Biocides in the Hospital Environment: Application and Tolerance Development.

Hospital-acquired infections are a rising problem with consequences for patients, hospitals, and health care workers. Biocides can be employed to prevent these infections, contributing to eliminate or reduce microorganisms' concentrations at the hospital environment. These antimicrobials belong to several groups, each with distinct characteristics that need to be taken into account in their selection for specific applications. Moreover, their activity is influenced by many factors, such as compound concentration and the presence of organic matter. This article aims to review some of the chemical biocides available for hospital infection control, as well as the main factors that influence their efficacy and promote susceptibility decreases, with the purpose to contribute for reducing misusage and consequently for preventing the development of resistance to these antimicrobials.

[1]  M. Gadebusch Bondio,et al.  Not in their hands only: hospital hygiene, evidence and collective moral responsibility , 2022, Medicine, Health Care and Philosophy.

[2]  R. Berisio,et al.  Resveratrol Reverts Tolerance and Restores Susceptibility to Chlorhexidine and Benzalkonium in Gram-Negative Bacteria, Gram-Positive Bacteria and Yeasts , 2022, Antibiotics.

[3]  G. Kampf Efficacy of biocidal agents and disinfectants against the monkeypox virus and other orthopoxviruses , 2022, The Journal of hospital infection.

[4]  C. Cristea,et al.  An Overview of Healthcare Associated Infections and Their Detection Methods Caused by Pathogen Bacteria in Romania and Europe , 2022, Journal of clinical medicine.

[5]  Ying Zhang,et al.  Clinical characteristics, tolerance mechanisms, and molecular epidemiology of reduced susceptibility to chlorhexidine among Pseudomonas aeruginosa isolated from a teaching hospital in China. , 2022, International journal of antimicrobial agents.

[6]  S. Jahan,et al.  Identifying and elucidating the resistance of Staphylococcus aureus isolated from hospital environment to conventional disinfectants. , 2022, American journal of infection control.

[7]  J. Sutton,et al.  Contribution of the efflux pump AcrAB-TolC to the tolerance of chlorhexidine and other biocides in Klebsiella spp. , 2022, Journal of medical microbiology.

[8]  E. Denamur,et al.  Reduced Chlorhexidine Susceptibility Is Associated with Tetracycline Resistance tet Genes in Clinical Isolates of Escherichia coli , 2022, Antimicrobial agents and chemotherapy.

[9]  R. Berisio,et al.  Inhibition of AdeB, AceI, and AmvA Efflux Pumps Restores Chlorhexidine and Benzalkonium Susceptibility in Acinetobacter baumannii ATCC 19606 , 2022, Frontiers in Microbiology.

[10]  B. Van den Poel,et al.  Increasing usage of chlorhexidine in health care settings: blessing or curse? A narrative review of the risk of chlorhexidine resistance and the implications for infection prevention and control , 2022, European Journal of Clinical Microbiology & Infectious Diseases.

[11]  Darrah K. Sleeth,et al.  Transmission of Respiratory Viral Diseases to Health Care Workers: COVID-19 as an Example. , 2022, Annual review of public health.

[12]  F. Lotfipour,et al.  Peracetic acid activity on biofilm formed by Escherichia coli isolated from an industrial water system , 2022, Letters in applied microbiology.

[13]  Jinlong Yuan,et al.  Effect of sodium hypochlorite on biofilm of Klebsiella pneumoniae with different drug resistance. , 2022, American journal of infection control.

[14]  J. Kalka,et al.  Inactivation of Spores and Vegetative Forms of Clostridioides difficile by Chemical Biocides: Mechanisms of Biocidal Activity, Methods of Evaluation, and Environmental Aspects , 2022, International journal of environmental research and public health.

[15]  Changsun Choi,et al.  Comparison of virucidal efficacy of sodium hypochlorite, chlorine dioxide, peracetic acid, and ethanol against hepatitis A virus by carrier and suspension tests , 2021, International Journal of Food Microbiology.

[16]  F. Saffari,et al.  Reduced Susceptibility to Biocides among Enterococci from Clinical and Non-Clinical Sources , 2021, Infection & chemotherapy.

[17]  M. Guedes,et al.  Virucidal efficacy of chlorhexidine: a systematic review , 2021, Odontology.

[18]  A. Sahebkar,et al.  Prevalence of resistance genes to biocides in antibiotic-resistant Pseudomonas aeruginosa clinical isolates , 2021, Molecular Biology Reports.

[19]  J. Lemos,et al.  Influence of type, concentration, exposure time, temperature, and presence of organic load on the antifungal efficacy of industrial sanitizers against Aspergillus brasiliensis (ATCC 16404). , 2021, Food microbiology.

[20]  E. Obłąk,et al.  Biological activity of quaternary ammonium salts and resistance of microorganisms to these compounds , 2021, World Journal of Microbiology and Biotechnology.

