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E IS NO ‘SILVER BULLET’ surface coverings is a hotly contested topic. Lucy Bilotto at Altro, weighs up the arguments.


Antimicrobial resistance occurs naturally over time, usually through genetic changes. However, the misuse and overuse of antimicrobials is accelerating this process.


The extremely widespread use of biocides threatens to speed up antimicrobial resistance because increased exposure means increased opportunity for genetic mutation within the bacteria. WHO stresses that this is not a problem of the future, but an immediate health risk. Data published by WHO’s Global Antimicrobial Surveillance System group in January 2018 revealed ‘widespread occurrence of antibiotic resistance among 500,000 people with suspected bacterial infections across 22 countries’. The most commonly reported resistant bacteria include E.coli and Salmonella, among others.


The company states that, ‘because the residues contain sub-lethal concentrations of the biocidal


product, the targeted bacteria are becoming more resilient against the products used to treat them’.


ANTI-BIOCIDE ARGUMENTS Organisations opposed to the use of biocides, however, argue that the use of these substances needs much tighter regulation, because the extremely widespread (and largely uncontrolled) use of these chemical additives in the world today leads to antimicrobial resistance.


The World Health Organisation (WHO) has identified antimicrobial resistance as a major risk to human life and is urging countries to collaborate in a global action plan to tackle the problem. The WHO factsheet explains:


Antimicrobial resistance happens when microorganisms (such as bacteria, fungi, viruses, and parasites) change when they are exposed to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics). Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.


As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.


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Genesis Biosciences, a company involved in the development of new ‘eco-benign’ antimicrobial products, explains that a key problem with today’s most commonly used biocides is the long-term contact between biocide residues and the bacteria they are designed to kill. The company states that, ‘because the residues contain sub-lethal concentrations of the biocidal product, the targeted bacteria are becoming more resilient against the products used to treat them’. In other words, the more ‘competitive’ bacteria (often those associated with serious health problems) are not entirely destroyed by the biocide. Instead they can remain in contact with the biocide over an extended period of time, if traditional hygiene processes are not followed stringently. This close contact between the bacteria and the chemical designed to kill it creates an ideal environment in which the bacteria can mutate and develop resistance. We all remember the claims about 99.9% of germs being killed by strong cleaning fluids. It is now understood that it is the remaining 0.1% of bacteria that is the long-term risk factor. A particular concern is that use of products containing biocides could lead to a harmful relaxation of cleaning regimes in areas where hygiene is critical, if reliance on the infection control capabilities of the products leads to complacency.


In recent years a number of scientific studies have contributed towards a better understanding of the processes of mutation involved in the development of antimicrobial resistance as a result of biocide use, in addition to the environmental impact of biocides leaching into water


HEALTHCARE | 27


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