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Coverage-guided fuzzing (CGF) is a widely used technique for exposing vulnerabilities in software. Despite its success, selecting the ideal CGF fuzzer or fuzzer combination for a particular program continues to pose a challenge, given that no single fuzzer or fuzzer combination consistently outperforms others. Furthermore, the integration of sanitizers during fuzzing also needs to be carefully considered, due to the overhead sanitizers introduced. This paper proposes AutoFuzz, a Multi-Armed Bandit (MAB)-based method that automatically schedules different fuzzing methods (a fuzzer and sanitizer combination) without the need for extensive pre-fuzzing experiments. AutoFuzz utilizes a non-stochastic multi-armed bandit to model the scheduling problem, and employs the Exp3 algorithm to run the MAB. AutoFuzz considers both coverage and crash gains in its reward calculation. Experimental results demonstrate that AutoFuzz performs better than standalone fuzzers and sanitizers and a Round Robin method (i.e., similar scheduling method to EnFuzz and Cupid), presenting a promising solution for efficient fuzzer selection and sanitizer usage during fuzz testing. [ABSTRACT FROM AUTHOR]

This study evaluated the efficacy of five commercially available sanitizers to reduce Salmonella (sessile and biofilm forms) count on experimentally inoculated materials representative of harvesting bins and picking bags in the fresh produce industry. Sessile Salmonella cells were grown onto tryptic soy agar to create a bacterial lawn, while multistrain Salmonella biofilms were grown in a Centers for Disease Control and Prevention (CDC) reactor at 22 ± 2 °C for 96 h. Samples were exposed to 500 ppm free chlorine, 500 ppm peroxyacetic acid (PAA), 75 psi steam, and 5% silver dihydrogen citrate (SDC) for 30 sec, 1, or 2 min or 100 ppm chlorine dioxide gas for 24 h. Sanitizer, surface type, and application time significantly affected the viability of Salmonella in both sessile and biofilm forms (P

In the last decade, extensive research has been performed on developing hand sanitizers that can be used to eradicate the diseases that are caused due to poor hand hygiene. Essential oils possess antibacterial and antifungal properties and thus have great potential to replace the available antibacterial agents. In the present study, sandalwood oil–based nanoemulsion (NE) and sanitizer have been formulated and well characterized for their properties. Antibacterial activity was assessed using growth inhibition studies, agar cup, viability assay, etc. The sandalwood oil NE synthesized had oil to surfactant ratio of 1:0.5 (2.5% sandalwood oil and 0.5% Tween 80) and was observed to have a droplet diameter of 118.3 ± 0.92 nm, the zeta potential of − 18.8 ± 2.01 mV, and stability of 2 months. The antibacterial activity of sandalwood NE and sanitizer was evaluated against microorganisms. The antibacterial activity was assessed using the zone of inhibition value of sanitizer, which was in the range of 19 to 25 mm against all microorganisms. Morphological analysis showed distant changes in membrane shape and size and microorganisms' morphology. The synthesized NE was thermodynamically stable and efficient enough to be used in sanitizer, and the formulated sanitizer showed great antibacterial efficacy. [ABSTRACT FROM AUTHOR]

Bacteriophages (phages) have gained considerable attention as effective antimicrobial agents that infect and kill pathogenic bacteria. Based on this feature, phages have been increasingly used to achieve food safety. They are stored in a medium or buffer to ensure stability; however, they cannot be directly applied to food under these conditions due to reasons such as regulatory considerations and concerns about marketability. This study developed a stabilizing solution that allowed the maintenance of phage activity for extended periods at room temperature while being directly applicable to food. The stability of phages stored in distilled water was relatively low. However, adding a stabilizer composed of sugars and salts improved the survival rates of phages significantly, resulting in stability for up to 48 weeks at room temperature. When Escherichia coli O157:H7-contaminated vegetables were washed with tap water containing phages, the phages reduced the pathogenic E. coli count by over 90% compared with washing with tap water alone. Additionally, when pathogenic E. coli-contaminated vegetables were placed in a phage-coated container and exposed to water, the coating of the container dissolved, releasing phages and lysing the pathogenic E. coli. This led to a significant 90% reduction in pathogenic E. coli contamination compared to that after water rinsing. These results suggest an effective and economical method for maintaining phage activity and establishing the potential for commercialization through application in the food industry. [ABSTRACT FROM AUTHOR]

Hydroponic farming systems play an increasingly important role in the sustainable production of nutrient-rich foods. The contamination of surfaces in hydroponic fresh produce production poses risks to the food safety of crops, potentially endangering public health and causing economic losses in the industry. While sanitizers are widely used in commercial hydroponic farms, their effectiveness against human pathogens on surfaces and their impact on plant health and quality are not known. In this study, we evaluated the efficacy of chemical sanitizers in eliminating Salmonella Typhimurium from inanimate surfaces in commercial hydroponic Nutrient Film Technique (NFT) systems. Further, we assessed the impact of sanitizers on the yield, quality, and nutritional value of lettuce and basil. Sanitizers (Virkon, LanXess, Pittsburgh, PA, USA; SaniDate 12.0, BioSafe Systems, East Hartford, CT, USA; KleenGrow, Pace Chemical Ltd., Delta, BC, Canada; Green Shield, United Labs Inc., St Charles, IL, USA; Zerotol, BioSafe Systems, East Hartford, CT, USA; Bleach, Pure Bright, ON, Canada) were tested against Salmonella Typhimurium inoculated on NFT surfaces (nutrient reservoir, growing channels, top covers, drain lines). The effective treatments were then tested for their impact on lettuce and basil in a split-plot experiment conducted in commercial NFT units. Crop yield, color, and nutrient content (chlorophyll and carotenoids) were measured throughout the crop life cycle. While all quaternary ammonium compounds (QAC), SaniDate 12.0 (200 ppm), Zorotol (5%), and Virkon (1%) eliminated Salmonella Typhimurium from commercial NFT surfaces, chlorine-based sanitizer treatments were statistically similar to water treatments on most surfaces. All chemical sanitizers impacted the yield, color, and nutritional value of lettuce and basil. SaniDate 12.0 (200 ppm) was the least detrimental to crops and was identified as a potential candidate for further validation in commercial hydroponic settings. The findings of this study will be translated into recommendations for the industry and will contribute to the development of future food safety guidelines and policies. [ABSTRACT FROM AUTHOR]

