Wesgate Rebecca, Grasha Pierre, Maillard Jean-Yves
Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
Deb Group, Denby, UK.
Am J Infect Control. 2016 Apr 1;44(4):458-64. doi: 10.1016/j.ajic.2015.11.009. Epub 2016 Jan 22.
In this study we assessed the propensity of biocide exposure in the development of antimicrobial resistance in bacteria.
Our protocol is based on reporting changes in established antimicrobial susceptibility profiles in biocides and antibiotics after during use exposure to a product. The during use exposure reflects worse conditions of product use during application. It differs from the term low concentration, which usually reflects a concentration below the minimal inhibitory concentration, but not necessarily a concentration that occurs in practice.
Our results showed that exposure to triclosan (0.0004%) was associated with a high risk of developing resistance and cross-resistance in Staphylococcus aureus and Escherichia coli. This was not observed with exposure to chlorhexidine (0.00005%) or a hydrogen peroxide-based biocidal product (in during use conditions). Interestingly, exposure to a low concentration of hydrogen peroxide (0.001%) carried a risk of emerging resistance to antibiotics if the presence of the oxidizing agent was maintained. We observed a number of unstable clinical resistances to antibiotics after exposure to the cationic biocide and oxidizing agent, notably to tobramycin and ticarcillin-clavulanic acid.
Using a decision tree based on the change in antimicrobial susceptibility test results, we were able to provide information on the effect of biocide exposure on the development of bacterial resistance to antimicrobials. Such information should address the call from the U.S. Food and Drug Administration and European Union Biocidal Products Regulation for manufacturers to provide information on antimicrobial resistance and cross-resistance in bacteria after the use of their product.
在本研究中，我们评估了杀菌剂暴露在细菌产生抗微生物药物耐药性过程中的倾向。
我们的方案基于报告在使用某种产品期间，杀菌剂和抗生素的既定抗菌药敏谱的变化。使用期间的暴露反映了产品在应用过程中更恶劣的使用条件。它与低浓度这一术语不同，低浓度通常反映低于最低抑菌浓度的浓度，但不一定是实际出现的浓度。
我们的结果表明，接触三氯生（0.0004%）与金黄色葡萄球菌和大肠杆菌产生耐药性及交叉耐药性的高风险相关。接触洗必泰（0.00005%）或基于过氧化氢的杀菌产品（在使用期间的条件下）未观察到这种情况。有趣的是，如果维持氧化剂的存在，接触低浓度的过氧化氢（0.001%）会有出现抗生素耐药性的风险。在接触阳离子杀菌剂和氧化剂后，我们观察到对多种抗生素存在不稳定的临床耐药性，尤其是对妥布霉素和替卡西林 - 克拉维酸。
通过基于抗菌药敏试验结果变化的决策树，我们能够提供有关杀菌剂暴露对细菌产生抗微生物药物耐药性影响的信息。此类信息应回应美国食品药品监督管理局和欧盟杀菌产品法规对制造商的要求，即要求他们提供有关产品使用后细菌中的抗微生物药物耐药性和交叉耐药性的信息。
