Overuse of Disinfectants in Intensive Care Units May Increase Risk of Antibiotic-Resistant Infections

A recent international study has uncovered a concerning link between the frequent use of disinfectants in intensive care units (ICUs) and the rise of antibiotic-resistant bacteria. Published in The Lancet Microbe, the research highlights that widespread decolonization procedures—such as disinfecting the entire body with chlorhexidine and administering mupirocin nasal treatment—may inadvertently contribute to increased antibiotic resistance.

Decolonization protocols, introduced in the 1990s, were initially effective in reducing the prevalence of MRSA (Methicillin-Resistant Staphylococcus aureus), a resistant bacterium responsible for severe infections. Many countries, including Scotland, successfully decreased MRSA infection rates from around 30-40% to below 5%. However, in Italy, the MRSA prevalence remains high at about 26%, prompting a reassessment of current practices.

The study compared two hospitals in Scotland employing different approaches: some utilizing universal decolonization for all patients, and others adopting targeted decolonization only for those testing positive for MRSA. Findings revealed that hospitals practicing universal decolonization observed higher rates of infections caused by MRSE (Methicillin-Resistant Staphylococcus epidermidis), another resistant bacterium that is gaining prominence. The excessive use of disinfectants like chlorhexidine and mupirocin appeared to promote resistance not only to the targeted bacteria but also to other strains.

According to Professor Hijazi, who coordinated the study, "Our research shows that overusing disinfectants in universal decolonization may be counterproductive, especially in settings where MRSA incidence is low. In some cases, it can lead to a rise in resistant bacteria like MRSE, posing new challenges for infection control."

Experts emphasize that current practices must be adapted to the evolving epidemiological landscape. While targeted decolonization remains necessary in high-risk regions like Italy, the blanket application of disinfectants in low-prevalence areas may need to be reconsidered. The study advocates for developing new guidelines that balance effective infection prevention with the risk of fostering antibiotic resistance.

As highlighted by the study's lead author, Marco Oggioni, "Efforts to prevent antibiotic-resistant infections are vital, but we must also critically evaluate the tools we use to achieve these goals. Reducing unnecessary disinfectant use could help mitigate resistance development while maintaining patient safety."

This research underscores the importance of tailored approaches in infection control and the need for ongoing surveillance and guideline updates to combat antibiotic resistance effectively. It calls for healthcare systems worldwide to rethink decolonization strategies, especially as resistance patterns continue to evolve.

Source: https://medicalxpress.com/news/2025-06-excessive-disinfectants-intensive-patients-antibiotic.html