A number of biocidal disinfectant chemicals are used as household products to prevent spread of pathogens. People are commonly exposed to multiple chemicals through those disinfectants. However, effects of interactions (e.g., synergism) between disinfectants on human health outcomes have been rarely studied. In this study, we aimed to investigate associations of a mixture of chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT) and polyhexamethylene guanidine (PHMG), which had been used as humidifier disinfectants (HDs) in South Korea, with HD-associated lung injury (HDLI) in a Korean population (n = 4058) with HD exposure through use of HD products. Exposure to HD was retrospectively assessed by an interview-based standardized survey, and HDLI was determined by clinical assessment. After adjusting for covariates, PHMG-specific exposure indices (e.g., amount of use, indoor air concentration, and weekly exposure level) were dose-dependently associated with HDLI (their odds ratios for the comparison of third tertile versus first tertile were 1.95, 1.77, and 2.16, respectively). CMIT/MIT exposure was not observed to have a significant association with HDLI in a single chemical exposure model; however, associations between PHMG exposure and HDLI were strengthened by co-exposure to CMIT/MIT in combined chemical exposure models, where synergistic interactions between CMIT/MIT use and PHMG indices (amount of use and weekly exposure level) were observed (p-interaction in additive scale: 0.02 and 0.03, respectively). Our findings imply that adverse effects of PHMG exposure on lung injury among HD users might be worsened by co-exposure to CMIT/MIT. Given that plenty of household products contain disinfectants on global markets, epidemiological and toxicological investigations are warranted on interaction effects of co-exposure to disinfectants. [ABSTRACT FROM AUTHOR]

The efficacy of a sanitizer in biofilm removal may be influenced by a combination of factors such as sanitizer exposure time and concentration, bacterial species, surface topography, and shear stresses. We employed an inline biofilm reactor to investigate the interactions of these variables on biofilm removal with chlorine. The CDC bioreactor was used to grow E. coli O157:H7 and L. monocytogenes biofilms as a single species or with Ralstonia insidiosa as a dual-species biofilm on stainless steel, PTFE, and EPDM coupons at shear stresses 0.368 and 2.462 N/m2 for 48 hours. Coupons were retrieved from a CDC bioreactor and placed in an inline biofilm reactor and 100, 200, or 500 ppm of chlorine was supplied for 1- and 4 min. Bacterial populations in the biofilms were quantified pre- and posttreatment by plating on selective media. After chlorine treatment, reduction (Log CFU/cm2) in pathogen populations obtained from three replicates was analyzed for statistical significance. A 1-min chlorine treatment (500 ppm), on dual-species E. coli O157:H7 biofilms grown at high shear stress of 2.462 N/m2 resulted in significant E. coli O157:H7 reductions on SS 316L (2.79 log CFU/cm2) and PTFE (1.76 log CFU/cm2). Similar trend was also observed for biofilm removal after a 4-min chlorine treatment. Single species E. coli O157:H7 biofilms exhibited higher resistance to chlorine when biofilms were developed at high shear stress. The effect of chlorine in L. monocytogenes removal from dual-species biofilms was dependent primarily on the shear stress at which they were formed rather than the surface topography of materials. Besides surface topography, shear stresses at which biofilms were formed also influenced the effect of sanitizer. The removal of E. coli O157:H7 biofilms from EPDM material may require critical interventions due to difficulty in removing this pathogen. The inline biofilm reactor is a novel tool to evaluate the efficacy of a sanitizer in bacterial biofilm removal.

This study has improved the sanitation of head-on gutted (HOG) Atlantic salmon (Salmo salar) by using neutral electrolyzed oxidizing water (NEW) ice. NEW and neutral electrolyzed oxidizing ice (NEI) were tested on Listeria monocytogenes and Pseudomonas aeruginosa-contaminated salmon fillet skin. Treatment by storage with melting NEI reduced P. aeruginosa by 1.1 and 2.4 log CFU/cm2, respectively. Storage with 100 ppm NEI suppressed L. monocytogenes by 1 log CFU/cm2. In the industry, storage of HOG salmon with a concentration of 100 ppm of NEI could therefore be used for pre-treatment to reduce microbial contamination before filleting. [ABSTRACT FROM AUTHOR]

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Phenolic branched-chain fatty acid (PBC-FA) emulsion was produced by dissolving it in ethanol and mixing with water (pH 7). The resulting monodispersed emulsion droplets were approximately 200 nm in diameter. The stability of the emulsion was evaluated by storing it at 4 and 20 °C for 30 days. The antimicrobial activity of the PBC-FA emulsion was tested against Escherichia coli and Listeria innocua (8 log CFU/mL) by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) using a microdilution method. The PBC-FA was effective against L. innocua with MIC and MBC of 14.1 μg/mL and caused membrane permeation as determined with SEM and Live/Dead cell assay, but was not effective against E. coli O157:H7 at the tested concentrations (5–250 μg/mL). We also evaluated PBC-FA emulsion's potential to be used as a wash against L. innocua inoculated on apples. The results showed that the 500 μg/mL PBC-FA emulsion with 5 % ethanol had equivalent antimicrobial activity (2–3 logs reductions) against L. innocua as the 20 μg/mL chlorine solution, a commonly used sanitizer. 500 μg/mL PBC-FA emulsion had better antimicrobial efficacy when organic matter (chemical oxygen demand: 9.0 g/L) was present compared to 20 μg/mL of chlorine. The effect of PBC-FA on the quality of the apples, was determined by measuring changes in color, firmness, and soluble solids content over a 14-day storage period at 20 °C. The quality of the apples was not affected by PBC-FA over the 14-day storage period, suggesting that PBC-FA emulsion can be used as a wash for apples without affecting their quality.