[21]  K. Seo,et al.  Effectiveness of calcium hypochlorite, quaternary ammonium compounds, and sodium hypochlorite in eliminating vegetative cells and spores of Bacillus anthracis surrogate , 2021, Journal of veterinary science.

[22]  P. Higgins,et al.  Rescued chlorhexidine activity by resveratrol against carbapenem-resistant Acinetobacter baumannii via down-regulation of AdeB efflux pump , 2020, PloS one.

[23]  Chien-Yu Lin,et al.  Differentiation of qacA and qacB using high-resolution melt curve analysis, and both qacA and qacB but not qacC or norA types increase chlorhexidine minimal inhibitory concentrations in Staphylococcus aureus isolates. , 2020, Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi.

[24]  H. Lapeere,et al.  Anaphylaxis related to disinfection with chlorhexidine in a teenager treated for cancer , 2020, Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners.

[25]  H. Breidablik,et al.  Effects of hand disinfection with alcohol hand rub, ozonized water, or soap and water: time for reconsideration? , 2020, Journal of Hospital Infection.

[26]  J. Weese,et al.  Presence of Qac genes in clinical isolates of methicillin-resistant and methicillin-susceptible Staphylococcus pseudintermedius and their impact on chlorhexidine digluconate susceptibility. , 2020, Veterinary surgery : VS.

[27]  T. Thongngarm,et al.  Basophil Activation Test-Confirmed, Ortho-phthalaldehyde-Induced Anaphylaxis after Cystoscopy. , 2020, Journal of investigational allergology & clinical immunology.

[28]  A. Şahiner,et al.  Comparison of bactericidal and fungicidal efficacy of antiseptic formulations according to EN 13727 and EN 13624 standards , 2019, Turkish Journal of Medical Sciences.

[29]  M. Holden,et al.  Chlorhexidine and octenidine use, carriage of qac genes, and reduced antiseptic susceptibility in methicillin-resistant Staphylococcus aureus isolates from a healthcare network. , 2019, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[30]  A. Kramer,et al.  Four steps to clean hospitals: LOOK, PLAN, CLEAN and DRY. , 2019, The Journal of hospital infection.

[31]  K. Vickery,et al.  Effect of disinfectant formulation and organic soil on the efficacy of oxidizing disinfectants against biofilms. , 2019, The Journal of hospital infection.

[32]  S. Tarlo,et al.  Chlorhexidine skin symptoms and allergy in dialysis patients and nurses , 2019, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[33]  Hong Chen,et al.  The impact and mechanism of quaternary ammonium compounds on the transmission of antibiotic resistance genes , 2019, Environmental Science and Pollution Research.

[34]  D. Todt,et al.  In vitro activity of active ingredients of disinfectants against drug-resistant fungi. , 2019, The Journal of hospital infection.

[35]  Jing Guo,et al.  Molecular epidemiology and decreased susceptibility to disinfectants in carbapenem-resistant Acinetobacter baumannii isolated from intensive care unit patients in central China. , 2019, Journal of infection and public health.

[36]  T. Selhorst,et al.  Interlaboratory reproducibility of a test method following four-field test methodology to evaluate the susceptibility of Clostridium difficile spores. , 2019, The Journal of hospital infection.

[37]  W. Rutala,et al.  Use of germicides in health care settings-is there a relationship between germicide use and antimicrobial resistance: A concise review. , 2019, American journal of infection control.

[38]  F. Bureš Quaternary Ammonium Compounds: Simple in Structure, Complex in Application , 2019, Topics in Current Chemistry.

[39]  S. Kaplan,et al.  The prevalence of antiseptic tolerance genes among staphylococci and enterococci in a pediatric population , 2019, Infection Control & Hospital Epidemiology.

[40]  J. Sutton,et al.  SmvA is an important efflux pump for cationic biocides in Klebsiella pneumoniae and other Enterobacteriaceae , 2019, Scientific Reports.

[41]  J. A. Vale,et al.  The clinical toxicology of sodium hypochlorite , 2019, Clinical toxicology.

[42]  Sushim K Gupta,et al.  An assay for determining the susceptibility of Salmonella isolates to commercial and household biocides , 2018, PloS one.

[43]  Caitlinn B. Lineback,et al.  Hydrogen peroxide and sodium hypochlorite disinfectants are more effective against Staphylococcus aureus and Pseudomonas aeruginosa biofilms than quaternary ammonium compounds , 2018, Antimicrobial Resistance & Infection Control.

[44]  M. Martinelli,et al.  In vitro bactericidal activity of 0.6% povidone-iodine eye drops formulation , 2018, European journal of ophthalmology.

[45]  H. Sax,et al.  The preventable proportion of healthcare-associated infections 2005–2016: Systematic review and meta-analysis , 2018, Infection Control & Hospital Epidemiology.

[46]  L. Coin,et al.  Non-antibiotic antimicrobial triclosan induces multiple antibiotic resistance through genetic mutation. , 2018, Environment international.

[47]  D. Mondal,et al.  Sodium hypochlorite is more effective than 70% ethanol against biofilms of clinical isolates of Staphylococcus aureus , 2018, American journal of infection control.

