Hand sanitizers are losing kill power against this germ in hospitals, study finds

In hospitals, one bacterial species is becoming increasingly tolerant to the alcohols used in hand sanitizer...

Posted: Aug 3, 2018 9:11 AM
Updated: Aug 3, 2018 9:11 AM

In hospitals, one bacterial species is becoming increasingly tolerant to the alcohols used in hand sanitizers, according to research published Wednesday in the journal Science Translational Medicine.

Globally, hospitals use isopropyl or ethyl alcohol-based disinfectants, such as hand rubs, to prevent patients from becoming sick from many germs. These are the same active ingredients found in hand sanitizers available for personal use and at schools -- but that doesn't mean people should give up on them.

Australia

Bacteria

Business and industry sectors

Business, economy and trade

Cleaning products

Consumer products

Continents and regions

Germs

Health and medical

Health care

Health care facilities

Hospitals

Life forms

Microscopic life

Oceania

Prevention and wellness

The bacterium Enterococcus faecium resides in our guts, but if encountered in a hospital, it can cause various complicated infections affecting the abdomen, skin, urinary tract and blood. This particular bug is a member of the Enterococci family, which ranks as the fourth and fifth leading cause of sepsis, a life-threatening bloodstream infection, in North America and Europe, respectively.

Many hospital-acquired infections have decreased or been kept in check by Australia's strict hygiene practices that rely on alcohol-based hand sanitizers. Yet drug-resistant E. faecium infections have increased in Australian hospitals over time, according to the study authors.

This alarming pattern prompted them to investigate whether E. faecium might be developing resistance to the alcohols used in hand rubs.

Another form of resistance

The researchers analyzed 139 bacterial samples from two Melbourne hospitals collected over 19 years ending in 2015. They studied how well each sample survived when exposed to diluted isopropyl alcohol.

The isolates gathered after 2009 were, on average, more tolerant to the alcohol compared with bacteria taken from before 2004, the researchers discovered. Conducting mice experiments and further analysis, they also saw that alcohol-tolerant bacterial samples harbored several genetic mutations involved in metabolism, which made them better equipped to live in the gut.

Although the results suggest that microbes can adapt to alcohols and other ingredients found in disinfectants, this conclusion cannot be drawn until more research is done, the researchers warn.

"There are two things we are working on," said Tim Stinear, a co-author of the study and professor at the University of Melbourne. "One is understanding exactly how the bacteria are becoming more tolerant. ... The second is what's going on in other parts of the world, and we are working with colleagues around the world to address that."

One-third of all enterococcal infections in Australian hospitals are caused by E. faecium, according to Stinear and his co-authors. Of these, 90% were ampicillin-resistant strains, and half of those were resistant to vancomycin, another common antibiotic. Even when doctors try a higher-grade antibiotic to treat such illnesses, the outcome may be further drug resistance -- and a longer-lasting infection for the patient.

Study co-author Paul Johnson, an infectious diseases professor and director of research at Austin Health in Melbourne, said that when it comes to preventing certain outbreaks, including vancomycin-resistant enterococci, hospitals might need to use more than standard precautions such as hand hygiene.

"We might need to specifically add additional control measures," he said. Such measures could include using an additional bacteria-killing agent, such as chlorhexidine, to sanitize hands in some medical care settings.

True perhaps in hospitals, but the same might not apply to the world at large.

Don't throw away the hand sanitizer

"The bottom line is, this is a really good study," said James Scott, a professor at the Dalla Lana School of Public Health at the University of Toronto.

"It's one of these things that microbiologists thought might happen for a long time, but no one really bothered to test it," said Scott, who did not participate in the research. Now, he said, it's "pretty clear" that alcohol-resistance does happen.

Yet, he added, the results might not translate to the everyday use of hand sanitizers.

"The germs that were tested in this study are really hospital-based germs, not the kind of thing you would encounter in the community routinely," he said. In the community, people use hand sanitizers to kill germs that spread foodborne illness, such as listeria and salmonella.

"The hospital situation is very different," he said, explaining that in the closed environment of a hospital with highly susceptible patients, there's an opportunity for organisms to evolve. "It can lead over time to a growth in resistance."

"Rubbing alcohol has long been used in medicine as a disinfectant for skin surfaces and environmental surfaces," Scott said. "It has been generally thought that rubbing alcohol was fairly safe from the emergence of resistance amid susceptible germs. This interesting and carefully done study refutes that assumption."

Scientists have known for a long time that rubbing alcohol is not a universal disinfectant, because a number of important germs are highly resistant to disinfection by alcohol, he said. One example: "Clostridium difficile, an agent of serious diarrheal disease responsible for hospital outbreaks."

