Antibiotic Resistant Infections Could Be Increasing Due to Use of Disinfectants in Intensive Care Unit (ICU): Study

Backing off of universal disinfection protocols may reduce incidents of antibiotic resistance among certain bacteria found in hospital intensive care units.

A new study suggests that disinfection protocols commonly used for all intensive care patients may be contributing to a rise in antibiotic-resistant bacterial infections, which are often difficult to treat and life-threatening.

According to findings published in the journal The Lancet Microbe on June 11, hospitals may need to reevaluate routine antiseptic practices implemented across many intensive care units (ICUs) worldwide.

Hospitals often apply antiseptic and antibiotic treatments to ICU patients upon admission, as part of an effort to reduce the risk of infections. This standard approach typically includes bathing with chlorhexidine and a nasal application of mupirocin, an antibiotic designed to eliminate harmful bacteria.

This is a practice that first started in the 1990s to prevent the spread of methicillin-resistant staphylococcus aureus (MRSA), a bacteria resistant to many forms of antibiotics.

However, researchers have found that these attempts to kill MRSA bacteria may be leading to the proliferation and spread of other antibiotic-resistant bacteria. These kinds of bacteria have become a serious global problem, since available treatments are not effective and the infections typically result in long hospital stays and an increased risk of death.

In this new report, an international team of researchers conducted a study at two intensive care units located in Scotland.

Led by Dr. Karolin Hijazi from the University of Aberdeen in the United Kingdom, the team tested reductions in universal disinfection practices from 2009 to 2022, comparing bacterial infection levels and rates of antibiotic resistant bacteria among ICU patients across the study period.

The first ICU followed universal disinfection but stopped the practice part way into the study in 2019, and only conducted targeted decolonization for patients who tested positive for MRSA. The second ICU observed in the study conducted targeted disinfection during the entire study period.

Researchers said the data showed a strong link between an increase in antibiotic resistant bacteria and universal disinfection procedures. The ICU that used universal disinfection procedures had more cases of methicillin-resistant sepidermidis (MRSE) compared to the hospital that used targeted disinfection.

MRSE was identified in 45%, or 334 of 735 bloodstream infections in ICU One. Of those, 197, or 58%, occurred before the de-escalation intervention. MRSE was found in 60% of 278 bloodstream infections in ICU Two.

However, ICU One did have a decrease in the incidence of MRSE bloodstream infections, dropping from 10 cases per 1,000 hospital bed days to 4 cases per 1,000 hospital bed days.

Researchers determined the findings show a need to reassess healthcare guidelines on the widespread use of universal disinfection procedures. Some countries may need to move to targeted disinfection protocols, while other countries that continue to have high rates of MRSA may need to continue universal disinfection procedures.

Antibiotic Resistance Continues To Spread

Antibiotic-resistant “superbugs” continue to be a widespread issue for healthcare settings globally. Research published in 2024 warned that nearly 40 million people will die from antibiotic-resistant infections by 2050 unless drastic measures are taken.

Research has long pointed to doctors’ inappropriate antibiotic prescribing as a key factor in the proliferation of superbugs. Even short-term antibiotic use can lead to prolonged disruption of the human microbiome that can cause antibiotic-resistance. Courses of common antibiotics like Cipro, taken for just five days, can disrupt the gut for up to one year.

Hospitals aren’t the only healthcare facilities impacted by antibiotic-resistant bacterial infections. Research published earlier this year indicated antibiotic-resistant bacteria is commonly found on the skin of nursing home residents.