ABSTRACT Salmonella enterica is a prominent cause of foodborne disease in the United States. However, the mechanism and route of pathogen transmission that leads to Salmonella infection in commercial processing plants are poorly understood. This study aimed to investigate the effect of mixed-species biofilms on S. enterica survival and persistence under sanitizer stress [Quaternary ammonium compounds (QACs)] by analyzing 78 floor drain samples from a meat processing facility and three S. enterica strains (serovars Cerro, Montevideo, and Typhimurium) isolated from that facility and an unrelated source. The four test groups were as follows: control, QAC treatment, Salmonella addition, and QAC treatment with Salmonella addition. DNAs were extracted, and 16S rRNA gene based on the variable region V4 amplicon sequencing was performed to analyze the relative abundance, core microbiome, and Alpha and Beta diversity using the qiime2 pipeline. At the genus level, the Brochothrix (45.56%), Pseudomonas (38.94%), Carnobacterium (6.18%), Lactococcus (4.68%), Serratia (3.14%), and Staphylococcus (0.82%) were shown to be the most prevalent in all drain samples. The results demonstrate that the relative abundance of different bacterial genera was affected by both QAC treatment and Salmonella addition, with some genera showing increases or decreases in abundance. Notably, the correlation network was constructed to understand the relationships between the different bacteria. Nitrospira had the greatest number of connections in the floor drain environment network, with two negative and eight positive correlations. The results suggest that Nitrospira in the mixed-species biofilm community may play a role in converting ammonium in the QAC sanitizer into nitrites. Thus, Nitrospira could be a potentially important genus in providing sanitizer resistance to pathogen-encompassed mixed-species biofilms.IMPORTANCESalmonella contamination in meat processing facilities can lead to foodborne illness outbreaks. Our study characterized the microbiome dynamics in beef facility drains and their response to Salmonella addition and common sanitizer (QAC). Nitrospira could be an important genus in providing sanitizer resistance to pathogen-encompassed mixed-species biofilms. The results provide insight into the impact of mixed-species biofilms on Salmonella survival and persistence under sanitizer stress in meat processing facilities. The results highlight the need to consider mixed-species biofilm effects when developing targeted interventions to enhance food safety.

Introduction: A quantitative review was performed on the effectiveness of peroxygen products that contain hydrogen peroxide (HP), peracetic acid (PAA) and potassium peroxy-monosulfate (PPMS) to eliminate non-fungal plant pathogens in agricultural and horticultural cropping systems. Methods: This quantitative analysis is a complementary follow-up to a previous study on efficacy of peroxygen against fungal plant pathogens. The meta- analysis evaluated the biocidal activity of peroxygen intervention treatments against 15 different non-fungal plant pathogens in 81 studies compared to independent non-treated controls that were conducted over the last 30 years. Results: The overall summary effect size was a Hedges' g(g+) of 1.98 for the random effects model, which indicates that peroxgen treatments caused a moderate to high reduction in viable propagules or disease progression in most cases. The range in efficacy was defined by the 95% prediction intervals (-0.82 to 4.80) and indicated peroxygen applications would range from ineffective to very highly effective in 95% of similar populations. Peroxygen compounds provided similar control (P = 0.5655) against bacteria, oomycetes and viruses, while being more effective against zygomycetes (P = 0.0001) than other organism types. Differences were observed between peroxygen active ingredients (a.i.) (P = 0.0203), where PPMS was more effective than HP + PAA. Differences were also observed when peroxygen compounds were applied on different target materials (P = 0.0004). Peroxygen compounds were moderately effective against non-fungal plant pathogens when applied in solution and on metal surfaces but ineffective when applied on plants under crop production conditions. Differences between target materials explained 50% of the true variances in a meta-regression model with the length of time peroxygens were in contact with target materials (P = 0.0416). Discussion: These results show that although the current recommended dose and contact time for commercial peroxygen products are expected to result in pathogen inactivation, their efficacy will likely be influenced by the organism and material being treated. This analysis serves as a base reference for considering efficacy performance of peroxygen compounds against non-fungal plant pathogens. [ABSTRACT FROM AUTHOR]

Novel ozone (O3) sanitizing treatments can be used to decrease the microbial load during cultivation, but they would affect the composition of the nutrient solution. Variations in the nutrient composition decrease crop yields, especially if a strong oxidizing agent such as ozone is used. In this study, O3 was applied throughout the culture every two days at doses of 0.0 (control); 0.5; 1.0; and 2.0 mg·L−1 for 3 min on baby red chard (Beta vulgaris L. cv. SCR 107) grown in a floating hydroponic system. Macronutrients and micronutrients in the nutrient solution, yield, antioxidant compounds, and oxidative stress enzymes were evaluated in plants. Macronutrients in the nutrient solution were not affected by O3, whereas micronutrients, such as Fe and Mn, decreased by 88.2 and 39.6%, respectively, at the 0.5 mg·L−1 dose. The dose of 0.5 mg·L−1 produced more fresh matter and leaf area than the control. Antioxidant capacity and total phenols were not significantly affected by O3 treatments; however, higher SOD, CAT, and APX activity after O3 applications were found. It is concluded that ozone applications to the nutrient solution affect the availability of some micronutrients and increase oxidative stress and yield in baby red chard plants. [ABSTRACT FROM AUTHOR]

Introduction:Pediatric sudden sensorineural hearing loss (SSNHL) is a rare otological emergency. With the emergence of the Coronavirus 19 pandemic, alcohol-based hand sanitizers are among the essential household items. Many hand sanitizers are frequently coupled with scents that young children may find pleasant.Case Report:A 5-year-old girl presented to our clinic with hearing loss after the consumption of alcohol-based hand sanitizer. A pure tone audiogram showed bilateral SSNHL. The child was prescribed systemic corticosteroids resulted in a slight improvement in hearing thresholds. The child was followed up at 6 and 18 months showing no further improvement in hearing thresholds.Conclusion:Although various infective, vascular, and immune responses have been proposed, alcohol-based hand sanitizer consumption has not been reported to present with SSNHL to the best of our knowledge. In the current scenario of the Coronavirus pandemic, otorhinolaryngologists must keep in mind that SSNHL may occur as a result of hazardous alcohol-based hand disinfectant consumption.

Hydroponic farming systems play an increasingly important role in the sustainable production of nutrient-rich foods. The contamination of surfaces in hydroponic fresh produce production poses risks to the food safety of crops, potentially endangering public health and causing economic losses in the industry. While sanitizers are widely used in commercial hydroponic farms, their effectiveness against human pathogens on surfaces and their impact on plant health and quality are not known. In this study, we evaluated the efficacy of chemical sanitizers in eliminating Salmonella Typhimurium from inanimate surfaces in commercial hydroponic Nutrient Film Technique (NFT) systems. Further, we assessed the impact of sanitizers on the yield, quality, and nutritional value of lettuce and basil. Sanitizers (Virkon, LanXess, Pittsburgh, PA, USA; SaniDate 12.0, BioSafe Systems, East Hartford, CT, USA; KleenGrow, Pace Chemical Ltd., Delta, BC, Canada; Green Shield, United Labs Inc., St Charles, IL, USA; Zerotol, BioSafe Systems, East Hartford, CT, USA; Bleach, Pure Bright, ON, Canada) were tested against Salmonella Typhimurium inoculated on NFT surfaces (nutrient reservoir, growing channels, top covers, drain lines). The effective treatments were then tested for their impact on lettuce and basil in a split-plot experiment conducted in commercial NFT units. Crop yield, color, and nutrient content (chlorophyll and carotenoids) were measured throughout the crop life cycle. While all quaternary ammonium compounds (QAC), SaniDate 12.0 (200 ppm), Zorotol (5%), and Virkon (1%) eliminated Salmonella Typhimurium from commercial NFT surfaces, chlorine-based sanitizer treatments were statistically similar to water treatments on most surfaces. All chemical sanitizers impacted the yield, color, and nutritional value of lettuce and basil. SaniDate 12.0 (200 ppm) was the least detrimental to crops and was identified as a potential candidate for further validation in commercial hydroponic settings. The findings of this study will be translated into recommendations for the industry and will contribute to the development of future food safety guidelines and policies.

