Popular hospital disinfectants ineffective against common superbugs

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Popular hospital disinfectants ineffective against common superbugs

A new study has found that hospital disinfectants, including high concentrations of bleach, are ineffective against Clostridium difficile spores, a major cause of antibiotic-related diseases.

This discovery highlights the urgency of adopting new disinfection methods, as the impact of antibiotic resistance and Clostridium difficile infections is increasingly gaining attention worldwide.

Popular hospital disinfectants ineffective against common superbugs

Research conducted during the World Antibiotic Awareness Week explored the effectiveness of chlorine-based chemicals recommended to combat Clostridium difficile, a leading cause of antibiotic-related diseases in global healthcare environments.

The latest study reveals that a major chlorine disinfectant used in hospitals fails to eliminate the primary cause of antibiotic-related diseases in global healthcare environments. This finding comes from research conducted at the University of Plymouth.

The study examined the spore reactions of three different strains to three clinical concentrations of sodium hypochlorite. Spores were then added to surgical and patient gowns, and examined using scanning electron microscopy to determine if there were any morphological changes in the spore coats.

The research indicates that despite many hospitals using high concentrations of bleach for treatment, Clostridium difficile spores, also known as C. difficile, remain entirely unaffected. In fact, chlorine-based chemicals used as surface disinfectants are no more effective at destroying spores than using water without additives.

The authors of the study, writing in the journal “Microbiology,” suggest that individuals working and undergoing treatment in clinical environments may unknowingly face the risk of infection from this superbug.

As the overuse of biocides contributes to the rise of global antimicrobial resistance (AMR), the researchers call for urgent studies to find alternative methods to disinfect Clostridium difficile spores and break the transmission chain in clinical environments.

Dr. Tina Joshi, Associate Professor of Molecular Microbiology at the University of Plymouth, and fourth-year medical student Humaira Ahmed, jointly conducted this research.

Dr. Joshi stated, “With the increasing incidence of antimicrobial resistance, the threat of superbugs to human health is also on the rise. However, this study not only fails to prove that our clinical environments are clean and safe for staff and patients, but it emphasizes the ability of C. difficile spores to tolerate disinfection at recommended active chlorine concentrations. It suggests that we need disinfectants and guidelines that are fit for purpose and align with the evolution of bacteria, and this study should have significant implications for current disinfection protocols in the global healthcare sector.”

Clostridium difficile is a microorganism that can cause diarrhea, colitis, and other intestinal complications, infecting millions globally each year. It results in approximately 29,000 deaths in the United States and nearly 8,500 deaths in Europe annually. Recent data indicates an increasing incidence of Clostridium difficile infections in the UK before the onset of the COVID-19 pandemic.

Dr. Joshi and colleagues had previously demonstrated the survival of Clostridium difficile spores when exposed to recommended concentrations of liquid sodium dichloroisocyanurate and personal protective fabrics, such as surgical gowns.

Dr. Joshi, a member of the Microbiology Society Council and Co-Chair of the Impact and Influence Committee, added, “Understanding how these spores interact with disinfectants is crucial for effectively managing Clostridium difficile infections and reducing the burden of infections in healthcare institutions. However, there are still unanswered questions about the tolerance of Clostridium difficile to disinfectants and whether it will be influenced by antibiotic co-resistance. With the continuous increase of AMR globally, it is now more urgent than ever to find answers to these questions, whether for Clostridium difficile or other superbugs.”

What is antibiotic resistance?

Antibiotic resistance occurs when bacteria, viruses, parasites, or fungi evolve and become less responsive or completely resistant to the effects of antibiotics.

This phenomenon is a natural process accelerated by the overuse and misuse of antibiotics in both humans and animals. Antibiotic resistance poses a significant global threat to public health, as it can lead to increased morbidity, mortality, and higher healthcare costs.

Key points about antibiotic resistance include:

Mechanisms of Resistance:
- Genetic Mutation: Bacteria can undergo genetic mutations that make them less susceptible to the effects of antibiotics.
- Horizontal Gene Transfer: Bacteria can also acquire resistance genes from other bacteria through processes like conjugation, transformation, and transduction.
Causes of Antibiotic Resistance:
- Overuse and Misuse: Inappropriate use of antibiotics, such as not completing a prescribed course or using antibiotics when they are not needed, contributes to the development of resistance.
- Inadequate Dosage: Incorrect dosage or improper use of antibiotics can fail to eliminate all the bacteria, allowing the surviving bacteria to develop resistance.
- Use in Agriculture: The use of antibiotics in livestock for growth promotion and disease prevention contributes to the overall increase in antibiotic resistance.
Impact on Public Health:
- Treatment Failures: Antibiotic-resistant infections are harder to treat and may require more extended hospital stays, more potent and expensive medications, and sometimes more invasive procedures.
- Increased Mortality: Patients with antibiotic-resistant infections are at a higher risk of mortality compared to those with susceptible infections.
- Spread of Resistant Strains: Resistant bacteria can spread within healthcare settings, communities, and globally, making it challenging to control outbreaks.
Global Concern:
- World Health Organization (WHO): The WHO has identified antibiotic resistance as one of the most significant threats to global health. They promote the responsible use of antibiotics, the development of new antibiotics, and global surveillance to monitor and combat resistance.
Initiatives and Solutions:
- Stewardship Programs: Antibiotic stewardship programs aim to optimize the use of antibiotics to treat infections and reduce the development of resistance.
- Research and Development: There is a need for continued research to develop new antibiotics, alternative treatments, and vaccines to prevent infections.
- Global Collaboration: Addressing antibiotic resistance requires international cooperation to regulate the use of antibiotics in humans and animals, improve surveillance, and share information and best practices.
Individual and Community Actions:
- Proper Antibiotic Use: Individuals can contribute by taking antibiotics only when prescribed by a healthcare professional and completing the full course of treatment.
- Prevention: Preventing infections through vaccination, good hygiene practices, and infection control measures can reduce the need for antibiotics.

In summary, antibiotic resistance is a complex and urgent global health issue that requires a multifaceted approach involving healthcare providers, policymakers, researchers, and the general public to mitigate its impact and preserve the effectiveness of antibiotics for future generations.