Ecolab Deutschland GmbH, Düsseldorf, Germany.
J Hosp Infect. 2010 Nov;76(3):200-5. doi: 10.1016/j.jhin.2010.05.020. Epub 2010 Jul 17.
Increased numbers of healthcare-acquired infections, including those caused by antibiotic-resistant microbes, have created a need for improved infection control use of disinfection regimens. Commensurate with this has been an increasing number of reports on resistance to a wide variety of antimicrobials, including biocides. Cross-resistance between these biocides and other biocidal or antimicrobial agents has been well-documented. Much of the literature lacks clear distinctions between adaptation of organisms to exposure to biocides, which reverses upon removal of the biocide, as opposed to resistance. Depending on the genetic basis of this resistance, it may be high level and not readily reversible. This lack of clear definitions complicates the evaluation of the relevance of these phenomena in practice. In this review we propose definitions of adaptative processes and biocide resistance and survey the literature according to these definitions. We conclude that the current risks to healthcare delivery caused by resistance related to biocides are low, provided that biocides are used under appropriate conditions. The need for further research is addressed.
医疗机构获得性感染（HAIs）的数量不断增加，包括由抗生素耐药微生物引起的感染，这使得人们需要改进感染控制和消毒剂的使用方案。相应地，关于各种抗生素（包括消毒剂）耐药的报告也越来越多。这些消毒剂与其他消毒剂或抗菌剂之间存在交叉耐药性，这已得到充分证实。许多文献缺乏对生物体适应消毒剂暴露的明确区分，这种适应在去除消毒剂后会逆转，而不是耐药性。根据这种耐药性的遗传基础，它可能是高水平的，并且不易逆转。这种缺乏明确定义的情况使这些现象在实践中的相关性评估变得复杂。在这篇综述中，我们提出了适应性过程和消毒剂耐药性的定义，并根据这些定义对文献进行了调查。我们得出的结论是，只要消毒剂在适当的条件下使用，目前由消毒剂相关耐药性对医疗保健带来的风险是低的。我们还提到了进一步研究的必要性。