[48]  A. Karadenizli,et al.  Investigation of the efficacy of alcohol-based solutions on adenovirus serotypes 8, 19 and 37, common causes of epidemic keratoconjunctivitis, after an adenovirus outbreak in hospital. , 2018, The Journal of hospital infection.

[49]  Xinglian Xu,et al.  Response of Formed-Biofilm of Enterobacter cloacae, Klebsiella oxytoca, and Citrobacter freundii to Chlorite-Based Disinfectants. , 2018, Journal of food science.

[50]  R. Haddadin,et al.  Multiple drug resistance and biocide resistance in Escherichia coli environmental isolates from hospital and household settings , 2018, Antimicrobial Resistance & Infection Control.

[51]  J. Boyce Alcohols as Surface Disinfectants in Healthcare Settings , 2018, Infection Control & Hospital Epidemiology.

[52]  J. Moore,et al.  In vitro activity of seven hospital biocides against Mycobacterium abscessus: Implications for patients with cystic fibrosis , 2018, International journal of mycobacteriology.

[53]  K. Moriya,et al.  Morphological bactericidal fast-acting effects of peracetic acid, a high-level disinfectant, against Staphylococcus aureus and Pseudomonas aeruginosa biofilms in tubing , 2017, Antimicrobial Resistance & Infection Control.

[54]  H. Ingmer,et al.  Susceptibility of vancomycin-resistant and -sensitive Enterococcus faecium obtained from Danish hospitals to benzalkonium chloride, chlorhexidine and hydrogen peroxide biocides. , 2017, Journal of medical microbiology.

[55]  D. Todt,et al.  Virucidal efficacy of peracetic acid for instrument disinfection , 2017, Antimicrobial Resistance & Infection Control.

[56]  G. Ramage,et al.  Tolerance of Pseudomonas aeruginosa in in-vitro biofilms to high-level peracetic acid disinfection. , 2017, The Journal of hospital infection.

[57]  K. Bibby,et al.  Free chlorine and monochloramine inactivation kinetics of Aspergillus and Penicillium in drinking water. , 2017, Water research.

[58]  S. Ignak,et al.  Frequency of antiseptic resistance genes in clinical staphycocci and enterococci isolates in Turkey , 2017, Antimicrobial Resistance & Infection Control.

[59]  A. Chughtai,et al.  Viral and bacterial upper respiratory tract infection in hospital health care workers over time and association with symptoms , 2017, BMC Infectious Diseases.

[60]  G. Kissling,et al.  Evaluation of the respiratory tract toxicity of ortho-phthalaldehyde, a proposed alternative for the chemical disinfectant glutaraldehyde , 2017, Inhalation toxicology.

[61]  C. Hölzel,et al.  Susceptibility to disinfectants in antimicrobial‐resistant and ‐susceptible isolates of Escherichia coli, Enterococcus faecalis and Enterococcus faecium from poultry–ESBL/AmpC‐phenotype of E. coli is not associated with resistance to a quaternary ammonium compound, DDAC , 2017, Journal of applied microbiology.

[62]  M. Jackson,et al.  Disinfectant Susceptibility Profiling of Glutaraldehyde-Resistant Nontuberculous Mycobacteria , 2017, Infection Control & Hospital Epidemiology.

[63]  A. Sharifi,et al.  Comparative analysis of the susceptibility to biocides and heavy metals of extended-spectrum β-lactamase-producing Escherichia coli isolates of human and avian origin, Germany. , 2017, Diagnostic microbiology and infectious disease.

[64]  A. Gálvez,et al.  Characterization of biocide-tolerant bacteria isolated from cheese and dairy small-medium enterprises. , 2017, Food microbiology.

[65]  G. Donelli,et al.  Strategies for combating bacterial biofilms: A focus on anti-biofilm agents and their mechanisms of action , 2017, Virulence.

[66]  A. Gálvez,et al.  Adaptation to Biocides Cetrimide and Chlorhexidine in Bacteria from Organic Foods: Association with Tolerance to Other Antimicrobials and Physical Stresses. , 2017, Journal of agricultural and food chemistry.

[67]  W. Egner,et al.  Chlorhexidine allergy in four specialist allergy centres in the United Kingdom, 2009–13: clinical features and diagnostic tests , 2017, Clinical and experimental immunology.

[68]  A. Gálvez,et al.  Virulence factors and antimicrobial resistance in Escherichia coli strains isolated from hen egg shells. , 2016, International journal of food microbiology.

[69]  M. Alfa,et al.  Evaluation of the ability of different detergents and disinfectants to remove and kill organisms in traditional biofilm. , 2016, American journal of infection control.

[70]  E. Obłąk,et al.  Quaternary ammonium salt N-(dodecyloxycarboxymethyl)-N,N,N-trimethyl ammonium chloride induced alterations in Saccharomyces cerevisiae physiology , 2016, Journal of Biosciences.