Background: Hand hygiene of the people working plays an important role in the infection prevention practices of any Institute. Objective: To study the efficacy of liquid soap in comparison to alcohol based hand sanitizer in reducing the bacterial count following the handwash among sanitation workers. Methodology: This Randomized Controlled Trial was carried out in various facilities of Kasturba Medical College, Mangalore, in 2017-18 The population comprised of sanitation workers attached to the college and study hospitals. They were divided equally across both the intervention arms. The method of EL Larson et al with minor modifications was used for the qualitative and quantitative analysis of microbial flora of the test subjects. Results: The baseline measurement of intervention 1 (liquid soap) was 2400 cfu and post post-intervention bacterial count for the same was 245cfu. The change score was 1825 cfu in the intervention- liquid soap. The baseline measurement of intervention arm 2 (hand sanitizer) was 1250 cfu and the post-intervention median bacterial count was 8.5 cfu. The change score was 1245 cfu in the intervention- hand sanitizer. The extent of decrease was higher in the hand sanitizer arm than hand washing arm however this difference was not high. Conclusion: The extent of decrease was higher in the hand sanitizer arm than hand washing arm however this difference was not significant and results nearly equal.

IntroductionA quantitative review was performed on the effectiveness of peroxygen products that contain hydrogen peroxide (HP), peracetic acid (PAA) and potassium peroxy-monosulfate (PPMS) to eliminate non-fungal plant pathogens in agricultural and horticultural cropping systems.MethodsThis quantitative analysis is a complementary follow-up to a previous study on efficacy of peroxygen against fungal plant pathogens. The meta-analysis evaluated the biocidal activity of peroxygen intervention treatments against 15 different non-fungal plant pathogens in 81 studies compared to independent non-treated controls that were conducted over the last 30 years.ResultsThe overall summary effect size was a Hedges’ g (g¯+) of 1.98 for the random effects model, which indicates that peroxgen treatments caused a moderate to high reduction in viable propagules or disease progression in most cases. The range in efficacy was defined by the 95% prediction intervals (-0.82 to 4.80) and indicated peroxygen applications would range from ineffective to very highly effective in 95% of similar populations. Peroxygen compounds provided similar control (P = 0.5655) against bacteria, oomycetes and viruses, while being more effective against zygomycetes (P = 0.0001) than other organism types. Differences were observed between peroxygen active ingredients (a.i.) (P = 0.0203), where PPMS was more effective than HP + PAA. Differences were also observed when peroxygen compounds were applied on different target materials (P = 0.0004). Peroxygen compounds were moderately effective against non-fungal plant pathogens when applied in solution and on metal surfaces but ineffective when applied on plants under crop production conditions. Differences between target materials explained 50% of the true variances in a meta-regression model with the length of time peroxygens were in contact with target materials (P = 0.0416).DiscussionThese results show that although the current recommended dose and contact time for commercial peroxygen products are expected to result in pathogen inactivation, their efficacy will likely be influenced by the organism and material being treated. This analysis serves as a base reference for considering efficacy performance of peroxygen compounds against non-fungal plant pathogens.

Plasma-treated water (PTW) has emerged as a potential sanitizing agent. This study evaluated antibacterial activity, inhibition of invasion, and biofilm disruption effects of PTW against Salmonella Typhimurium. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined for different PTW types. Time-kill assays were conducted to assess bactericidal effects, while polarized Caco-2 cells were used to evaluate invasion inhibition. Biofilm formation and cell viability were examined following PTW treatment using Salmonella Typhimurium isolates, while biofilm disruption and regrowth prevention were investigated using the Bioflux system. PTW exhibited antibacterial activity against all Salmonella Typhimurium isolates, with MICs of 25% for PTW1 and PTW2, and 50% for PTW3, PTW4, and PTW5. MBCs of 50% in media were observed for all PTW types. Undiluted PTW1 and PTW2 showed the highest bactericidal capacity, significantly reduced Salmonella viability, and completely inhibited bacterial invasion, while PTW3 and PTW5 also showed significant invasion reduction. Bioflux experiments confirmed the eradication of biofilms by PTW1 and PTW2, with no regrowth observed 72 h after PTW was removed. PTW demonstrated significant antibacterial activity, inhibition of invasion, biofilm disruption, and reduction of bacterial viability against Salmonella Typhimurium. This highlights PTW's potential as an effective sanitizer for reducing Salmonella contaminations. [ABSTRACT FROM AUTHOR]

Essential oils (EOs) have strong antibacterial properties and can be potential sanitizers to reduce pathogen load and prevent cross-contamination during postharvest washing. The objective of this study was to investigate the efficacy of emulsions containing oregano (OR; Origanum vulgare) and winter savory (WS; Satureja montana) EOs at different concentrations (0.94 and 1.88 µL/mL) and storage times (0 h, 24 h, and 7 days), in reducing Escherichia coli O157:H7 on the surface of three types of lettuce (romaine, crisphead, and butterhead). The EO emulsions were compared with one no-rinse treatment and three rinse treatments using water, 200 ppm chlorine, and 80 ppm peroxyacetic acid (PAA), respectively, in a simulated washing system. The results showed that while the EO emulsions significantly reduced E. coli O157:H7 on crisphead lettuce over time, not all treatments were effective for romaine and butterhead lettuce. The mixture of OR and WS at concentrations of 0.94 and 1.88 µL/mL was found to be the most effective in reducing E. coli O157:H7 on inoculated lettuce, resulting in reductions of 3.52 and 3.41 log CFU/g, respectively. Furthermore, the PAA and the mixture of OR and WS at 1.88 µL/mL effectively limited bacterial cross-contamination close to the detection limit for all lettuce types during all storage times. These results suggest that OR and WS EOs could serve as potential alternatives to chemical sanitizers for postharvest lettuce washing. [ABSTRACT FROM AUTHOR]

