Disinfection's impact on the environment, molecular cross-resistance with antibiotics, and modern reduction approaches

消毒对环境的影响、与抗生素的分子交叉耐药性以及现代减量方法

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Abstract

Industrial disinfectant use has become concerning due to its antimicrobial resistance (AMR)- promoting properties, leading to antibiotic and disinfectant co-resistance. This research investigates the genetic processes by which disinfectants enhance bacterial resistance to antibiotics by analyzing multidrug efflux pumps and mobile genetic elements (MGEs). Bacterial cells that encounter disinfectants tend to increase their production of efflux pumps, which simultaneously protect them against disinfectants and various antibiotics. Multidrug resistance in Pseudomonas aeruginosa arises when the bacterium encounters chlorine disinfectants, which activate the MexEF-OprN efflux pump. Horizontal gene transfer (HGT) is an essential factor for the simultaneous selection of both antibiotic- and disinfectant-resistance genes. Scientific evidence demonstrates that chlorination, along with other disinfectants, increases horizontal gene transfer rates, thereby facilitating the exchange of antibiotic resistance genes among bacterial species. The uptake of foreign genetic material occurs through the combined effects of increased membrane permeability and oxidative stress, which promote the process. The development of resistance results from two main mechanisms: horizontal gene transfer and natural genetic adaptations. Bacteria are exposed to disinfectants, which can cause genetic mutations that activate resistance proteins and other defense systems. The resistance of Pseudomonas aeruginosa bacteria to antibiotics increases due to changes in the pmrB gene. Some experimental results indicate that contact with disinfectants may decrease bacterial antibiotic resistance by either slowing bacterial growth or altering the production of virulence factors. This paper highlights the need for stricter regulations on disinfectant use, given their potential to foster the development of multidrug resistance. Further research into the genetic mechanisms underlying disinfectant-induced resistance is essential to understand better and mitigate its impact on public health. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43188-026-00340-4.

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