[71]  David J. Weber,et al.  Disinfection and Sterilization in Health Care Facilities , 2016, Infectious Disease Clinics of North America.

[72]  A. Fasanella,et al.  Biocidal and Sporicidal Efficacy of Pathoster® 0.35% and Pathoster® 0.50% Against Bacterial Agents in Potential Bioterrorism Use , 2016, Health security.

[73]  F. Baquero,et al.  Multiple adaptive routes of Salmonella enterica Typhimurium to biocide and antibiotic exposure , 2016, BMC Genomics.

[74]  Y. Peñate,et al.  Povidone‐iodine induced post‐surgical irritant contact dermatitis localized outside of the surgical incision area. Report of 27 cases and a literature review , 2016, International journal of dermatology.

[75]  J. Maillard,et al.  Use of a predictive protocol to measure the antimicrobial resistance risks associated with biocidal product usage. , 2016, American journal of infection control.

[76]  J. Sutton,et al.  Establishment of a multi-species biofilm model to evaluate chlorhexidine efficacy. , 2016, The Journal of hospital infection.

[77]  J. Vila,et al.  Reduced susceptibility to biocides in Acinetobacter baumannii: association with resistance to antimicrobials, epidemiological behaviour, biological cost and effect on the expression of genes encoding porins and efflux pumps. , 2015, The Journal of antimicrobial chemotherapy.

[78]  M. Doble,et al.  Bacterial resistance in biofilm-associated bacteria. , 2015, Future microbiology.

[79]  M. Amin,et al.  Allergic reaction to ortho‐phthalaldehyde following flexible laryngoscopy , 2015, The Laryngoscope.

[80]  Y. Ni,et al.  Frequency of biocide-resistant genes and susceptibility to chlorhexidine in high-level mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MuH MRSA). , 2015, Diagnostic microbiology and infectious disease.

[81]  C. Donskey,et al.  Unlocking the Sporicidal Potential of Ethanol: Induced Sporicidal Activity of Ethanol against Clostridium difficile and Bacillus Spores under Altered Physical and Chemical Conditions , 2015, PloS one.

[82]  G. Zeng,et al.  Quaternary ammonium compounds (QACs): a review on occurrence, fate and toxicity in the environment. , 2015, The Science of the total environment.

[83]  S. Pavlostathis,et al.  Quaternary ammonium disinfectants: microbial adaptation, degradation and ecology. , 2015, Current opinion in biotechnology.

[84]  C. Donskey,et al.  Induced Sporicidal Activity of Chlorhexidine against Clostridium difficile Spores under Altered Physical and Chemical Conditions , 2015, PloS one.

[85]  M. T. Crespo,et al.  Aeromonas biofilm on stainless steel: efficiency of commonly used disinfectants , 2015 .

[86]  L. Peixe,et al.  A hospital sewage ST17 Enterococcus faecium with a transferable Inc18-like plasmid carrying genes coding for resistance to antibiotics and quaternary ammonium compounds (qacZ). , 2015, Journal of global antimicrobial resistance.

[87]  J. Caudill,et al.  Evaluation of the toxicity data for peracetic acid in deriving occupational exposure limits: a minireview. , 2015, Toxicology letters.

[88]  Zelong Han,et al.  A case of acute glutaraldehyde-induced colitis following polyps treated by EMR , 2015, International Journal of Colorectal Disease.

[89]  P. McNamara,et al.  The impact of triclosan on the spread of antibiotic resistance in the environment , 2015, Front. Microbiol..

[90]  J. Weese,et al.  Hospital-Associated Infections in Small Animal Practice , 2015, Veterinary Clinics of North America: Small Animal Practice.

[91]  M. Memmi,et al.  Health care-associated hepatitis C virus infection. , 2014, World journal of gastroenterology.

[92]  N. Benomar,et al.  Role of EfrAB efflux pump in biocide tolerance and antibiotic resistance of Enterococcus faecalis and Enterococcus faecium isolated from traditional fermented foods and the effect of EDTA as EfrAB inhibitor. , 2014, Food microbiology.

[93]  V. S. Bernad,et al.  Fundamentos de antisepsia, desinfección y esterilización , 2014 .

[94]  G. López,et al.  Coordinated response of phospholipids and acyl components of membrane lipids in Pseudomonas putida A (ATCC 12633) under stress caused by cationic surfactants. , 2014, Microbiology.

[95]  A. Yan,et al.  Bacterial multidrug efflux pumps: mechanisms, physiology and pharmacological exploitations. , 2014, Biochemical and biophysical research communications.

[96]  G. Hédelin,et al.  Asthma among workers in healthcare settings: role of disinfection with quaternary ammonium compounds , 2014, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[97]  I. Schwebke,et al.  Evaluation of a Virucidal Quantitative Carrier Test for Surface Disinfectants , 2014, PloS one.

[98]  R. Santos,et al.  Chlorhexidine activity against bacterial biofilms. , 2013, American journal of infection control.