Emergence of "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)" causing "COVID-19" or "coronavirus disease 19" as pandemic has got worldwide attention towards hygiene as the first line of defense for the infection control. It is first line of defense not only from COVID-19 but also from other infectious diseases caused by deadly pathogens such as cholera, hepatitis, tuberculosis, polio, etc. Absence of any particular vaccine or treatment let World Health Organization (WHO) recommend to the public to maintain social distancing along with regularly washing their hands with soap, sanitize their hands (where washing is not possible), and disinfect their belongings and buildings to avoid the infection. Out of various formulations available in the market, WHO has recommended alcohol-based hand sanitizers, which mainly comprise of ethanol, isopropyl alcohols, and hydrogen peroxides in different combinations due to their high potential to kill the broad range of pathogens including bacterial, viral, fungal, helminthes, etc. Therefore, alcohol-based sanitizers are in high demand since centuries to prevent infection from pathogenic diseases. Ethanol is the most common and popular alcohol in terms of vanishing wide range of pathogens, convenient to use and its production. Ethanol is produced worldwide and is used in various sectors, e.g., beauty and cosmetics, food and beverages, and as the most demanding gasoline additive. The present review is focused on the ethanol production in India, its diversified applications emphasizing hand sanitizers with discussions on formulation of sanitizer and disinfectants, and viability of lignocellulosic and food grain–based ethanol. The review article also emphasizes on the technological details of 1G and 2G ethanol production, their associated challenges, and inputs for the improved ethanol yields so as to strengthen the supply chain of ethanol in India, and making "Atmanirbhar Bharat" (Self-reliant India) campaign of Indian government successfully viable. [ABSTRACT FROM AUTHOR]

Although the use of sanitizer starts around the middle of twentieth century but it becomes popular in early twenty first century (second decade of twenty first century during COVID-19 pandemic). To prevent the spread of COVID-19, World Health Organisation (WHO) recommended the use of sanitizers made up with different combinations of isopropyl alcohols, ethanol and hydrogen peroxides. Literature suggests some toxic effect of use and misuse of these components of sanitizers. Therefore, in the present study an attempt has been made to investigate the use of available hand sanitizers and their adverse effects on human body as well as to collect and correlate the gathered information with their occupation which may further trigger the adverse effect of sanitizer on human being. Out of the total respondents, 98% are using but very few (2%) are not using any type of sanitizer. Age group 2 (16-25 years) is the largest user of hand sanitizer which shows the maximum awareness of this age group related to sanitation and hygiene. Data obtained suggests that males (57.5%) are more aware to sanitization in comparison to female (41.8%). Among the total respondents, house wives were very few (0.8%) which shows lack of awareness among them may be due to their busy schedule and household works. The obtained data revealed that education plays a key role in the spread of sanitation and hygiene awareness. Most of the peoples are using the sanitizers of established brands. The data also revealed that 88% of the respondents were observing the various impacts on the body (49% skin dryness, 16% skin allergy 12% skin irritation and itching while 12% respondents are not sure about the impacts). Only 12% peoples responded that they are not observing any impacts of sanitizer. Besides this, different components used in sanitizers pose threat to the different spheres of the environment. Based on the findings of the present study, we can conclude that sanitizer is impacting the human health and environment in various ways. Therefore, there is a need of mass awareness regarding the use and disposal of disinfectants. [ABSTRACT FROM AUTHOR]

Microorganisms can interfere with meat quality, being a public health problem. The aim of this study was to characterize the antimicrobial susceptibility profile of Staphylococcus spp. isolated from utensils of a bovine slaughterhouse and to evaluate the antibacterial and antibiofilm activity of the essential oil of Rosmarinus officinalis L. (rosemary). Samples of surfaces and utensils used during slaughter in the northwest of the state of Paraná, Brazil were collected. After isolation and differentiation of the isolates by the coagulase test, the antimicrobial susceptibility test, Staphylococcus aureus identification and mecA gene research were performed. The study for biofilm production was carried out by the method of adhesion in borosilicate tube and by adhesion in polystyrene plate. Subsequently, the inhibitory activity of the R. officinalis essential oil and its ability to inhibit biofilm were investigated. Twenty-two of the samples collected were identified as coagulase-negative Staphylococcus and five as coagulase-positive Staphylococcus. There was resistance to all antibiotics tested, with clindamycin (33.33%) and rifampicin (29.6%) showing the highest rate. None of the samples was confirmed as Staphylococcus aureus or for the presence of the mecA resistance gene. The essential oil inhibited the growth of 48% of the isolates at a concentration of 16,000 µg/mL. Of these isolates, 33% were positive for biofilm production and this biofilm was also inhibited by the essential oil. This work revealed that multidrug-resistant Staphylococcus and biofilm producers are present in the slaughter environment and are susceptible to the essential oil of R. officinalis. [ABSTRACT FROM AUTHOR]

Introduction: Pediatric sudden sensorineural hearing loss (SSNHL) is a rare otological emergency. With the emergence of the Coronavirus 19 pandemic, alcohol-based hand sanitizers are among the essential household items. Many hand sanitizers are frequently coupled with scents that young children may find pleasant. Case Report: A 5-year-old girl presented to our clinic with hearing loss after the consumption of alcohol-based hand sanitizer. A pure tone audiogram showed bilateral SSNHL. The child was prescribed systemic corticosteroids resulted in a slight improvement in hearing thresholds. The child was followed up at 6 and 18 months showing no further improvement in hearing thresholds. Conclusion: Although various infective, vascular, and immune responses have been proposed, alcohol-based hand sanitizer consumption has not been reported to present with SSNHL to the best of our knowledge. In the current scenario of the Coronavirus pandemic, otorhinolaryngologists must keep in mind that SSNHL may occur as a result of hazardous alcohol-based hand disinfectant consumption. [ABSTRACT FROM AUTHOR]

