Evaluation of Antibacterial Activity of Three Quaternary Ammonium Disinfectants on Different Germs Isolated from the Hospital Environment

Effectiveness and Durability of a Quaternary Ammonium Compounds-Based Surface Coating to Reduce Surface Contamination

Foodborne diseases are of major concern as they have a significant impact on public health, both socially and economically. The occurrence of cross-contamination of food in household kitchens is a serious threat and the adoption of safe food practices is of paramount importance. This work aimed to study the effectiveness and durability of a commercial quaternary ammonium compound-based surface coating which, according to the manufacturer, retains its antimicrobial activity for 30 days, and is suitable for all types of hard surfaces for the prevention and/or control of cross-contamination. For that, its antimicrobial efficacy, killing contact time and durability on three different surfaces-polyvinyl chloride, glass, and stainless-steel-against three pathogens-Escherichia coli ATCC 25922, Acinetobacter baumannii ESB260 and Listeria monocytogenes Scott A-were tested according to the current antimicrobial treated surfaces efficacy test (ISO22196:2011). The results showed that the antimicrobial coating was effective against all pathogens with a reduction of >5.0 log CFU/cm² in less than one minute for the three surfaces, but its durability was less than one week on all surfaces cleaned in the usual manner. Additionally, trace amounts (≤0.2 mg/kg) of the antimicrobial coating, which may migrate into food when contacting the surface, did not show cytotoxicity to human colorectal adenocarcinoma cells. The suggested antimicrobial coating has the potential to significantly reduce surface contamination, ensure surface disinfection and reduce the likelihood of cross-contamination in domestic kitchens, although it is less durable than suggested. The use of this technology in household settings is an attractive complement to the existing cleaning protocols and solutions that are already in place.

Quaternary Ammonium Salts: Insights into Synthesis and New Directions in Antibacterial Applications

The overuse of antibiotics has led to the emergence of a large number of antibiotic-resistant genes in bacteria, and increasing evidence indicates that a fungicide with an antibacterial mechanism different from that of antibiotics is needed. Quaternary ammonium salts (QASs) are a biparental substance with good antibacterial properties that kills bacteria through simple electrostatic adsorption and insertion into cell membranes/altering of cell membrane permeability. Therefore, the probability of bacteria developing drug resistance is greatly reduced. In this review, we focus on the synthesis and application of single-chain QASs, double-chain QASs, heterocyclic QASs, and gemini QASs (GQASs). Some possible structure-function relationships of QASs are also summarized. As such, we hope this review will provide insight for researchers to explore more applications of QASs in the field of antimicrobials with the aim of developing systems for clinical applications.

Hygiene of Medical Devices and Minimum Inhibitory Concentrations for Alcohol-Based and QAC Disinfectants among Isolates from Physical Therapy Departments

Disinfectants are used intensively to control and prevent healthcare-associated infections. With continuous use and exposure to disinfectants, bacteria may develop reduced susceptibility. The study aimed to check the hygiene of devices in the physiotherapy department. For isolated bacterial strains, we aimed to determine the minimum inhibitory concentration of five different disinfectant wipe products currently in use. Microbiological environmental sampling in four various institutions in four different cities from two counties was performed, followed by CFU calculation and identification using matrix-assisted laser desorption and ionization with time-of-flight analyzer mass spectrometry (MALDI-TOF). The sampling was performed on three different occasions: before patient use, after patient use, and after disinfection. The susceptibility of isolates to three different alcohol-based and three different quaternary ammonium compounds (QAC) disinfectant wipes was examined by determining the minimal inhibitory concentrations (MIC). We identified 27 different bacterial species from 11 different genera. Gram-positive bacteria predominated. The most abundant genera were Staphylococcus, Micrococcus, and Bacillus. The average MIC values of alcohol-based disinfectants range between 66.61 and 148.82 g/L, and those of QAC-based disinfectants range between 2.4 and 3.5 mg/L. Distinctive strains with four-fold increases in MIC values, compared to average values, were identified. The widespread use of disinfectants can induce a reduction in the susceptibility of bacteria against disinfectants and affect the increase in the proportion of antibiotic-resistant bacteria. Therefore, it is urgent to define clear criteria for defining a microorganism as resistant to disinfectants by setting epidemiological cut-off (ECOFF) values and standardizing protocols for testing the resistance of microorganisms against disinfectants.

