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Resistance Is Futile If You Clean Properly

Rotation of similar products won’t make much difference in the end result, but rotating quats with bleach is still recommended

Rotation of similar products won’t make much difference in the end result, but rotating quats with bleach is still recommended

Does rotation of disinfectant products reduce the potential for antimicrobial resistance? Or is the whole premise of that question questionable?

Read all the articles from the July-August 2003 issue on cleaning and disinfecting your facility:

The Product Claim Game
Navigating the world of disinfectants, one bottle at a time

Defining the Terms
Clarification on some common terms you may encounter while developing a cleaning and disease control program for your facility.

The Bleach Niche
Is the old standby, sodium hypochlorite, still the gold standard?

Great Points in the Fine Print
Learning how to glean important information from a bottle label can help you narrow your choices of available products. Here are a few tips on learning the lingo.

Being Chemically Balanced Is No Guarantee
A cleaning a day keeps the bugs at bay, but the question is, how much cleaning should you do—and how frequently?

Don't Let the Fomites Get You Down
You may have had a hand in cross-infection in the past—without even knowing it

No one seems to know for sure, and that’s one reason some shelters stay on the safe side by using several different disinfectants, alternating products biweekly or bimonthly.

But while the misuse of antibiotics has been implicated in the development of resistant bacterial strains, there is little evidence to support the theory that disinfectants play a similar role. Unlike antibiotics, which either break down cell walls of bacteria or interfere with reproduction by blocking different biochemical pathways, surface disinfectants absorb onto microbial cells, writes OSHA Review publisher Rodney Stine in the November 2001 issue of Infection Control Today. “According to research ...such absorption increases the permeability of the cell membrane, ultimately leading to rupture and leakage of the contents of the cell,” he writes. “The cell dies. There is no chance for mutation.”

Viruses suffer a similar fate. Even if its genetic material survives, in the face of a strong enough disinfectant a virus will lose its ability to reproduce. “[Parvovirus] mutates very occasionally, but it’s not like a bacteria which is mutating to escape antibiotic treatment,” says Cornell University virologist Colin Parrish. “It’s more like it mutates because it’s hostadapting, and that’s something that happens over a very long period of time. We’ve seen nothing in the virus genome sequence that says that there are any changes that would be induced by a detergent or a disinfectant.”

Moreover, chemical concentrations in disinfectants are much higher than those of anything that’s ingested internally. “The thing about antibiotics is that they have to be a little gentler because the organism has to be able to take them in and not suffer toxic side effects,” says Kate Hurley, director of the Maddie’s Shelter Medicine Program at UC Davis. “So they can’t just trash the viruses and bacteria in the way that a disinfectant can get away with.”

“We’ve been using disinfectants for, in the case of bleach, a long time—pretty much since we knew about germs,” she says. “And we don’t see the kind of evolution or resistance that we do to antibiotics.”

Rotating a quat and a bleach is best, since bleach is effective against more microbes but quats can clean—and you’ll have a better chance of attacking your microbial enemies from all sides.
While some shelters rotate quaternary ammonium compounds, the quats are too similar in their mechanisms to make a difference, says Hurley. “It’s just like rotating two penicillin antibiotics is not really going to help you that much in terms of antibiotic resistance,” she says. The mechanisms of disinfectants are not well enough understood, concluded a 1999 article in Clinical Microbiology Reviews (“Antiseptics and Disinfectants: Activity, Action, and Resistance,” Vol. 12, No. 1). The issue deserves more study, noted authors Gerald McDonnell and A. Denver Russell, and there may be other reasons behind anecdotes of acquired resistance to disinfectants. “Many ... reports of resistance,” they wrote, “have often paralleled issues including inadequate cleaning, incorrect product use, or ineffective infection control practices, which cannot be underestimated.”

And therein lies the real reason a shelter might want to use a couple of different products: What one scrub job hasn’t killed, the other just might. Rotating a quat and a bleach is best, since bleach is effective against more microbes but quats can clean—and you’ll have a better chance of attacking your microbial enemies from all sides.

 

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