title: Resistance and cross-resistance to oxidising agents of bacterial isolates from endoscope washer disinfectors.
abstract: Bacteria isolated from washer disinfectors using chlorine dioxide as a high-level disinfectant were exposed to peracetic acid, chlorine dioxide and hydrogen peroxide to investigate their susceptibility and possible bacterial cross-resistance to these highly reactive oxidising biocides. A standard suspension test was used to establish a rate of kill of these biocides against two stable isolates (Bacillus subtilis and Micrococcus luteus). Suspension tests demonstrated that 'in use' concentrations were not always effective to provide the required disinfection efficacy within recommended exposure times and in some instances a 60min exposure was necessary to achieve a reduction in number by a factor of 10(5). It appears that vegetative Gram-positive isolates can become resistant to oxidising agents in vitro, and that cross-resistance to related compounds can occur. Since these bacteria are deemed to be susceptible to highly reactive biocides, there should be further study of the resistance mechanisms in these isolates to explain their survival.
authors.affiliation: Welsh School of Pharmacy, Cardiff University, Cardiff, UK.
authors.forename: D J H
authors.initials: DJ
authors.lastname: Martin
authors.forename: S P
authors.initials: SP
authors.lastname: Denyer
authors.forename: G
authors.initials: G
authors.lastname: McDonnell
authors.forename: J-Y
authors.initials: JY
authors.lastname: Maillard
mesh_terms: D001412:Bacillus subtilis / Q000187:drug effects / Q000302:isolation & purification; D017606:Chlorine Compounds / Q000494:pharmacology; D015169:Colony Count, Microbial; D004202:Disinfectants / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D019723:Endoscopes / Q000382:microbiology*; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D006861:Hydrogen Peroxide / Q000494:pharmacology; D050296:Microbial Viability; D016982:Micrococcus luteus / Q000187:drug effects / Q000302:isolation & purification; D010087:Oxides / Q000494:pharmacology; D013997:Time Factors
chemical_list: D017606:Chlorine Compounds; D004202:Disinfectants; D010087:Oxides; C025109:chlorine dioxide; D006861:Hydrogen Peroxide