1887

Access Microbiology open research platform logo

Volume 6, Issue 2

Cleaning up our disinfectants: usage of antimicrobial biocides in direct-to-consumer products in Australia Open Access

Abstract

In supermarkets and chemists worldwide, consumers are faced with an array of antimicrobial domestic cleaning and personal hygiene products purporting to kill germs and keep people safe. Many of these proven active ingredients (biocides) encourage the development of antimicrobial resistance (AMR) in microbes and microbial populations, in turn increasing the likelihood of AMR infections. In order to understand and address the selective pressure towards AMR posed by the unrestricted use of biocides, it is necessary to understand which biocides are most frequently found in consumer products and the current regulatory framework that governs their use. In this research we survey the biocidal active ingredients in the major categories of cleaning and personal care products available from supermarkets and pharmacies in Australia, and comment on the regulations that dictate how these products are tested and marketed. Benzalkonium chloride and ethanol were the two most prevalent antimicrobial biocides in this study, while triclosan, which is banned in several jurisdictions, was found in a small number of products. In Australia, many antimicrobial consumer products are regulated for efficacy and safety under the Therapeutic Goods Act, but the potential to drive microbial adaptation and AMR is not considered. Overall this survey underscores the broad use and light regulation of antimicrobial biocides in products available to the general public in Australia, and provides an information resource to inform further research and stewardship efforts.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): antimicrobial resistance , antiseptic , benzalkonium chloride , biocide , disinfectant and quaternary ammonium compound
Funding
This study was supported by the:
  • Australian Research Council (Award DE200101524)
    • Principle Award Recipient: FrancescaShort
© 2024 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000714.v3
2024-02-14
2024-05-16
Loading full text...

Full text loading...

/deliver/fulltext/acmi/6/2/acmi000714.v3.html?itemId=/content/journal/acmi/10.1099/acmi.0.000714.v3&mimeType=html&fmt=ahah