[99]  J. Maillard,et al.  The effect of cationic microbicide exposure against Burkholderia cepacia complex (Bcc); the use of Burkholderia lata strain 383 as a model bacterium , 2013, Journal of applied microbiology.

[100]  S. Lamaudière,et al.  Comparison of the virucidal efficiency of peracetic acid, potassium monopersulfate and sodium hypochlorite on hepatitis A and enteric cytopathogenic bovine orphan virus , 2013, Journal of applied microbiology.

[101]  J. Maillard,et al.  Does microbicide use in consumer products promote antimicrobial resistance? A critical review and recommendations for a cohesive approach to risk assessment. , 2013, Microbial drug resistance.

[102]  C. J. Law,et al.  The major facilitator superfamily transporter MdtM contributes to the intrinsic resistance of Escherichia coli to quaternary ammonium compounds. , 2013, The Journal of antimicrobial chemotherapy.

[103]  S. Shih,et al.  Efficacy of alcohols and alcohol-based hand disinfectants against human enterovirus 71. , 2013, The Journal of hospital infection.

[104]  G. Moscato,et al.  Allergy to ortho-phthalaldehyde in the healthcare setting: advice for clinicians , 2013, Expert review of clinical immunology.

[105]  M. Jackson,et al.  Aldehyde-resistant mycobacteria bacteria associated with the use of endoscope reprocessing systems. , 2012, American Journal of Infection Control.

[106]  W. Rutala,et al.  Efficacy of Improved Hydrogen Peroxide against Important Healthcare-Associated Pathogens , 2012, Infection Control & Hospital Epidemiology.

[107]  L. Guardabassi Veterinary hospital-acquired infections: the challenge of MRSA and other multidrug-resistant bacterial infections in veterinary medicine. , 2012, Veterinary journal.

[108]  D. Paulson,et al.  In vivo evaluation of the persistant and residual antimicrobial properties of three hand-scrub and hand-rub regimes in a simulated surgical environment. , 2012, The Journal of hospital infection.

[109]  A. Hamouda,et al.  Klebsiella pneumoniae susceptibility to biocides and its association with cepA, qacΔE and qacE efflux pump genes and antibiotic resistance. , 2012, The Journal of hospital infection.

[110]  C. Decamp,et al.  Prevalence and antimicrobial resistance of Enterococcus spp and Staphylococcus spp isolated from surfaces in a veterinary teaching hospital. , 2012, Journal of the American Veterinary Medical Association.

[111]  N. Miner,et al.  Rinsability of Orthophthalaldehyde from Endoscopes , 2012, Diagnostic and therapeutic endoscopy.

[112]  D. McKenna,et al.  Chlorhexidine bathing to reduce central venous catheter-associated bloodstream infection: impact and sustainability. , 2012, The American journal of medicine.

[113]  R. Vijayakumar,et al.  In vitro Antifungal Efficacy of Biguanides and Quaternary Ammonium Compounds against Cleanroom Fungal Isolates , 2012, PDA Journal of Pharmaceutical Science and Technology.

[114]  I. Tryland,et al.  No simple solution to waterborne fungi: various responses to water disinfection methods , 2012 .

[115]  U. Holzgrabe,et al.  Quaternary Ammonium Salts and Their Antimicrobial Potential: Targets or Nonspecific Interactions? , 2012, ChemMedChem.

[116]  Y. Niwano,et al.  Bactericidal effects and cytotoxicity of new aromatic dialdehyde disinfectants (ortho-phthalaldehyde). , 2011, Biocontrol science.

[117]  R. Briandet,et al.  Resistance of bacterial biofilms to disinfectants: a review , 2011, Biofouling.

[118]  J. Weese Infection control in veterinary practice; the time is now. , 2011, The Journal of small animal practice.

[119]  Tudor I. Oprea,et al.  Microbial efflux pump inhibition: tactics and strategies. , 2011, Current pharmaceutical design.

[120]  M. Barton,et al.  Carriage of methicillin-resistant Staphylococcus aureus by veterinarians in Australia. , 2011, Australian veterinary journal.

[121]  J. Johansen,et al.  Occupational contact urticaria caused by didecyl dimethyl ammonium chloride. , 2011 .

[122]  T. Matsui,et al.  Ortho-phthalaldehyde-induced skin mucous membrane damage from inadequate washing , 2011, BMJ Case Reports.

[123]  P. Marujo,et al.  Involvement, and dissemination, of the enterococcal small multidrug resistance transporter QacZ in resistance to quaternary ammonium compounds. , 2011, The Journal of antimicrobial chemotherapy.

[124]  Bjørn Tore Lunestad,et al.  Does the wide use of quaternary ammonium compounds enhance the selection and spread of antimicrobial resistance and thus threaten our health? , 2010, Microbial drug resistance.

[125]  K. Whitehead,et al.  Virucidal efficacy of disinfectant actives against feline calicivirus, a surrogate for norovirus, in a short contact time. , 2010, American journal of infection control.

