the proliferation of Antimicrobial Resistance species, particularly multidrug-resistant pathogens. The One Health approach and WHO action plan to combat AMR require active surveillance and monitoring of AMR species; however, biocidal resistance is often overlooked. ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens and numerous fungal species have demonstrated drug and biocidal resistance where increased patient mortality is a risk. Currently, there is a lack of information on the impact of biocide application on environmental habitats and ecosystems. Undoubtedly, the excessive application of disinfectants and AMR will merge to result in secondary disasters relating to soil infertility, loss of biodiversity and destruction of ecosystems.

Effective Antimicrobial Solutions for Eradicating Multi-Resistant and β-Lactamase-Producing Nosocomial Gram-Negative Pathogens

“…Whilst offering alternative therapeutics is one way of dealing with rising antibiotic resistance, a more useful method to combat the issue is working towards infection prevention. Effective biocidal options play a crucial role in reducing drug-resistant bacteria and their biofilm counterparts that persist on clinical surfaces and the surrounding environment, where the current emergence of biocide-resistant bacterial strains have made it even more difficult to eliminate them [ 6 ]. In the present study, all biocidal agents, including peracetic acid, triameen and BAC demonstrated excellent activity against MDR GNB at concentrations recommended by the manufacturer (0.1%) ( Table 4 and Figure 2 ).…”

“…Studies report a prevalence of 8% of hospitalised patients developing HAIs, with 20% of these involving MDR species having a higher risk of mortality or re-admission [ 4 ] The European Centre for Disease Prevention and Control (ECDC) estimates approximately 8.9 million HAIs yearly in Europe, with the Gram-negative Pseudomonas aeruginosa and the Enterobacterale Escherichia coli prominent agents of disease [ 5 ]. Importantly, Gram-negative non-fermenting species such as P. aeruginosa are intrinsically resistant to common antibiotics such as ampicillin, cephalosporins, and macrolides, where MDR is common [ 6 ]. The extended-spectrum β-lactamase enzymes (CTX-M, TEM, SHV, PER, VEB, and TLA) which hydrolyse extended-spectrum cephalosporins and penicillins are abundant in GNB and are plasmid transferrable, promoting pan-resistance in species [ 1 ].…”

“…As antibiotic therapy options become increasingly limited for these GNB, prevention of transmission is essential to reduce the spread of such high-risk organisms. Alarmingly, the presence of biocide resistance has emerged in AMR species, where sublethal biocidal exposure proliferates resistance in numerous species [ 6 ]. For example, evidence of resistance to quaternary ammonium compounds (QACs) and benzalkonium chloride (BAC) in MDR species due to the presence biocidal resistance genes (BRGs) has emerged, including the qacE and qacA/B genes common in the Enterobacteriaceae family and Pseudomonas species [ 10 ].…”

Environmental impacts of the widespread use of chlorine-based disinfectants during the COVID-19 pandemic

“…In all cases, chlorine compounds can react with a vast range of organic and inorganic materials and other anthropogenic chemicals. This leads to the formation of DBPs in different types of aquatic systems like wastewater, surface water, and tap water due to elevated CBD application (Li et al 2021 ; Meade et al 2021 ; Paul et al 2021 ; Wang et al 2021 ).…”

Deep Functional Profiling of Wild Animal Microbiomes Reveals Probiotic Bacillus pumilus Strains with a Common Biosynthetic Fingerprint

“…The biodiversity of microbial communities is maintained by the counteraction of the production and degradation of antibiotics [1]. The external influence of disinfectants and antibiotics drives additional selective pressures, dramatically reducing the biodiversity of microbiomes [2,3] and providing conditions for antibiotic resistance propagation [4] and evolution [5]. Reduced microbiome biodiversity, in turn, is attributed to its impaired functionality [6,7] and health disorders [8], including the emergence and transmission of infectious diseases [9], autoimmune diseases [10,11], and allergic diseases [12,13].…”