References

  1. Maillard J-Y, Pascoe M. Disinfectants and antiseptics: mechanisms of action and resistance. Nat Rev Microbiol 2024; 22:4–17 [View Article] [PubMed]
     [Google Scholar]
  2. Marty Cooney R, Manickam N, Becherer P, Harmon LS, Gregg L et al. The use of 3.15% chlorhexidine gluconate/70% alcohol hub disinfection to prevent central line-associated bloodstream infections in dialysis patients. Br J Nurs 2020; 29:S24–S26 [View Article] [PubMed]
     [Google Scholar]
  3. Blazejewski C, Wallet F, Rouzé A, Le Guern R, Ponthieux S et al. Efficiency of hydrogen peroxide in improving disinfection of ICU rooms. Crit Care 2015; 19:30 [View Article] [PubMed]
     [Google Scholar]
  4. Hahn S, Schneider K, Gartiser S, Heger W, Mangelsdorf I. Consumer exposure to biocides--identification of relevant sources and evaluation of possible health effects. Environ Health 2010; 9:7 [View Article] [PubMed]
     [Google Scholar]
  5. Pastor-Nieto MA, Alcántara-Nicolás F, Melgar-Molero V, Pérez-Mesonero R, Vergara-Sánchez A et al. Preservatives in personal hygiene and cosmetic products, topical medications, and household cleaners in Spain. Actas Dermosifiliogr 2017; 108:758–770 [View Article] [PubMed]
     [Google Scholar]
  6. Fraise AP. Biocide abuse and antimicrobial resistance--a cause for concern?. J Antimicrob Chemother 2002; 49:11–12 [View Article] [PubMed]
     [Google Scholar]
  7. Antimicrobial Resistance Collaborators Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 2022; 399:629–655
     [Google Scholar]
  8. Wozniak TM, Dyda A, Merlo G, Hall L. Disease burden, associated mortality and economic impact of antimicrobial resistant infections in Australia. Lancet Reg Health West Pac 2022; 27:100521 [View Article] [PubMed]
     [Google Scholar]
  9. Rice LB. Federal funding for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE. J Infect Dis 2008; 197:1079–1081 [View Article] [PubMed]
     [Google Scholar]
  10. McEwen SA, Collignon PJ. Antimicrobial resistance: a one health perspective. Microbiol Spectr 2018; 6: [View Article] [PubMed]
     [Google Scholar]
  11. Martin MJ, Thottathil SE, Newman TB. Antibiotics overuse in animal agriculture: a call to action for health care providers. Am J Public Health 2015; 105:2409–2410 [View Article] [PubMed]
     [Google Scholar]
  12. Goossens H, Ferech M, Vander Stichele R, Elseviers M. ESAC Project Group Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet 2005; 365:579–587 [View Article] [PubMed]
     [Google Scholar]
  13. Kampf G. Biocidal agents used for disinfection can enhance antibiotic resistance in Gram-negative species. Antibiotics 2018; 7:110 [View Article] [PubMed]
     [Google Scholar]
  14. Merchel Piovesan Pereira B, Tagkopoulos I. Benzalkonium chlorides: uses, regulatory status, and microbial resistance. Appl Environ Microbiol 2019; 85:e00377-19 [View Article] [PubMed]
     [Google Scholar]
  15. Kim M, Weigand MR, Oh S, Hatt JK, Krishnan R et al. Widely used benzalkonium chloride disinfectants can promote antibiotic resistance. Appl Environ Microbiol 2018; 84:e01201-18 [View Article] [PubMed]
     [Google Scholar]
  16. Merchel Piovesan Pereira B, Wang X, Tagkopoulos I. Biocide-induced emergence of antibiotic resistance in Escherichia coli. Front Microbiol 2021; 12:640923 [View Article] [PubMed]
     [Google Scholar]
  17. Chuanchuen R, Beinlich K, Hoang TT, Becher A, Karkhoff-Schweizer RR et al. Cross-resistance between triclosan and antibiotics in Pseudomonas aeruginosa is mediated by multidrug efflux pumps: exposure of a susceptible mutant strain to triclosan selects nfxB mutants overexpressing MexCD-OprJ. Antimicrob Agents Chemother 2001; 45:428–432 [View Article] [PubMed]
     [Google Scholar]
  18. Short FL, Lee V, Mamun R, Malmberg R, Li L et al. Benzalkonium chloride antagonises aminoglycoside antibiotics and promotes evolution of resistance. EBioMedicine 2021; 73:103653 [View Article] [PubMed]
     [Google Scholar]
  19. Li L, Short FL, Hassan KA, Naidu V, Pokhrel A et al. Systematic analyses identify modes of action of ten clinically relevant biocides and antibiotic antagonism in Acinetobacter baumannii. Nat Microbiol 2023; 8:1995–2005 [View Article] [PubMed]
     [Google Scholar]
  20. Martínez-Carballo E, González-Barreiro C, Sitka A, Kreuzinger N, Scharf S et al. Determination of selected quaternary ammonium compounds by liquid chromatography with mass spectrometry. Part II. Application to sediment and sludge samples in Austria. Environ Pollut 2007; 146:543–547 [View Article] [PubMed]