[126]  O. Uygur-Bayramiçli,et al.  Chemical Colitis Due to Glutaraldehyde: Case Series and Review of the Literature , 2009, Digestive Diseases and Sciences.

[127]  R. Trengove,et al.  Comparative susceptibility of planktonic and 3‐day‐old Salmonella Typhimurium biofilms to disinfectants , 2009, Journal of applied microbiology.

[128]  J. Maillard,et al.  Polyhexamethylene biguanide exposure leads to viral aggregation , 2009, Journal of applied microbiology.

[129]  Diana Anderson,et al.  Anaphylaxis with use of eye‐drops containing benzalkonium chloride preservative , 2009, Clinical & experimental optometry.

[130]  J. Maillard,et al.  Evaluation of the bactericidal efficacy of three different alcohol hand rubs against 57 clinical isolates of S. aureus. , 2009, Journal of Hospital Infection.

[131]  H. Flemming,et al.  Persistence of Pseudomonas aeruginosa in drinking-water biofilms on elastomeric material , 2009 .

[132]  P. Morley,et al.  Characteristics of Biosecurity and Infection Control Programs at Veterinary Teaching Hospitals , 2022 .

[133]  Andrew A. White,et al.  Anaphylaxis following cystoscopy with equipment sterilized with Cidex OPA (ortho-phthalaldehyde): a review of two cases. , 2008, Journal of endourology.

[134]  K. Coombs,et al.  Survival of enveloped and non-enveloped viruses on surfaces compared with other micro-organisms and impact of suboptimal disinfectant exposure. , 2008, The Journal of hospital infection.

[135]  I. Hunter,et al.  Efficacy of common hospital biocides with biofilms of multi-drug resistant clinical isolates. , 2008, Journal of medical microbiology.

[136]  M. Webber,et al.  Triclosan resistance in Salmonella enterica serovar Typhimurium. , 2008, The Journal of antimicrobial chemotherapy.

[137]  P. Spedding,et al.  Evaporation of the Ethanol and Water Components Comprising a Binary Liquid Mixture , 2008 .

[138]  T. Elliott,et al.  Sporicidal activity of two disinfectants against Clostridium difficile spores. , 2008, British journal of nursing.

[139]  T. Kondo,et al.  Reduction of disinfectant bactericidal activities in clinically isolated Acinetobacter species in the presence of organic material. , 2008, The Journal of antimicrobial chemotherapy.

[140]  L. Piddock,et al.  Commonly used farm disinfectants can select for mutant Salmonella enterica serovar Typhimurium with decreased susceptibility to biocides and antibiotics without compromising virulence. , 2007, The Journal of antimicrobial chemotherapy.

[141]  P. S. Boeris,et al.  Modification of phospholipid composition in Pseudomonas putida A ATCC 12633 induced by contact with tetradecyltrimethylammonium , 2007, Journal of applied microbiology.

[142]  A. Henriques,et al.  Structure, assembly, and function of the spore surface layers. , 2007, Annual review of microbiology.

[143]  S. Sørensen,et al.  Substrate specificity of the OqxAB multidrug resistance pump in Escherichia coli and selected enteric bacteria. , 2007, The Journal of antimicrobial chemotherapy.

[144]  C. Robertson,et al.  A microbiological evaluation of hospital cleaning methods , 2007, International journal of environmental health research.

[145]  Sara Cleto,et al.  Antimicrobial mechanisms of ortho ‐phthalaldehyde action , 2007, Journal of basic microbiology.

[146]  B. Adams,et al.  Ortho-phthalaldehyde causing facial stains after cystoscopy. , 2007, Archives of Dermatology.

[147]  A. Dusé,et al.  Efflux pump activity in fluoroquinolone and tetracycline resistant Salmonella and E. coli implicated in reduced susceptibility to household antimicrobial cleaning agents. , 2007, International journal of food microbiology.

[148]  K. Poole Efflux pumps as antimicrobial resistance mechanisms , 2007, Annals of medicine.

[149]  Navid Omidbakhsh A new peroxide-based flexible endoscope-compatible high-level disinfectant. , 2006, American journal of infection control.

[150]  P. Setlow Spores of Bacillus subtilis: their resistance to and killing by radiation, heat and chemicals , 2006, Journal of applied microbiology.

[151]  S. Sattar,et al.  Broad-spectrum microbicidal activity, toxicologic assessment, and materials compatibility of a new generation of accelerated hydrogen peroxide-based environmental surface disinfectant , 2006, American Journal of Infection Control.

[152]  T. Nito,et al.  Ortho-phthalaldehyde-induced anaphylaxis after laryngoscopy. , 2006, The Journal of allergy and clinical immunology.

[153]  J. D. de Waard,et al.  [Inactivation of mycobacteria by disinfectants with a tuberculocidal label]. , 2006, Enfermedades infecciosas y microbiologia clinica.

[154]  H. C. van der Mei,et al.  Resistance to a polyquaternium-1 lens care solution and isoelectric points of Pseudomonas aeruginosa strains. , 2006, The Journal of antimicrobial chemotherapy.

