Chun Hye-Sun, Park Chulmin, Nho Dukhee, Lee Raeseok, Cho Sung-Yeon, Kim Chang-Joo, Lee Dong-Gun
Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea Seoul, Korea.
Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Infect Chemother. 2024 Dec;56(4):522-533. doi: 10.3947/ic.2024.0097.
Healthcare-associated infections (HAI) caused by multidrug-resistant organisms have emerged as a significant global issue, posing substantial challenges to healthcare systems. Low- and intermediate-level disinfectants are extensively utilized for cleaning and disinfecting surfaces in hospitals to mitigate environmental transmission of HAI. Therefore, the need for more effective and environmentally safe disinfectants is increasing. This study aimed to assess the effect of antimicrobial wipes used for surface cleaning and disinfection in healthcare environments.
A microbe library comprising 188 bacterial and fungal isolates, including multidrug-resistant strains, was established and used to evaluate the antimicrobial effect of three types of antimicrobial wipes: A (didecyldimethylammonium chloride [DDAC] 0.31% and 3-(trimethoxysilyl)-propyldimethyloctadecyl ammonium chloride [Si-QAC] 0.45%); B (benzalkonium chloride [BAK] 0.63%); and C (DDAC 0.5% and BAK 0.9%). The antimicrobial effect of the wipes was assessed and compared in three assays: rapid bactericidal effect assay of the three wipes, minimum inhibitory concentration (MIC) assay of DDAC and BAK, and a time-kill assay of the DDAC and Si-QAC combination.
The rapid antimicrobial effect evaluation showed that both wipes A and C, which contain a combination of two quaternary ammonium compounds (QACs), exhibited similar antimicrobial effect (=0.8234). Antimicrobial wipe A demonstrated better effect against Gram-positive bacteria and fungi than wipe C ( <0.05). The antimicrobial efficacy of the A wipe against strains was superior to that of both the B and C wipes. Moreover, DDAC exhibited MIC₅₀ values that were 2 to 3-fold lower than those of BAK for Gram-negative bacteria and fungi. The time-kill assay results for the DDAC and Si-QAC combination exhibited a growth reduction of >3 logs for and whereas approximately 2 logs of reduction was observed for and at 3 hour.
The results suggest that antimicrobial wipes containing relatively lower concentrations of QAC (wipe A) achieve similar rapid bactericidal effect as that of those with higher concentrations (wipe C). For Gram-negative bacteria, including multidrug-resistant strains and fungal isolates, DDAC presented lower MICs compared with BAK. Furthermore, the combination therapy with DDAC and Si-QAC demonstrated enhanced efficacy compared to treatment with either agent alone, except in the case of strains. Further research is needed to develop antimicrobial wipes that minimize the environmental impact while ensuring effective disinfection.
由多重耐药菌引起的医疗保健相关感染(HAI)已成为一个重大的全球问题,给医疗保健系统带来了巨大挑战。低水平和中等水平消毒剂被广泛用于医院表面的清洁和消毒,以减少HAI的环境传播。因此,对更有效且环境安全的消毒剂的需求日益增加。本研究旨在评估用于医疗环境中表面清洁和消毒的抗菌湿巾的效果。
建立了一个包含188种细菌和真菌分离株(包括多重耐药菌株)的微生物库,并用于评估三种抗菌湿巾的抗菌效果:A(0.31%双癸基二甲基氯化铵[DDAC]和0.45% 3-(三甲氧基甲硅烷基)丙基二甲基十八烷基氯化铵[Si-QAC]);B(0.63%苯扎氯铵[BAK]);C(0.5% DDAC和0.9% BAK)。在三种试验中评估并比较了湿巾的抗菌效果:三种湿巾的快速杀菌效果试验、DDAC和BAK的最低抑菌浓度(MIC)试验以及DDAC和Si-QAC组合的时间-杀菌试验。
快速抗菌效果评估表明,含有两种季铵化合物(QACs)组合的湿巾A和C均表现出相似的抗菌效果(=0.8234)。抗菌湿巾A对革兰氏阳性菌和真菌的效果优于湿巾C(<0.05)。A湿巾对菌株的抗菌效力优于B和C湿巾。此外,对于革兰氏阴性菌和真菌,DDAC的MIC₅₀值比BAK低2至3倍。DDAC和Si-QAC组合的时间-杀菌试验结果显示,对于和,生长减少>3个对数,而对于和,在3小时时观察到约2个对数的减少。
结果表明,含有相对较低浓度QAC的抗菌湿巾(湿巾A)与高浓度湿巾(湿巾C)具有相似的快速杀菌效果。对于革兰氏阴性菌,包括多重耐药菌株和真菌分离株,DDAC的MICs低于BAK。此外,与单独使用任何一种药物相比,DDAC和Si-QAC的联合治疗显示出增强的疗效,但菌株除外。需要进一步研究开发在确保有效消毒的同时尽量减少环境影响的抗菌湿巾。