This 2018 paper is a review of laboratory-based research into the problem of antimicrobial resistance – both resistance to microbiocides and also the issue of whether antibiotic resistance could be linked to microbiocide exposure.
In summary, studies continue to show that biocides are effective in infection prevention in most situations but may fail when used incorrectly. Following such suboptimal exposure, bacteria can develop increased tolerance to commonly used biocides via mechanisms that can, in some cases, confer cross-tolerance to antibiotics. It can also occur via coselection of biocide and antibiotic resistance genes located on the same mobile elements. Although, so far, most evidence of biocide adaptation is based on laboratory findings, there are indications that these may be relevant to the clinic, an aspect that clearly needs further investigation.
Lucy Bock concludes, the link to cross-tolerance and coselection of tolerance to antibiotics is probably the most worrying aspects of biocide adaptation, but is only becoming obvious now that we are beginning to describe some of the biocide resistance mechanisms. The lack of clinical examples of cross-resistance, coselection and increased biocide tolerance, therefore, does not prove that these do not occur, rather that lack of knowledge of mechanisms of biocide resistance has not allowed such studies to be conducted.
Bock LJ. Bacterial biocide resistance: a new scourge of the infectious disease world?. Archives of Disease in Childhood. 2019 Jan 31:archdischild-2018. It can be downloaded from https://www.researchgate.net/profile/Lucy_Bock/publication/330765993_Bacterial_biocide_resistance_A_new_scourge_of_the_infectious_disease_world/links/5c54777b299bf12be3f3ea19/Bacterial-biocide-resistance-A-new-scourge-of-the-infectious-disease-world.pdf