INF ECT ION PR EVENT ION & CONT ROL
and improve disinfection. SiQuats did not arrive until after the midpoint of the century, with continued improvement in efficacy. In 2008, two UK scientists solved the puzzle that had baffled so many for over half a century, allowing us to now mix multiple SiQuats into compounds now described as “5th generation”. These SiQuat combinations produce broad spectrum of kill for bacteria, viruses, and fungi. They are not deactivated by anionic soaps or detergents and they can stay in place for years on some surfaces making the surface hostile to all microbes. As they do not reduce in concentration
after adhering to a surface, there is no opportunity for a microbe to come into contact with them at sub therapeutic levels (as happened with multiple Quats for NASA), and therefore no opportunity for resistance to be acquired. They are probably the only true micro biocides in use today.
Is the “entourage effect” relevant for the 5th generation SiQuats? There is no doubt that, individually, SiQuats do not kill all microorganisms. We would expect that, as we combine them, they would collectively kill the same microorganisms. However, this does not tell the full story. Once combined, they begin to kill microorganisms that none of them kill individually. There are numerous comparisons that could all point to this simple yet complex truth. The most compelling and closely related theory is probably the “entourage effect”.1,10 The entourage effect is a proposed mechanism by which cannabis compounds act synergistically to modulate the overall psychoactive effects of the plant, primarily
by the action of tetrahydrocannabinol (THC). The current wave of excitement in Cannabis commerce has translated into a flurry of research on alternative sources, particularly yeasts, and complex systems for laboratory production have emerged. However, these presuppose that single compounds are a desirable goal. Rather, the case for Cannabis synergy, via the “entourage effect”, is currently sufficiently strong as to suggest that one molecule is unlikely to match the therapeutic and even industrial potential of Cannabis itself as a phytochemical factory. The astounding plasticity of the Cannabis genome additionally, obviates the need for genetic modification techniques. In 1998, Professors Raphael Mechoulam and Shimon Ben-Shabat posited that, the endocannabinoid system demonstrated an “entourage effect” in which a variety of “inactive” metabolites and closely related molecules markedly increased the activity of the primary endogenous cannabinoids, anandamide and 2-arachidonoylglycerol.10
This and many other studies support the hypothesis that, greater efficacy is obtained when combining the multiple anticonvulsant components, rather than using individual known anticonvulsants in the cannabis plant.
There are other examples of this “holism
theory/ entourage effect” working in practice. In 2015 Fisher et al published their results after impregnating urinary catheters (known to be a high risk of causing an infection) with three antibiotics.11-13
An unexpected
consequence of the combination of antibiotics was to find that together they killed species of bacteria known to be resistant to all three antibiotics individually. They theorise that the bacteria were unable to fend off the attack of the multiple antibiotics due to their similar but different interactions with the cell membrane. When this same hypothesis is applied to the 5th generation SiQuats, we see a similar picture. Bacteria and viruses, in particular, that are normally considered to be resistant to Quats and SiQuats, are being killed by the 5th generation SiQuats. These differences in resistant microbes, and the lack of acquired resistance were not seen initially, as there were issues surrounding the accuracy of efficacy testing.9
There were three main problems with differentiating the efficacy and longevity of the 5th generation SiQuats when compared to previous generations of individual SiQuats: l In 2008 (when the first 5th generation compounds were developed) there was no way of proving that the SiQuats were still available and active on any given surface, as there was no reliable test for their presence.
l The actual efficacy tests themselves were designed for internal medicine and then adapted for use on surfaces and skin testing. While useful for determining species, they are not sensitive enough to be able to count actual numbers of colony forming units (CFUs).9
l The standard tests for microbial efficacy were poorly designed for use with chemicals that are most efficacious
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