[155]  C. Burns,et al.  Respiratory Cancer Risks Among Workers With Glutaraldehyde Exposure , 2006, Journal of Occupational and Environmental Medicine.

[156]  R. Grillot,et al.  In vitro testing of fungicidal activity of biocides against Aspergillus fumigatus. , 2005, Journal of medical microbiology.

[157]  K. Poole Efflux-mediated antimicrobial resistance. , 2005, The Journal of antimicrobial chemotherapy.

[158]  Teruyo Ito,et al.  Susceptibilities to antiseptic agents and distribution of antiseptic-resistance genes qacA/B and smr of methicillin-resistant Staphylococcus aureus isolated in Asia during 1998 and 1999. , 2005, Journal of medical microbiology.

[159]  A. T. Sheldon Antiseptic "resistance": real or perceived threat? , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[160]  E. Zeiger,et al.  Genetic toxicity and carcinogenicity studies of glutaraldehyde--a review. , 2005, Mutation research.

[161]  P. Setlow,et al.  Analysis of factors that influence the sensitivity of spores of Bacillus subtilis to DNA damaging chemicals , 2005, Journal of applied microbiology.

[162]  M. Uyeda,et al.  Evaluation of the Antimicrobial Activity and Materials Compatibility of Orthophthalaldehyde as a High-level Disinfectant , 2005, The Journal of international medical research.

[163]  Y. Cossart,et al.  Is biofilm accumulation on endoscope tubing a contributor to the failure of cleaning and decontamination? , 2004, The Journal of hospital infection.

[164]  P. Morley,et al.  Environmental surveillance for Salmonella enterica in a veterinary teaching hospital. , 2004, Journal of the American Veterinary Medical Association.

[165]  W. Sokol Nine episodes of anaphylaxis following cystoscopy caused by Cidex OPA (ortho-phthalaldehyde) high-level disinfectant in 4 patients after cytoscopy. , 2004, The Journal of allergy and clinical immunology.

[166]  J. Weese,et al.  Isolation of methicillin-resistant Staphylococcus aureus from the environment in a veterinary teaching hospital. , 2004, Journal of veterinary internal medicine.

[167]  E C Cole,et al.  Investigation of antibiotic and antibacterial agent cross‐resistance in target bacteria from homes of antibacterial product users and nonusers , 2003, Journal of applied microbiology.

[168]  T. Alston,et al.  Perioral stains after ortho-phthalaldehyde disinfection of echo probes. , 2003, Anesthesiology.

[169]  M. Másson,et al.  Soft antibacterial agents. , 2003, Current medicinal chemistry.

[170]  S. Hession Endoscope Disinfection by Ortho-phthalaldehyde in a Clinical Setting: An Evaluation of Reprocessing Time and Costs Compared With Glutaraldehyde , 2003, Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates.

[171]  H. Schweizer,et al.  High-level triclosan resistance in Pseudomonas aeruginosa is solely a result of efflux. , 2003, American journal of infection control.

[172]  P. Lambert,et al.  Cellular impermeability and uptake of biocides and antibiotics in Gram‐positive bacteria and mycobacteria , 2002, Symposium series.

[173]  J. Maillard Bacterial target sites for biocide action , 2002, Journal of applied microbiology.

[174]  J. Maillard,et al.  Cellular impermeability and uptake of biocides and antibiotics in Gram‐negative bacteria , 2002, Journal of applied microbiology.

[175]  K. Poole Mechanisms of bacterial biocide and antibiotic resistance , 2002, Journal of applied microbiology.

[176]  S. Iijima,et al.  Investigation of Irritant Skin Reaction by 10% Povidone-Iodine Solution after Surgery , 2002, Dermatology.

[177]  P. Lambert,et al.  Pseudomonas aeruginosa cells adapted to benzalkonium chloride show resistance to other membrane-active agents but not to clinically relevant antibiotics. , 2002, The Journal of antimicrobial chemotherapy.

[178]  I. Grant,et al.  Bactericidal effect of chlorine on Mycobacterium paratuberculosis in drinking water , 2001, Letters in applied microbiology.

[179]  A. D. Russell,et al.  Possible mechanisms for the relative efficacies of ortho‐phthalaldehyde and glutaraldehyde against glutaraldehyde‐resistant Mycobacterium chelonae , 2001, Journal of applied microbiology.

[180]  A. D. Russell,et al.  Comparison of the mycobactericidal activity of ortho- phthalaldehyde, glutaraldehyde and other dialdehydes by a quantitative suspension test. , 2001, The Journal of hospital infection.

[181]  C Winder,et al.  The toxicology of chlorine. , 2001, Environmental research.

[182]  J. Maillard,et al.  Development of resistance to chlorhexidine diacetate in Pseudomonas aeruginosa and the effect of a "residual" concentration. , 2000, The Journal of hospital infection.

