Wessels Stephen, Ingmer Hanne
DHI, Agern Allé 5, DK-2970 Hørsholm, Denmark.
Regul Toxicol Pharmacol. 2013 Dec;67(3):456-67. doi: 10.1016/j.yrtph.2013.09.006. Epub 2013 Sep 27.
This review deals with three categories of active substances for disinfectant products, their modes of action (MOA), and how MOA can help predict propensity for resistance in microorganisms. Within the European Union applications for approval of disinfectants of all kinds must be submitted in a few years, and documentation on MOA and resistance must be part of those applications. Peracetic acid is an unspecific, pervasive oxidizer of C-C double bonds and reduced atoms. This MOA would imply poor chance for development of resistance in microorganisms, as borne out by the absence of such reports in the literature. The quaternary ammonium compounds (QAC's) are much more specific in their antimicrobial mechanism. Even very low concentrations cause damage to the cytoplasmic membrane due to perturbation of the bilayers by the molecules' alkyl chains. Development of microbial resistance to QAC's, as well as cross-resistance to antibiotics, are particularly well documented. The polymer PHMB is antimicrobial because it disturbs the cell membrane's bilayer by interacting with it along the surface of the membrane. Resistance to the polymer appears not to develop despite many years of use in many fields. However, PHMB's toxicity to humans upon inhalation dictates great caution when deploying the substance.
本综述涉及消毒产品的三类活性物质、它们的作用方式（MOA），以及作用方式如何有助于预测微生物产生耐药性的倾向。在欧盟，各类消毒剂的批准申请必须在几年内提交，而关于作用方式和耐药性的文件必须作为这些申请的一部分。过氧乙酸是一种对碳 - 碳双键和还原原子具有非特异性、普遍性的氧化剂。这种作用方式意味着微生物产生耐药性的可能性很小，正如文献中没有此类报告所证明的那样。季铵化合物（QAC）在其抗菌机制上更为特异。即使是非常低的浓度也会由于分子的烷基链对双层膜的扰动而对细胞质膜造成损害。微生物对QAC产生耐药性以及对抗生素产生交叉耐药性的情况有特别充分的文献记载。聚合物聚六亚甲基双胍具有抗菌作用，因为它通过沿细胞膜表面与之相互作用而扰乱细胞膜的双层结构。尽管在许多领域使用多年，但似乎并未出现对该聚合物的耐药性。然而，聚六亚甲基双胍吸入对人体有毒性，因此在使用该物质时需要格外谨慎。