     [Google Scholar]
  21. Kümmerer K, Eitel A, Braun U, Hubner P, Daschner F et al. Analysis of benzalkonium chloride in the effluent from European hospitals by solid-phase extraction and high-performance liquid chromatography with post-column ion-pairing and fluorescence detection. J Chromatogr A 1997; 774:281–286 [View Article] [PubMed]
     [Google Scholar]
  22. Maillard J-Y. Impact of benzalkonium chloride, benzethonium chloride and chloroxylenol on bacterial antimicrobial resistance. J Appl Microbiol 2022; 133:3322–3346 [View Article] [PubMed]
     [Google Scholar]
  23. Abbood HM, Hijazi K, Gould IM. Chlorhexidine resistance or cross-resistance, that is the Question. Antibiotics 2023; 12:798 [View Article] [PubMed]
     [Google Scholar]
  24. Saha T, Khadka P, Das SC. Alcohol-based hand sanitizer - composition, proper use and precautions. Germs 2021; 11:408–417 [View Article] [PubMed]
     [Google Scholar]
  25. Food and Drug Administration Safety and effectiveness of consumer Antiseptics; topical antimicrobial drug products for over-the-counter human use. final rule. Fed Regist 2016; 81:61106–61130
     [Google Scholar]
  26. Food and Drug Administration Safety and effectiveness of health care Antiseptics; topical antimicrobial drug products for over-the-counter human use. final rule. Fed Regist 2017; 82:60474–60503
     [Google Scholar]
  27. Weatherly LM, Gosse JA. Triclosan exposure, transformation, and human health effects. J Toxicol Environ Health B Crit Rev 2017; 20:447–469 [View Article] [PubMed]
     [Google Scholar]
  28. Dhillon GS, Kaur S, Pulicharla R, Brar SK, Cledón M et al. Triclosan: current status, occurrence, environmental risks and bioaccumulation potential. Int J Environ Res Public Health 2015; 12:5657–5684 [View Article] [PubMed]
     [Google Scholar]
  29. Regulation (EU) No 528/2012 of the European Parliament and of the Council Concerning the Making Available on the Market and Use of Biocidal Products. European Union 2012
     [Google Scholar]
  30. Forward Regulatory Plan 2023-2025: Biocides Regulations Canada: 2023
     [Google Scholar]
  31. Therapeutic Goods Act 1989 Australia: 1989
     [Google Scholar]
  32. Therapeutic Goods Administration TGA Instructions for Disinfectant Testing Australia: 2021
     [Google Scholar]
  33. World Health Organisation WHO Guidelines on Hand Hygiene in Health Care Geneva, Switzerland: WHO Press; 2009
     [Google Scholar]
  34. Kampf G, Exner M, Schwebke I, Gebel J. Ethanol is indispensable and safe as a biocidal active substance for hand disinfection. J Hosp Infect 2021; 108:205–206 [View Article] [PubMed]
     [Google Scholar]
  35. Commission Delegated Regulation (EU) 2021/407 Amending Regulation (EU) No 528/2012 to Include Citric Acid as an Active Substance in Annex 1 Thereto European Union; 2020
     [Google Scholar]
  36. Dear K, Gan D, Stavrakoglou A, Ronaldson C, Nixon RL. Hyperkeratotic flexural erythema (more commonly known as granular parakeratosis) with use of laundry sanitizers containing benzalkonium chloride. Clin Exp Dermatol 2022; 47:2196–2200 [View Article] [PubMed]
     [Google Scholar]
  37. SCENIHR Assessment of the Antibiotic Resistance Effects of Biocides; 2009 http://ec.europa.eu/health/ph_risk/committees/04_scenihr/docs/scenihr_o_021.pdf
  38. United States Environmental Protection Agency Antimicrobial Testing Methods & Procedures: MB-06-10
     [Google Scholar]
  39. Wieck S, Olsson O, Kümmerer K. Consumers’ perceptions of biocidal products in households. Int J Hyg Environ Health 2018; 221:260–268 [View Article] [PubMed]
     [Google Scholar]
  40. McCullough AR, Parekh S, Rathbone J, Del Mar CB, Hoffmann TC. A systematic review of the public’s knowledge and beliefs about antibiotic resistance. J Antimicrob Chemother 2016; 71:27–33 [View Article] [PubMed]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.0.000714.v3
Loading
Cleaning up our disinfectants: usage of antimicrobial biocides in direct-to-consumer products in Australia
Access Microbiology 6, 000714.v3 (2024); https://doi.org/10.1099/acmi.0.000714.v3
/content/journal/acmi/10.1099/acmi.0.000714.v3
/content/journal/acmi/10.1099/acmi.0.000714.v3
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF

Supplementary material 2

EXCEL

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error