Biocidal Agents Used for Disinfection Can Enhance Antibiotic Resistance in Gram-Negative Species
Open accessAbstract
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 Enterobacter cloacae or Escherichia coli. 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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Chemical disinfectants have a tendency to increase the degree of antimicrobial resistance in potential human pathogens.
“While disinfectants are rapidly effective, they have several important limitations, including temporary action [7, 8], high environmental impact, and a tendency to increase the degree of antimicrobial resistance (AMR) in potential human pathogens [9].”
From Profiling the resistome and virulome of Bacillus strains used for probiotic-based sanitation: a multicenter WGS analysis (2025) · cites this paper as [9]
The Abstract reports that several disinfectant agents can increase antibiotic resistance in Gram-negative species, including pathogens relevant to healthcare-associated infections. But the review concerns sublethal exposure and also reports no described cross-resistance for seven agents; it does not establish a general tendency for chemical disinfectants as a whole. (LLM, conf=0.86)
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References 90 · Cited by 230
Research works printed but not linked: 2
- [77]Kampf G. Antiseptic stewardship for alcohol-based hand rubs Antiseptic Stewardship: Biocide Resistance and Clinical Implications Kampf G. Springer International Publishing Cham, Switzerland 2018 643 650
- [81]Kampf G. Antiseptic stewardship for skin antiseptics Antiseptic Stewardship: Biocide Resistance and Clinical Implications Kampf G. Springer International Publishing Cham, Switzerland 2018 651 660
- Authors
- Kampf, G.
- Affiliations
- Universitätsmedizin Greifswald (DE)
- Corresponding author
- Kampf, Günter
- ORCID
- Kampf, Günter
- Venue
- Antibiotics
- Publisher
- MDPI AG
- Published
- 2018-12-14
- Volume
- 7
- Issue
- 4
- Pages
- 110
- ISSN
- 2079-6382 (ISSN-L)
- PMC
- PMC6316403
- OpenAlex
- W2905122874
- Cited by
- 230
- References
- 90
- Citations by year
- 2026: 12 · 2025: 23 · 2024: 33 · 2023: 35 · 2022: 45 · 2021: 42 · 2020: 26 · 2019: 13 · 2017: 1
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Antibiotics (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Physical Sciences › Chemistry › Organic Chemistry › Antimicrobial agents and applications
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- disinfectants, biocides, antibiotic resistance, cross-resistance, Gram-negative bacteria, benzalkonium chloride, chlorhexidine, triclosan, octenidine, sodium hypochlorite, didecyldimethylammonium chloride, horizontal gene transfer, efflux pumps, ampicillin resistance, cefotaxime resistance, sulfamethoxazole resistance, nosocomial infections, alcohol-based hand rub
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