INFECTION CONTROL
In Altro’s article, there are several allusions to biocides being part of the problem, rather than part of the solution, highlighting the prolonged exposure to biocides as giving microbes the opportunity to develop resilience. If biocides were being considered as the sole solution to AMR, then this discussion would be extremely damning. However, all credible biocide suppliers clearly and consistently state that, regardless of how effective their biocide is at killing microbes, products must still be cleaned regularly and supported with good hand hygiene. To use figures from the article itself, ‘a surface containing a biocide will reduce 99.9% of microbes, leaving 0.1% as a long-term risk factor’. Introduce an effective cleaning regime and stringent hand hygiene protocols to eliminate any residual bacteria, as well as dirt and grime that may harbour microbes, and the result is the ultimate hygiene solution. A multifaceted solution for a multifaceted problem.
Triclosan
The decisions made surrounding the use of triclosan in certain applications are a demonstration of the importance of using the appropriate biocide for the right purpose. The underlying aim of all regulations on the use and supply of biocides is to provide a protective framework for the public and the environment. With that in mind, being able to prove that a biocide can perform to the purpose for which it has been included is extremely important. Triclosan is in no way representative of any other biocidal group, and decisions made about its fate are not transferrable to other active substances. However, these decisions provide peace of mind to all in the industry, especially suppliers of biocides, that regulations are being taken seriously.
The University of Cardiff research project does indeed show a risk of microbes developing resistance to certain active substances, triclosan included. However, the discussion of that research project acknowledges that the testing was conducted on lower concentrations and over a longer exposure time than would typically be expected in real life. The project tested other biocides, which, even at reduced concentrations, were not shown to trigger resistance. When considering the study in its entirety, one can also draw the valid conclusion that, contrary to the message in Altro’s article, not all biocides perform the same, While there are some valid concerns about the use of triclosan, it is important to recognise that not all antimicrobials are the same; they perform different functions and act in different ways. The decisions surrounding the inappropriate use of one biocide for one or any
38 Health Estate Journal April 2020
‘Biocides lead to relaxed cleaning regimes’:
The suggestion that including a biocide to improve hygiene levels could result in a reduced cleaning regime / practice of those surfaces is incredibly misleading. To hypothetically suggest that a healthcare environment would relax its cleaning regimes because some surfaces have in- built protection demonstrates a distinct lack of understanding about mandatory protocols that dictate the materials used and frequency of cleaning regimes. Accepting this suggestion on face value, while the inclusion of silver-based biocides into surfaces will actively and constantly reduce the presence of microbes on the protected surface, they are not effective against grime and dirt. In any environment, let alone areas where hygiene is of high concern, regular cleaning is a core tool to maintain levels of
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application does not in any way damn all biocides.
cleanliness. Biocides assist cleaning protocols in the upkeep of hygiene in between cleaning, making products easier to keep hygienically clean, as opposed to surfaces that have no protection from microbial activity.
Should a facility allow its cleaning regimes to relax due to the presence of biocidal surfaces, it would be a result of poor policy, not because of biocides. Additionally, the inclusion of biocides in many materials does not impact the aesthetics of the product, so it is unlikely that cleaning staff would be able to identify whether or not a surface contains a biocide.
Questions about silver-based biocides
‘Silver based biocides don’t work in dry environments’:
There is a common misconception that surfaces treated with silver-based antimicrobial additives need to be wet to work. However, silver biocides work in
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