Summary: Background: Hand hygiene is critical to lower the potential for the spread of SARS-CoV-2 and other infectious agents by direct contact. When running water and soap are not available for hand hygiene, ethanol-based hand sanitizers are currently the recommended standard of care [1–3]. Though recently published data showed comparable in vitro effectiveness of benzalkonium chloride (BAK)-based and ethanol-based hand sanitizers against SARS-CoV-2 virus, a paucity of peer-reviewed data on the effectiveness of these formulations against other types of infective coronaviruses remains. This work assessed human coronavirus HCoV-229E (genus Alphacoronavirus) concurrently with SARS-CoV-2, Isolate USA-WA1/2020 (genus Betacoronavirus) to fill this gap. Methods: The test was conducted according to EN14476:2013-A2:2019 [EN14476] Quantitative Suspension Test for the Evaluation of Virucidal Activity in the Medical Area [4]. Two BAK-based hand sanitizers, five ethanol-based hand sanitizers, and an 80% ethanol reference formulation were tested for antiviral activity against SARS-CoV-2 and HCoV-229E at 15- and 30- second contact times. Results: Both SARS-CoV-2 and HCoV-229E were reduced by greater than 4.00-log10 within 15 seconds of contact. Virus decay constants (k) following first-order kinetics were similar for BAK and ethanol-based formulations against both test viruses. The SARS-CoV-2 results reported herein mirrored previous data reported by Herdt et al. (2021). Conclusion: BAK and ethanol hand sanitizer formulations inactivate SARS-CoV-2 and HCoV-229E at similar rates. This data supports previously published effectiveness data for both chemistries and indicates that additional coronavirus strains and variants would demonstrate similar inactivation trends.

Although the use of sanitizer starts around the middle of twentieth century but it becomes popular in early twenty first century (second decade of twenty first century during COVID-19 pandemic). To prevent the spread of COVID-19, World Health Organisation (WHO) recommended the use of sanitizers made up with different combinations of isopropyl alcohols, ethanol and hydrogen peroxides. Literature suggests some toxic effect of use and misuse of these components of sanitizers. Therefore, in the present study an attempt has been made to investigate the use of available hand sanitizers and their adverse effects on human body as well as to collect and correlate the gathered information with their occupation which may further trigger the adverse effect of sanitizer on human being. Out of the total respondents, 98% are using but very few (2%) are not using any type of sanitizer. Age group 2 (16-25 years) is the largest user of hand sanitizer which shows the maximum awareness of this age group related to sanitation and hygiene. Data obtained suggests that males (57.5%) are more aware to sanitization in comparison to female (41.8%). Among the total respondents, house wives were very few (0.8%) which shows lack of awareness among them may be due to their busy schedule and household works. The obtained data revealed that education plays a key role in the spread of sanitation and hygiene awareness. Most of the peoples are using the sanitizers of established brands (Dettol). The data also revealed that 88% of the respondents were observing the various impacts on the body (49% skin dryness, 16% skin allergy 12% skin irritation and itching while 12% respondents are not sure about the impacts). Only 12% peoples responded that they are not observing any impacts of sanitizer. Besides this, different components used in sanitizers pose threat to the different spheres of the environment. Based on the findings of the present study, we can conclude that sanitizer is impacting the human health and environment in various. Therefore there is a need of mass awareness regarding the use and disposal of disinfectants.

This study verified the factors affecting the antifungal efficacy of sanitizers against ochratoxin A-producing fungi. The fungi Penicillium nordicum, Penicillium verrucosum, and Aspergillus westerdijkiae were exposed to three sanitizers at three concentrations: peracetic acid (0.3, 0.6, 1%), benzalkonium chloride (0.3, 1.2, 2%), and sodium hypochlorite (0.5, 0.75, 1%) at three exposure times (10, 15, and 20 min), three temperatures (10, 25, and 40 °C), and with the presence of organic matter simulating clean (0.3%) and dirty (3%) environments. All the tested conditions influenced the antifungal action of the tested sanitizers. Peracetic acid and benzalkonium chloride were the most effective sanitizers, and sodium hypochlorite was ineffective according to the parameters evaluated. The amount of organic matter reduced the antifungal ability of all sanitizers. The longer exposure time was more effective for inactivating fungi. The temperature acted differently for benzalkonium chloride, which tended to be favored at low temperatures, than for sodium hypochlorite and peracetic acid, which were more effective at higher temperatures. The knowledge of the parameters that influence the action of sanitizers on spoilage fungi is vital in decision-making related to sanitizing processes in the food industry. [ABSTRACT FROM AUTHOR]

The recently emerged novel coronavirus, "severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2)," caused a highly contagious disease called coronavirus disease 2019 (COVID‐19). It has severely damaged the world's most developed countries and has turned into a major threat for low‐ and middle‐income countries. Since its emergence in late 2019, medical interventions have been substantial, and most countries relied on public health measures collectively known as nonpharmaceutical interventions (NPIs). We aimed to centralize the accumulative knowledge of NPIs against COVID‐19 for each country under one worldwide consortium. International COVID‐19 Research Network collaborators developed a cross‐sectional online survey to assess the implications of NPIs and sanitary supply on the incidence and mortality of COVID‐19. The survey was conducted between January 1 and February 1, 2021, and participants from 92 countries/territories completed it. The association between NPIs, sanitation supplies, and incidence and mortality were examined by multivariate regression, with the log‐transformed value of population as an offset value. The majority of countries/territories applied several preventive strategies, including social distancing (100.0%), quarantine (100.0%), isolation (98.9%), and school closure (97.8%). Individual‐level preventive measures such as personal hygiene (100.0%) and wearing facial masks (94.6% at hospitals; 93.5% at mass transportation; 91.3% in mass gathering facilities) were also frequently applied. Quarantine at a designated place was negatively associated with incidence and mortality compared to home quarantine. Isolation at a designated place was also associated with reduced mortality compared to home isolation. Recommendations to use sanitizer for personal hygiene reduced incidence compared to the recommendation to use soap. Deprivation of masks was associated with increased incidence. Higher incidence and mortality were found in countries/territories with higher economic levels. Mask deprivation was pervasive regardless of economic level. NPIs against COVID‐19 such as using sanitizer, quarantine, and isolation can decrease the incidence and mortality of COVID‐19. [ABSTRACT FROM AUTHOR]

Novel ozone (O3) sanitizing treatments can be used to decrease the microbial load during cultivation, but they would affect the composition of the nutrient solution. Variations in the nutrient composition decrease crop yields, especially if a strong oxidizing agent such as ozone is used. In this study, O3 was applied throughout the culture every two days at doses of 0.0 (control); 0.5; 1.0; and 2.0 mg·L−1 for 3 min on baby red chard (Beta vulgaris L. cv. SCR 107) grown in a floating hydroponic system. Macronutrients and micronutrients in the nutrient solution, yield, antioxidant compounds, and oxidative stress enzymes were evaluated in plants. Macronutrients in the nutrient solution were not affected by O3, whereas micronutrients, such as Fe and Mn, decreased by 88.2 and 39.6%, respectively, at the 0.5 mg·L−1 dose. The dose of 0.5 mg·L−1 produced more fresh matter and leaf area than the control. Antioxidant capacity and total phenols were not significantly affected by O3 treatments; however, higher SOD, CAT, and APX activity after O3 applications were found. It is concluded that ozone applications to the nutrient solution affect the availability of some micronutrients and increase oxidative stress and yield in baby red chard plants.