Kinetics of Bacterial Adaptation, Growth, and Death at Didecyldimethylammonium Chloride sub-MIC Concentrations

Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) are standard indexes for determining disinfection effectiveness. Nevertheless, they are static values disregarding the kinetics at sub-MIC concentrations where adaptation, growth, stationary, and death phases can be observed. The understanding of these dynamic mechanisms is crucial to designing effective disinfection strategies. In this study, we studied the 48 h kinetics of Bacillus cereus and Escherichia coli cells exposed to sub-MIC concentrations of didecyldimethylammonium chloride (DDAC). Two mathematical models were employed to reproduce the experiments: the only-growth classical logistic model and a mechanistic model including growth and death dynamics. Although both models reproduce the lag, exponential and stationary phases, only the mechanistic model is able to reproduce the death phase and reveals the concentration dependence of the bactericidal/bacteriostatic activity of DDAC. This model could potentially be extended to study other antimicrobials and reproduce changes in optical density (OD) and colony-forming units (CFUs) with the same parameters and mechanisms of action.

Reduced Susceptibility and Increased Resistance of Bacteria against Disinfectants: A Systematic Review

Disinfectants are used to reduce the concentration of pathogenic microorganisms to a safe level and help to prevent the transmission of infectious diseases. However, bacteria have a tremendous ability to respond to chemical stress caused by biocides, where overuse and improper use of disinfectants can be reflected in a reduced susceptibility of microorganisms. This review aims to describe whether mutations and thus decreased susceptibility to disinfectants occur in bacteria during disinfectant exposure. A systematic literature review following PRISMA guidelines was conducted with the databases PubMed, Science Direct and Web of Science. For the final analysis, 28 sources that remained of interest were included. Articles describing reduced susceptibility or the resistance of bacteria against seven different disinfectants were identified. The important deviation of the minimum inhibitory concentration was observed in multiple studies for disinfectants based on triclosan and chlorhexidine. A reduced susceptibility to disinfectants and potentially related problems with antibiotic resistance in clinically important bacterial strains are increasing. Since the use of disinfectants in the community is rising, it is clear that reasonable use of available and effective disinfectants is needed. It is necessary to develop and adopt strategies to control disinfectant resistance.

Effect of Surfosept and Deconex® 53 Disinfectant Agents on the Accuracy and Dimensional Stability of Panasil Dental Impression Materials: An Experimental Study

Materials and Methods

This in vitro study was performed on 30 dental casts. The samples were divided into one control group and two experimental groups to be disinfected with Surfosept (1%) and Deconex® 53 (2%) using a sequential sampling method (10 per group). The impressions in the experimental groups (i.e., Surfosept and Deconex® 53) were rinsed and dried; then, the disinfectant was sprayed on the impressions and remained for 30 seconds before pouring with stone. In the control group, the impressions were only rinsed and dried and were poured in 10 minutes. Cast dimensions were measured by a profile projector device, and the mean values obtained from the experimental groups were compared with those of the control group.

Results

There were no significant differences among the groups regarding the height of the resulting dies without undercut (P=0.62). Moreover, there was no significant difference among the groups regarding the distance between the two dies (P=0.77). However, the diameter of the dies with undercut and without undercut was different significantly among the control and experimental groups (P < 0.005).

Conclusion

In general, no significant difference was encountered between dimensional stability and accuracy of the dental impressions using Surfosept and Deconex® 53 in this study.

Microbiological Monitoring of the Environment Using the "Association Rules" Approach and Disinfection Procedure Evaluation in a Hospital Center in Morocco

Background

The hospital environment, especially surfaces and medical devices, is a source of contamination for patients.

Objective

This study carried out, to the best of our knowledge, for the first time at Taza Hospital in Morocco aimed to assess the microbiological quality of surfaces and medical devices in surgical departments and to evaluate the disinfection procedure in time and space.

Methods

Samples were taken by swabbing after cleaning the hospital surface or medical device, to isolate and identify germs which were inoculated on semiselective culture media then identified by standard biochemical and physiological tests, using the analytical profile index (API) galleries. Moreover, the association rules extraction model between sites on the one hand and germs on the other hand was used for sampling.

Results

The study showed that 83% of the samples have been contaminated after biocleaning. The most contaminated services have been men's and women's surgeries. 62% of isolated germs have been identified as Gram-positive bacteria, 29% as Gram-negative bacteria, and 9% as fungi. Concerning the association rules extraction model, a strong association between some contaminated sites and the presence of germ has been found, such as the association between wall and nightstand and door cuff, meaning that the wall and nightstand contamination is systematically linked to that of the door cuff. The disinfection procedure efficacy evaluation has enabled suggesting renewing it each 4 h.

Conclusion

Microbiological monitoring of surfaces is necessary at hospital level through the use of the association rule extraction model, which is very important to optimize the sampling, cleaning, and disinfection site scenarios of the most contaminated ones.