Relationship of Sanitizers, Disinfectants, and Cleaning Agents with Antimicrobial Resistance

Sanitizers, disinfectants, and cleaning agents are vital to food hygiene assurance and are a major public health protection measure. Limiting microbial antibiotic resistance is also a global public health priority. Although many factors contribute to the rise in antimicrobial resistance in bacteria infecting humans, antibiotic use in both human clinical settings and for food-producing animals are primary contributors. Some concerns have been raised about the possibility of coselection between food hygiene chemicals and reduced antimicrobial susceptibility. This article reviews available evidence from individual studies purporting to demonstrate a possible risk of antimicrobial resistance development, following biocide usage. Furthermore, the conclusions of several key expert reports and meta-analysis publications were assessed for supportive evidence of a relationship between biocide usage in food production and resistance development. Although many studies report on the isolation of antimicrobial-resistant bacterial strains in food, evidence is lacking on the attribution of this resistance to biocide usage. Also, although a theoretical risk of causality exists, many of the studies performed to demonstrate this are in vitro studies using laboratory-grown or -trained bacterial isolates, challenged with sublethal (below the recommended food industry) disinfectant or sanitizing agent concentrations. The proper use of, and adherence to biocide manufacturer's instruction for use, and the avoidance of biocide active agent dilution (e.g., through biofilm presence) must be ensured in food production environments. It is recommended that in situ studies should be performed to further assess causality, ensured a clear differentiation between interpretation of stable antimicrobial resistance and phenotypic adaptation. Furthermore, authorization of new biocidal active substances should take a scientific and risk-based approach regarding the potential for driving microbial resistance.