[183]  J. Maillard,et al.  A NOTE: Ortho‐Phthalaldehyde: proposed mechanism of action of a new antimicrobial agent , 2000, Letters in applied microbiology.

[184]  Donald V. Belsito,et al.  Allergic contact dermatitis from glutaraldehyde in health‐care workers , 2000, Contact dermatitis.

[185]  C. Winder,et al.  Outer membrane protein shifts in biocide‐resistant Pseudomonas aeruginosa PAO1 , 2000, Journal of applied microbiology.

[186]  M. Kopferschmitt‐Kubler,et al.  Quaternary ammonium compounds and occupational asthma , 2000, International archives of occupational and environmental health.

[187]  D. Allison,et al.  An evaluation of the potential of the multiple antibiotic resistance operon (mar) and the multidrug efflux pump acrAB to moderate resistance towards ciprofloxacin in Escherichia coli biofilms. , 2000, The Journal of antimicrobial chemotherapy.

[188]  F. Dubois-Brissonnet,et al.  Specific variations of fatty acid composition of Pseudomonas aeruginosa ATCC 15442 induced by Quaternary Ammonium Compounds and relation with resistance to bactericidal activity , 1999, Journal of applied microbiology.

[189]  J. Maillard,et al.  Ortho‐phthalaldehyde: a possible alternative to glutaraldehyde for high level disinfection , 1999, Journal of applied microbiology.

[190]  L. Méchin,et al.  Adaptation of Pseudomonas aeruginosa ATCC 15442 to didecyldimethylammonium bromide induces changes in membrane fatty acid composition and in resistance of cells , 1999, Journal of applied microbiology.

[191]  S. Parikh,et al.  Structural basis and mechanism of enoyl reductase inhibition by triclosan. , 1999, Journal of molecular biology.

[192]  R J Heath,et al.  Mechanism of Triclosan Inhibition of Bacterial Fatty Acid Synthesis* , 1999, The Journal of Biological Chemistry.

[193]  Antoni R. Slabas,et al.  Molecular basis of triclosan activity , 1999, Nature.

[194]  A. Holck,et al.  The qacG gene on plasmid pST94 confers resistance to quaternary ammonium compounds in staphylococci isolated from the food industry , 1999, Journal of applied microbiology.

[195]  S. Levy,et al.  Triclosan targets lipid synthesis , 1998, Nature.

[196]  A. Holck,et al.  The Staphylococcus qacH gene product: a new member of the SMR family encoding multidrug resistance. , 1998, FEMS microbiology letters.

[197]  P. Stewart,et al.  Nonuniform spatial patterns of respiratory activity within biofilms during disinfection , 1995, Applied and environmental microbiology.

[198]  S. Sattar,et al.  Feasibility of a combined carrier test for disinfectants: studies with a mixture of five types of microorganisms. , 1994, American journal of infection control.

[199]  L. Rubin,et al.  Use of disinfectants to reduce microbial contamination of hubs of vascular catheters , 1993, Journal of clinical microbiology.

[200]  S. Sattar,et al.  Chemical disinfection of hepatitis A virus on environmental surfaces , 1990, Applied and environmental microbiology.

[201]  S. Sattar,et al.  Efficacies of selected disinfectants against Mycobacterium tuberculosis , 1990, Journal of clinical microbiology.

[202]  M G Baldry,et al.  The bactericidal, fungicidal and sporicidal properties of hydrogen peroxide and peracetic acid. , 1983, The Journal of applied bacteriology.

[203]  P. Gélinas,et al.  Neutralization of the activity of eight disinfectants by organic matter. , 1983, The Journal of applied bacteriology.

[204]  G. A. Miles,et al.  The antibacterial properties of sodium dichloroisocyanurate and sodium hypochlorite formulations. , 1979, The Journal of applied bacteriology.

[205]  J. Kelsey,et al.  Sporicidal activity of hospital disinfectants , 1974, Journal of clinical pathology.

[206]  J. F. Guastavino,et al.  Synthesis and Properties of Cleavable Quaternary Ammonium Compounds. , 2021, Journal of oleo science.

[207]  A. Gálvez,et al.  Biocide Tolerance and Antibiotic Resistance in Salmonella Isolates from Hen Eggshells. , 2017, Foodborne pathogens and disease.

[208]  E. Dworniczek,et al.  Antibacterial activity of gemini quaternary ammonium salts. , 2014, FEMS microbiology letters.

[209]  G. Fleming,et al.  Effect of subinhibitory concentrations of benzalkonium chloride on the competitiveness of Pseudomonas aeruginosa grown in continuous culture. , 2010, Microbiology.

[210]  A D Russell,et al.  Concentration: a major factor in studying biocidal action. , 2000, The Journal of hospital infection.

[211]  J. S. Chapman,et al.  Preservative tolerance and resistance , 1998, International journal of cosmetic science.

[212]  B. Demple,et al.  Redox signaling and gene control in the Escherichia coli soxRS oxidative stress regulon--a review. , 1996, Gene.