"It is important for people to understand that this study is specifically concerned with one particular germ that is increasingly implicated in hospital-acquired infections," Scott said. "This study really only applies to the specific environment of hospitals, and I'm confident that alcohol-based disinfectants will continue to remain highly effective in general use."

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 941120

Reported Deaths: 15315
CountyCasesDeaths
Marion1282511983
Lake633041097
Allen53609758
Hamilton43827447
St. Joseph41906590
Elkhart33545490
Vanderburgh30383448
Tippecanoe26820249
Johnson23609417
Hendricks22250341
Porter21737346
Clark17409229
Madison17366384
Vigo16108281
Monroe14466191
LaPorte14311239
Delaware14070221
Howard13865272
Kosciusko11418135
Hancock10841165
Warrick10674177
Bartholomew10542168
Floyd10430205
Wayne9959226
Grant9130204
Morgan8865160
Boone8389111
Dubois7710123
Dearborn762289
Henry7608130
Noble7413101
Marshall7362128
Cass7176117
Lawrence6957153
Shelby6584111
Jackson656785
Gibson6156107
Harrison603786
Huntington600195
Montgomery5805105
DeKalb574291
Knox5494104
Miami542488
Putnam536768
Clinton533665
Whitley524953
Steuben497268
Wabash483592
Jasper479160
Jefferson470092
Ripley454277
Adams444068
Daviess4169108
Scott405865
White391857
Clay390857
Greene388392
Decatur385296
Wells384983
Fayette374278
Posey359941
Jennings353156
Washington332047
LaGrange321375
Spencer317835
Fountain316555
Randolph312888
Sullivan307449
Owen283863
Starke280064
Fulton277553
Orange275859
Jay254837
Perry251652
Carroll243729
Franklin239338
Rush234130
Vermillion233250
Parke219820
Tipton209655
Pike207639
Blackford168334
Pulaski163551
Crawford146018
Newton144345
Benton142516
Brown135346
Martin128217
Switzerland125810
Warren114616
Union96911
Ohio79711
Unassigned0479

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 1365800

Reported Deaths: 21596
CountyCasesDeaths
Franklin1522221560
Cuyahoga1344852327
Hamilton976051320
Montgomery670271141
Summit562091047
Lucas50900863
Butler47417655
Stark41580976
Lorain31567532
Warren30001331
Mahoning26963639
Clermont25628292
Lake24585417
Delaware22313145
Licking20487241
Fairfield20420221
Greene20309272
Trumbull19866509
Medina19796287
Clark17879328
Richland16314234
Portage16130229
Wood15681208
Allen14115256
Miami13786253
Muskingum12641152
Wayne11946238
Columbiana11708241
Tuscarawas10953269
Marion10725148
Pickaway10465129
Scioto10324127
Erie9747171
Ross9436176
Lawrence8755125
Hancock8458141
Ashtabula8317185
Geauga8173156
Belmont8140187
Jefferson7527172
Huron7423128
Union731851
Washington7183120
Athens697165
Sandusky6848134
Darke6756136
Knox6671122
Seneca6358137
Ashland5948113
Auglaize587188
Shelby5727101
Brown564171
Mercer557890
Defiance5483101
Madison543371
Crawford5425114
Highland541581
Fulton530683
Clinton525580
Logan512182
Preble4994110
Putnam4833106
Guernsey470364
Williams459282
Perry449852
Champaign445964
Ottawa436884
Jackson425362
Pike388843
Morrow383851
Fayette375853
Coshocton374766
Adams360675
Hardin359069
Gallia347356
Holmes3259108
Henry324668
Van Wert314670
Hocking301769
Wyandot280658
Carroll262652
Paulding242243
Meigs213942
Monroe189749
Noble169340
Morgan165829
Harrison157940
Vinton138118
Unassigned05
Fort Wayne
Cloudy
55° wxIcon
Hi: 56° Lo: 47°
Feels Like: 55°
Angola
Cloudy
50° wxIcon
Hi: 53° Lo: 46°
Feels Like: 50°
Huntington
Cloudy
55° wxIcon
Hi: 55° Lo: 47°
Feels Like: 55°
Decatur
Cloudy
55° wxIcon
Hi: 56° Lo: 47°
Feels Like: 55°
Van Wert
Cloudy
52° wxIcon
Hi: 55° Lo: 47°
Feels Like: 52°
Rain chances continue for at least the first half of Thursday before gradually tapering off.
WFFT Radar
WFFT Temperatures
WFFT National

Community Events