Listeria monocytogenes is a ubiquitous organism that can be found in food-related environments, and sanitizers commonly prevent and control it. The aim of this study is to perform a meta-analysis of L. monocytogenes response to sanitizer treatments. According to the principle of systematic review, we extracted 896 records on the mean log-reduction of L. monocytogenes from 84 publications as the dataset for this study. We applied a mixed-effects model to describe L. monocytogenes response to sanitizer treatment by considering sanitizer type, matrix type, biofilm status, sanitizer concentration, treatment time, and temperature. Based on the established model, we compared the response of L. monocytogenes under different hypothetical conditions using forest plots. The results showed that environmental factors (i.e., sanitizer concentration, temperature, and treatment time) affected the average log-reduction of L. monocytogenes (p < 0.05). L. monocytogenes generally exhibited strong resistance to citric acid and sodium hypochlorite but had low resistance to electrolyzed water. The planktonic cells of L. monocytogenes were less resistant to peracetic acid and sodium hypochlorite than the adherent and biofilm cells. Additionally, the physical and chemical properties of the contaminated or inoculated matrix or surface also influenced the sanitizer effectiveness. This review may contribute to increasing our knowledge of L. monocytogenes resistance to sanitizers and raising awareness of appropriate safety precautions. [ABSTRACT FROM AUTHOR]

Objective  Tobacco residue, also known as third-hand smoke (THS), contains toxicants and lingers in dust and on surfaces and clothes. THS also remains on hands of individuals who smoke, with potential transfer to infants during visitation while infants are hospitalized in neonatal intensive care units (NICUs), raising concerns (e.g., hindered respiratory development) for vulnerable infants. Previously unexplored, this study tested handwashing (HW) and sanitization efficacy for finger-nicotine removal in a sample of adults who smoked and were visiting infants in an NICU. Study Design  A cross-sectional sample was recruited to complete an interview, carbon monoxide breath samples, and three nicotine wipes of separate fingers (thumb, index, and middle). Eligible participants (n  = 14) reported current smoking (verified with breath samples) and were randomly assigned to 30 seconds of HW (n  = 7) or alcohol-based sanitization (n  = 7), with the order of finger wipes both counterbalanced and randomly assigned. After randomization, the first finger was wiped for nicotine. Participants then washed or sanitized their hands and finger two was wiped 5 minutes later. An interview assessing tobacco/nicotine use and exposure was then administered, followed by a second breath sample and the final finger wipe (40–60 minutes after washing/sanitizing). Results  Generalized linear mixed models found that HW was more effective than sanitizer for nicotine removal but failed to completely remove nicotine. Conclusions  Without proper protections (e.g., wearing gloves and gowns), NICU visitors who smoke may inadvertently expose infants to THS. Research on cleaning protocols are needed to protect vulnerable medical populations from THS and associated risks. Key Points NICU infants may be exposed to THS via visitors. THS is not eliminated by HW or sanitizing. THS removal protections for NICU infants are needed. [ABSTRACT FROM AUTHOR]

For decades, quaternary ammonium compounds (QAC)-based sanitizers have been broadly used in food processing environments to control foodborne pathogens such as Listeria monocytogenes. Still, there is a lack of consensus on the likelihood and implication of reduced Listeria susceptibility to benzalkonium chloride (BC) that may emerge due to sublethal exposure to the sanitizers in food processing environments. With a focus on fresh produce processing, we attempted to fill multiple data and evidence gaps surrounding the debate. We determined a strong correlation between tolerance phenotypes and known genetic determinants of BC tolerance with an extensive set of fresh produce isolates. We assessed BC selection on L. monocytogenes through a largescale and source-structured genomic survey of 25,083 publicly available L. monocytogenes genomes from diverse sources in the United States. With the consideration of processing environment constraints, we monitored the temporal onset and duration of adaptive BC tolerance in both tolerant and sensitive isolates. Finally, we examined residual BC concentrations throughout a fresh produce processing facility at different time points during daily operation. While genomic evidence supports elevated BC selection and the recommendation for sanitizer rotation in the general context of food processing environments, it also suggests a marked variation in the occurrence and potential impact of the selection among different commodities and sectors. For the processing of fresh fruits and vegetables, we conclude that properly sanitized and cleaned facilities are less affected by BC selection and unlikely to provide conditions that are conducive for the emergence of adaptive BC tolerance in L. monocytogenes. [ABSTRACT FROM AUTHOR]

Abstract This study aimed to achieve an in vitro quantification of the effects of composition and formulation factors on the killing rates of alcohol-based hand sanitizers. The killing rates of 85% ethyl alcohol (ET) and isopropyl alcohol (IPA) were studied under different conditions such as pH, electrolyte concentration, or inclusion of herbal extracts (cucumber, carrot, and aloe vera), a quaternary ammonium compound, or thickener over different time intervals. Changes in the activities were retested after 3 months as an indication of stability. From two-way ANOVA, both the time of exposure and the sanitizer type affected the activity against Staphylococcus aureus (P = 0.001 for both alcohols), whereas for Escherichia coli, time of exposure was significant (P = 0.027), while sanitizer type was less significant (P = 0.063). Extreme pHs, the presence of ions, and the inclusion of additives such as benzalkonium chloride (BAC), plant extracts, or carbomer impacted the 3-month activity of the samples differently. Important differences existing in the activities of ET and IPA, as a function of formulation factors or use conditions have been quantified using in vitro methods. Formulations should best be tailored for particular purposes and the all-purpose hand sanitizer may not exist. Graphic Abstract

