Bacterial Resistance to Hospital Disinfection

With the number of infections caused by bacteria that are multidrug resistant (MDR) increasing, it is imperative that these infections can be controlled. Biocides are used to prevent contamination in a variety of topical and hard-surface applications and are an essential component of infection control in hospitals. They are also used for disinfection and preservation of foodstuffs and within the home environment for a range of applications which again includes hard-surface disinfection. Whilst antibiotic resistance has been well studied in a variety of bacteria, there is little known about potential resistance mechanisms to biocides. We have yet to see well-documented outbreaks caused by biocide-resistant bacteria, although this is rarely looked for. Development of resistance to biocides is thought to be more difficult than for antibiotics for several reasons including the high concentration of biocides used in many applications and that biocides act on multiple targets. However, the increased use of biocides has led to speculation of development of resistance to biocides and whether this leads to cross resistance to antibiotics. This chapter will consider the different resistance mechanisms to biocides in bacteria, the possible link between biocide and antibiotic resistance and whether we should be concerned about bacterial biocide resistance.