Abstract：
OBJECTIVE: Hospital-acquired infections (HAIs) caused by antimicrobial-resistant ESKAPE pathogens are a significant concern for the healthcare industry, with an estimated cost of up to ${\\$}$45 billion per year in the US alone. Clostridioides difficile is an additional opportunistic pathogen that also poses a serious threat to immunocompromised patients in hospitals. Infections caused by these pathogens lead to increased hospital stays and repeated readmission, resulting in a significant economic burden. Disinfectants and sporicidals are essential to reduce the risk of these pathogens in hospitals, but commercially available products can have a number of disadvantages including inefficacy, long contact times, short shelf lives, and operator health hazards. In this study we evaluated the effectiveness of Rosin (a natural substance secreted by coniferous trees as a defence mechanism against wounds in tree bark) and its commercial derivative Rosetax-21 as disinfectants and sporicidal against the six ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) and spore preparations from Clostridioides difficile.
RESULTS: Both Rosin and Rosetax-21 were tested under simulated clean and dirty conditions (with BSA) against the ESKAPE pathogens, and C. difficile spore preparations. In clean conditions, Rosin (5% weight/volume: w/v) demonstrated significant efficacy against five of the ESKAPE pathogens, with A. baumannii and E. faecium being the most susceptible, and K. pneumoniae the most resistant, showing only a one-log reduction after a 5 min treatment. However, in dirty conditions, all pathogens including K. pneumoniae exhibited at least a 3-log reduction to Rosin within 5 min. Rosetax-21 (5% w/v) was found to be less effective than Rosin in clean conditions, a trend that was exacerbated in the presence of BSA. Additionally, both Rosin and Rosetax-21 at 2.5% (w/v) achieved complete eradication of C. difficile spores when combined with 0.5% glutaraldehyde, though their standalone sporicidal activity was limited.
CONCLUSIONS: The findings from this study highlight the potential of Rosin and Rosetax-21 as both bactericidal and sporicidal disinfectants, with their efficacy varying based on the conditions and the pathogens tested. This presents an avenue for the development of novel healthcare disinfection strategies, especially against HAIs caused by antimicrobial-resistant ESKAPE pathogens and C. difficile.
RESULTS: Both Rosin and Rosetax-21 were tested under simulated clean and dirty conditions (with BSA) against the ESKAPE pathogens, and C. difficile spore preparations. In clean conditions, Rosin (5% weight/volume: w/v) demonstrated significant efficacy against five of the ESKAPE pathogens, with A. baumannii and E. faecium being the most susceptible, and K. pneumoniae the most resistant, showing only a one-log reduction after a 5 min treatment. However, in dirty conditions, all pathogens including K. pneumoniae exhibited at least a 3-log reduction to Rosin within 5 min. Rosetax-21 (5% w/v) was found to be less effective than Rosin in clean conditions, a trend that was exacerbated in the presence of BSA. Additionally, both Rosin and Rosetax-21 at 2.5% (w/v) achieved complete eradication of C. difficile spores when combined with 0.5% glutaraldehyde, though their standalone sporicidal activity was limited.
CONCLUSIONS: The findings from this study highlight the potential of Rosin and Rosetax-21 as both bactericidal and sporicidal disinfectants, with their efficacy varying based on the conditions and the pathogens tested. This presents an avenue for the development of novel healthcare disinfection strategies, especially against HAIs caused by antimicrobial-resistant ESKAPE pathogens and C. difficile.
摘要：
目的：由抗菌药物耐药ESKAPE病原体引起的医院获得性感染（HAIs）是医疗保健行业的重要关注点，仅在美国，估计每年的成本就高达450亿美元。艰难梭菌是一种额外的机会病原体，也对医院中免疫功能低下的患者构成严重威胁。由这些病原体引起的感染导致住院时间增加和重复的再入院,造成了巨大的经济负担。消毒剂和孢子虫对降低这些病原体在医院中的风险至关重要，但市售产品可能有许多缺点，包括无效，接触时间长,保质期短,和操作员健康危害。在这项研究中，我们评估了松香（针叶树分泌的一种天然物质，作为对树皮伤口的防御机制）及其商业衍生物Rosetax-21作为消毒剂和杀孢子剂对六种ESKAPE病原体（屎肠球菌，金黄色葡萄球菌,肺炎克雷伯菌,鲍曼不动杆菌,铜绿假单胞菌,和肠杆菌物种）和艰难梭菌的孢子制剂。
结果：松香和Rosetax-21均在模拟清洁和肮脏条件下（使用BSA）对ESKAPE病原体进行了测试，和艰难梭菌孢子制剂。在清洁条件下,松香（5％重量/体积：w/v）显示出对五种ESKAPE病原体的显着功效，鲍曼不动杆菌和屎肠杆菌最易感，肺炎克雷伯菌的耐药性最强,在5分钟的治疗后仅显示一个对数的减少。然而,在肮脏的条件下，包括肺炎克雷伯菌在内的所有病原体在5分钟内显示出至少3-log的松香减少。在清洁条件下，Rosetax-21（5％w/v）的效果不如松香，在BSA的存在下加剧了这一趋势。此外,当与0.5%戊二醛结合时，2.5％（w/v）的松香和Rosetax-21均完全根除艰难梭菌孢子，尽管它们独立的杀孢子活性有限。
结论：这项研究的发现强调了松香和Rosetax-21作为杀菌和杀孢子消毒剂的潜力，其功效根据所测试的条件和病原体而有所不同。这为开发新的医疗保健消毒策略提供了途径，特别是针对由抗菌素耐药性ESKAPE病原体和艰难梭菌引起的HAIs。
结果：松香和Rosetax-21均在模拟清洁和肮脏条件下（使用BSA）对ESKAPE病原体进行了测试，和艰难梭菌孢子制剂。在清洁条件下,松香（5％重量/体积：w/v）显示出对五种ESKAPE病原体的显着功效，鲍曼不动杆菌和屎肠杆菌最易感，肺炎克雷伯菌的耐药性最强,在5分钟的治疗后仅显示一个对数的减少。然而,在肮脏的条件下，包括肺炎克雷伯菌在内的所有病原体在5分钟内显示出至少3-log的松香减少。在清洁条件下，Rosetax-21（5％w/v）的效果不如松香，在BSA的存在下加剧了这一趋势。此外,当与0.5%戊二醛结合时，2.5％（w/v）的松香和Rosetax-21均完全根除艰难梭菌孢子，尽管它们独立的杀孢子活性有限。
结论：这项研究的发现强调了松香和Rosetax-21作为杀菌和杀孢子消毒剂的潜力，其功效根据所测试的条件和病原体而有所不同。这为开发新的医疗保健消毒策略提供了途径，特别是针对由抗菌素耐药性ESKAPE病原体和艰难梭菌引起的HAIs。
