At your next medical appointment pay attention to the cleaning practices of the clinic. Most likely the room, particularly the exam table which is touched by all patients, will be cleaned using some type of disinfectant product between each patient. This act of cleaning re-assures you; you can be confident knowing that the infection that the last patient had does not remain in the room. You note the chemical odor left behind by the disinfectant wipes the nurse used to clean the room, putting you even further at ease. But what if you’re wrong? What if for some reason the infectious bacteria left behind is not eliminated by the disinfectant and you are now susceptible to infection? As more of our antibiotics are rendered useless by bacterial resistance it is more important now than ever that we ensure our disinfectants do not suffer the same fate.
A high price was and continues to be paid for the growing problem of antibiotic resistance by Staphylococcus aureus. The lessons learned in this area of study cannot be overlooked as we look to the future of potential Staphylococcus aureus resistance to our disinfection agents in hospitals, fitness centers, and schools. All potential solutions must be explored including alternatives to chemical disinfectants and novel products. We must take a hard look at our disinfecting practices and procedures as well as alternative such as those similar to phage therapy and others currently in research for antibiotic resistance solutions. Unless we can manage to get ahead of this problem now, future generations will have a much larger problem to solve.
The primary reason I have chosen this topic for additional research is that I believe that we have an opportunity to prepare and respond to inevitable disinfectant resistance better than we did antibiotic resistance, based primarily on what we have learned regarding antibiotic resistance in the last 40 years.
The number of nosocomial or hospital acquired infections have been steadily rising in the wake of alarmingly greater antibiotic resistance (Meade & Garvey, 2018). Different types of bacteria have different levels of susceptibility to antiseptics such as disinfectant agents (Al-Salihi, 2019). Currently Gram-negative bacteria such as Staphylococcus aureus, which is very commonly found in hospitals, gyms, etc. is among those microorganisms that is fairly susceptible to many of our commonly used disinfectants (Russell, 2002). However, the same cannot be said for Methicillin-resistant Staphylococcus aureus (MRSA) susceptibility to the antibiotics we once used to treat it. This same pattern of antibiotic resistance has begun to be identified with disinfectant resistance (Zmantar, Kouidhi, Miladi, & Bakhrouf, 2011).
I propose a comprehensive study in the field of Staphylococcus aureus resistance to current disinfectants. This study will extrapolate meaningful lessons and proven solutions from ongoing antibiotic resistance research and apply them to the impending problem of disinfectants and disinfecting practices as appropriate. Through better regulation and more thoughtful use of disinfecting agents, use of novel and naturally occurring products, potential use of bacteriophages in disinfection, and public education on practices that can aid in limiting spread of Staphylococcus aureus in hospital and community settings we will be able to slow and potentially halt the impending disinfectant-resistant Staphylococcus aureus more effectively than we were with antibiotic-resistant Staphylococcus aureus, known as Methicillin-resistant Staphylococcus aureus (MRSA) (CDC, 2018).
Methods will include partnering with institutions already researching antibiotic resistance since the research infrastructure (i.e. the laboratory techniques, equipment, and procedures) will already be in place. This will help alleviate cost and potentially time spent repeating similar work already conducted in areas such as DNA and genome sequencing, etc.
Methods will mirror already used methods of tracking and responding to new information in the field of antibiotic resistance. This includes antibiotic use proven best practices and how we apply them to current disinfectant use practices to slow developing resistance, such as exploring any potential overuse and misuse of specific disinfectant products or practices that create a favorable environment for the development of resistant Staphylococcus aureus as well as expanded studies on specific chemical use in disinfecting and rate of development of resistance as a data point when considering preferred products (Abdallah et al., 2014).
Other methods will also include the use of food sterilization techniques and how they have potentially effected resistance and what practices or techniques may reduce resistance formation.
Once this study identifies any potential actions that can be taken by patients and consumers to reduce the spread of nosocomial and community-acquired Staphylococcus aureus education initiative will be pursued to increase awareness of the general population in an effort to reduce the need for excessive disinfectant in exchange for more thoughtful processes if introducing the ill and potentially ill to high-use public spaces.
Implementation of this proposed research brings with it multiple issues however mitigating factors can be put into place to alleviate some aspects of them. First, funding this research would be difficult. This is because there are many other issues which currently have the public’s attention and funding preferences. Large corporations that play a great role in conducting and paying for research may have little to gain on initial investment into this issue. As previously tasted, current disinfection agents are fairly effective against Staphylococcus aureus, so the urgency of this issue is difficult to communicate. There is no obvious and immediate benefit for any organizations which may take on this research i.e. this research is not directly aimed at creating a product to be sold for a company to recoup research costs.
Laboratory access may also be a concern since some aspects of this research would be very similar to research currently being conducted on antibiotic resistance. While sharing facilities, equipment, etc. may help to keep costs down, the research already being conducted in those spaces is far from over and arguably just as important.
The benefits of this research are numerous and important. Knowing what potential options we have for slowing disinfectant resistance to Staphylococcus aureus as well as alternative means of disinfecting surfaces will allow us to better prepare for out future. Nosocomial infections as well as those contracted in other Staphylococcus aureus-prone locations such as gyms are on the rise and our ability to disinfect high-use surfaces is extremely important. Acting now to change our behavior in regards to disinfection practices and methods can help us to avoid creating a superbug as we did with Methicillin-resistant Staphylococcus aureus (MRSA) (NIH, 2014). Adding unmanageable disinfectant resistance to the already problematic antibiotic resistance would have grave consequences for the human race.
- Abdallah, M., Chataigne, G., Ferreira-theret, P., Benoliel, C., Drider, D., Dhulster, P., & Chihib, N. (2014). Effect of growth temperature, surface type and incubation time on the resistance of staphylococcus aureus biofilms to disinfectants. Applied Microbiology and Biotechnology,98(6), 2597-607. doi: http://dx.doi.org.ezproxy2.apus.edu/10.1007/s00253-013-5479-4
- Al-Salihi, S. (2019). Antibacterial activity of some disinfectants and detergents on some pathogenic bacteria.Journal of Pharmaceutical Sciences and Research,11(2), 590-597. Retrieved from https://search-proquest-com.ezproxy1.apus.edu/docview/2189507618?accountid=8289
- Meade, E., & Garvey, M. (2018). Efficacy testing of novel chemical disinfectants on clinically relevant microbial pathogens. American Journal of Infection Control, 46(1), 44-49. doi:10.1016/j.ajic.2017.07.001
- Russell, A. (2002). Bacterial resistance to disinfectants. British Journal of Infection Control, 3(3), 22–24. https://doi.org/10.1177/175717740200300306
- Stop the Spread of Superbugs. (2018, November 01). Retrieved May 25, 2019, from https://newsinhealth.nih.gov/2014/02/stop-spread-superbugs
- What CDC is Doing: Antibiotic Resistance (AR) Solutions Initiative | Antibiotic/Antimicrobial Resistance | CDC. (2018, September 10). Retrieved May 24, 2019, from https://www.cdc.gov/drugresistance/solutions-initiative/index.html
- Zmantar, T., Kouidhi, B., Miladi, H., & Bakhrouf, A. (2011). Detection of macrolide and disinfectant resistance genes in clinical staphylococcus aureus and coagulase-negative staphylococci.BMC Research Notes,4, 453. doi: http://dx.doi.org.ezproxy2.apus.edu/10.1186/1756-0500-4-453