Cross-resistance between biocides and antimicrobials: an emerging question

The widespread use of biocides, and their resulting dissemination in the environment, can contribute to adaptations in bacteria leading to the development of low-level susceptibility to antibacterial agents. The mechanisms of resistance in bacteria are similar for both antimicrobials and biocides, and exposure to biocides can result in cross-resistance to antibacterial agents. Resistance mechanisms altering the activity of biocide and antibiotic molecules are discussed with regard to regulation and mode of action in the light of laboratory studies of induced resistance. It is clear that in order to preserve their activity and avoid the development of possible cross-resistance, prudent use of antibacterial agents is to be strongly recommended, not only in clinical settings but also in veterinary and agricultural and other applications.