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Driving Antibiotic Resistance Evolution of E. coli by Three Commonly Used Disinfectants Under Concentration-Increasing Stress

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Tieyu Wang, Yongqi Li, Jun Xia Jun Xia Jun Xia Yanyang Li, Jun Xia Jun Xia Jun Xia Jun Xia Jun Xia Jun Xia Mengqi Chai, Hangfei Bai, Tieyu Wang, Song Jiang, Jun Xia Tieyu Wang, Tieyu Wang, Jun Xia Jun Xia

Summary

Scientists found that three common disinfectants (including those used in hospitals and cleaning products) can make E. coli bacteria become resistant to both the disinfectants themselves and important antibiotics when exposed to low concentrations over time. This means that leftover disinfectant residues in our environment might be helping create "superbug" bacteria that are harder to treat with medicines. The findings suggest we need to be more careful about how we use and dispose of disinfectants to prevent creating more antibiotic-resistant infections.

Antimicrobial resistance (AMR) has become a major global public health challenge, and widely residual disinfectants in the environment are one of the key drivers of bacterial AMR development. This study aimed to investigate the inductive effects of three commonly used disinfectants—benzalkonium bromide (BAB), glutaraldehyde (GTA), and povidone-iodine (PVP-I)—on the resistance of Escherichia coli (E. coli), as well as the resultant bacterial phenotypic and genetic alterations. Three disinfectants frequently detected in clinical and environmental settings were selected as the research objects: first, their bactericidal efficacy against environmental bacteria was determined; subsequently, a concentration-increasing gradient approach was adopted to systematically explore the evolutionary patterns of E. coli resistance under the stress of sub-inhibitory concentrations (SICs). After induction, the bacterial resistance levels to disinfectants and various antibiotics, growth characteristics, and biofilm-forming ability were detected, and combined with whole-genome analysis to investigate genetic-level changes. The results showed that all three disinfectants could enhance E. coli resistance to themselves (12–48-fold) and antibiotics, and the induced antibiotic resistance exhibited favorable genetic stability. Among them, BAB induced the strongest resistance, with the most significant increase in resistance levels to multiple antibiotics (16–64-fold); GTA had the weakest inductive effect, only slightly enhancing bacterial resistance to a small number of antibiotics. Notably, all induced strains exhibited reduced growth rates yet markedly enhanced biofilm-forming capacity, alongside acquired genomic structural variations. Their gene functions displayed shared adaptive signatures in coping with environmental stress, while core pathogenicity-associated genes remained conserved. This study demonstrates that inducing E. coli using environmentally relevant low concentrations of disinfectant residues as initial induction doses drives the evolution of bacterial antimicrobial resistance (AMR), with distinct resistance induction risks among the three disinfectant types. These findings offer critical insights for standardizing disinfectant application, mitigating the transmission of bacterial AMR, and underscore the imperative of interdisciplinary collaboration to tackle the environmental risks posed by disinfectant residues.

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