Introduction: The hand harbors different species of bacteria that may play a role in the transmission of infectious diseases. Therefore, this study was conducted to determine the bacterial profile of hands and assess the efficacy of the three most common methods of hand cleansing on the reduction of that bacteria. Materials and methods: Hand swaps were collected from 150 adults. The identity of bacteria was done by standard microbiological procedures. Each participant applied one of three selected methods of hand cleansing namely, handwashing with water and plain soap, hand rubbing with an alcohol-based sanitizer, and hand wiping with alcohol-free hand sanitizer wipes. A second swap was collected after cleansing to determine the efficacy of each method by calculating the percentage of the reduction of isolated bacteria. Results: Most isolated bacteria were commensal flora like Coagulase Negative Staphylococcus (92%), and Corynebacterium spp (81.3%). Other pathogenic bacteria were isolated mainly, Staphylococcus aureus (32%), Escherichia coli (10%), Pseudomonas aeruginosa (2.6%), Klebsiella spp (2.6%) and Acinetobacter spp. (2%). The hand rubbing was more efficacy than handwashing without a statistically significant difference (P>0.05), and the hand wiping had lower efficacy than the other two methods with statistically significant difference (P

Aim: The study aimed to access the knowledge, practice, and compliance related to COVID-19 among people residing in Province 2, Nepal. Materials and methods: A descriptive cross-sectional study was conducted from October 2020 to March 2021. A total of 457 participants of eight districts of Province 2 were enrolled after obtaining consent. Data were collected by face-to-face interviews with participants. A total of 31 validated pre-structured questionnaires were asked to participants in which 11 questions were for knowledge, 12 questions were for practices, and 8 questions were for compliance related to COVID-19. For tool validation, pre-testing was done in 10.0% of individuals of the targeted study population of Mahottari district. Results: Out of 457 participants, 353(77.2%) were male. The majority of the participants were unmarried (68.3%), had only school-level education (26.5%), Hindu by religion (89.7%), farmers (23.0%), and businessmen (23.0%). More than 75.0% of individuals had knowledge about the causative agent of COVID-19 symptoms and the purpose of isolation. About 53.8% of participants had good knowledge of social distancing, 31.1% had knowledge of masks, and 39.3% knew about sanitizer. Moreover, 94.3% of the respondents had good knowledge of hand-washing practice with soap-water and use of sanitizer, 89.1% had good knowledge of wearing masks and 82.9% followed social distancing. Compliance with standard procedures of sneezing was recorded in 43.1%, washing hands with soap water/sanitizer was 82.3%, and disposal of masks was 53.6%. A significant association was observed between gender with knowledge and compliance (p

Background: The deadly COVID-19 pandemic has swept the globe since December 2019. Due to the significant risk of infection, frontline health workers had to use Personal Protective Equipment and hand hygiene products, to help prevent transmission of infection. The present study aims to compare the adverse skin responses between healthcare workers (HCW) and non-healthcare workers (NHCW). Materials and methods: A descriptive, cross-sectional study of HCW and NHCW throughout the country wa executed. A self-structured questionnaire was utilized to gather data from 404 HCWs and 826 NHCWs during a two-month period using multistage sampling. STATA (v16) was used to analyse the data. Results: 41.87% of the study participants experienced adverse skin reactions, which were more prevalent amongs HCW (65.10%) than NHCW (30.51%). The most frequently reported skin condition was skin dryness (34.39%), followed by skin peeling (11.71%). Users of alcohol-based hand sanitizers (ABHS) were more likely to get itch (8.13%), whereas soap water users were more likely to suffer from skin peeling (35.74%) and rash (7.46%). There was a significant (p < 0.001) association between occupation and adverse skin responses, with HCW being 3.5 times more likely to have adverse skin manifestations than NHCW. Conclusion: The research showed that healthcare workers were at a greater risk to developing skin reactions than the overall population with frequent use of hand hygiene measures being a significant risk factor.

The environmental control of microbial pathogens currently relies on compounds that do not exert long-lasting activity on surfaces, are impaired by soil, and contribute to the growing problem of antimicrobial resistance. This study presents the scientific development and characterization of GS-2, a novel, water-soluble ammonium carboxylate salt of capric acid and L-arginine that demonstrates activity against a range of bacteria (particularly Gram-negative bacteria), fungi, and viruses. In real-world surface testing, GS-2 was more effective than a benzalkonium chloride disinfectant at reducing the bacterial load on common touch-point surfaces in a high-traffic building (average 1.6 vs. 32.6 CFUs recovered from surfaces 90 min after application, respectively). Toxicology testing in rats confirmed GS-2 ingredients were rapidly cleared and posed no toxicities to humans or animals. To enhance the time-kill against Gram-positive bacteria, GS-2 was compounded at a specific ratio with a naturally occurring monoterpenoid, thymol, to produce a water-based antimicrobial solution. This GS-2 with thymol formulation could generate a bactericidal effect after five minutes of exposure and a viricidal effect after 10 min of exposure. Further testing of the GS-2 and thymol combination on glass slides demonstrated that the compound retained bactericidal activity for up to 60 days. Based on these results, GS-2 and GS-2 with thymol represent a novel antimicrobial solution that may have significant utility in the long-term reduction of environmental microbial pathogens in a variety of settings. [ABSTRACT FROM AUTHOR]

Introduction: Quaternary ammonium compounds (QACs) have been available since 1908 and are widely used as sanitizers in diverse environments. However, the use of subinhibitory concentrations of QACs has been related to the development of microbial resistance. Material and methods: In this study, based on a theoretical survey in biomedical literature databases following the guidelines of the Cochrane handbook, an analysis of the current situation of resistance to QACs in bacteria of medical and veterinary interest was carried out. After selection within the 1996 articles found in the literature search, 7 studies that evaluated the profile of susceptibility to benzalkonium chloride in pathogenic bacteria were included. Results: The analysis of the studies revealed that among potential human and animal pathogens, resistance to QACs is most investigated in Gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii. In these species, in some isolates, concomitant resistance to QACs and clinically relevant antimicrobials was detected. A single study showed resistance in Gram-positive bacteria, revealing that Enterococcus faecium has a high potential to become resistant to QACs. Among the mechanisms of resistance to QACs, the presence of the qacE gene stands out, which was reported in three of the included studies. Conclusion: Despite the relevance of resistance to QACs among pathogenic bacteria, few studies have been conducted to monitor this event. Thus, negligence in the epidemiological surveillance of resistance to these sanitizers will certainly impact their effectiveness in the near future. [ABSTRACT FROM AUTHOR]