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. 2022 Sep 7;133(6):3322–3346. doi: 10.1111/jam.15739

TABLE 1.

Impact of BKC exposure/treatment on antimicrobial susceptibility in bacteria

Bacteria Exposure/treatment MIC before exposure MIC post exposure Reference
Stepwise training
P. aeruginosa ATCC 9027 Subculture in increasing concentrations of BKC ND MIC: >200 mg l−1 Adair et al. (1975)
E. coli O157; S enterica serovar enteritidis, typhimurium, virchow Growth in increasing concentration ‐ starting sub‐MIC level MIC: 400 mg l−1 S. enterica, virchow and enterica, <100 mg l−1 virchow MIC: >1000 mg l−1 for E. coli Braoudaki and Hilton (2004)
S enterica serovar enteritidis, typhimurium, virchow Growth in increasing concentration ‐ starting sub‐MIC level MIC for S. enterica serovar enteritidis 32 mg l−1, virchow 256 mg l−1 and typhimurium 64 mg l−1 MIC for S. enterica serovar enteritidis 256 mg l−1; virchow 256 mg l−1 and typhimurium from 64 mg l−1 Braoudaki and Hilton (2005)
Cronobacter sakazakii and enterocolitica Subculture in increasing concentrations of BKC; starting sub‐MIC level

MIC: 15 mg l−1 for C. sakazakii

MIC: 20 mg l−1 for Y. enterocolitica

MIC: 56.95 mg l−1 for C. sakazakii

MIC: 50.63 mg l−1 for Y. enterocolitica

Capita et al. (2019)
S. marcescens (Breed's no. 1377) Subculture in increasing concentrations of BKC from highest concentration showing growth MIC: 50–100 mg l−1 MIC: 100,000 mg l−1 in three passages over a period of 15 days, and 50,000 mg l−1 in eight passages during 45 days Chaplin (1951)
S. enterica isolates from poultry (n = 125) and swine (n = 132) Exposure to sub‐inhibitory concentrations MIC: 32–256 mg l−1 ‐ most at 64 mg l−1 MIC: 128–256 mg l−1 Chuanchuen et al. (2008)
189 Salmonella strains, including 48 serotypes from various origins (such as clinical sources, food, the environment and water) Growth in (0.25 or 0.5 MIC). Biocide formulation concentration increased in a stepwise manner until the biocide concentration reached 4X MIC MIC:15 mg l−1 MIC: 50 mg l−1 Condell et al. (2014)
E. coli and K. pneumoniae mutants with different TRI susceptibility Growth in sub‐inhibitory concentrations (0.5 MIC), followed by agar with concentration of 2.5 to 33 × MIC MIC: 16 mg l−1 MIC: 32 mg l−1 Curiao et al. (2015)
P. aeruginosa NCIMB 10421 clinical isolates of P. aeruginosa Subculture in increasing concentrations of BKC (2‐fold steps) MIC: 50 mg l−1 MIC: 580 mg l−1 after 25 subcultures Joynson et al. (2002)
P. aeruginosa Subculture in increasing concentrations of BKC until cessation of growth MIC: 200 mg l−1 Growth in BKC up to 1600 mg l−1 Kim et al. (2018)
16 P. aeruginosa from hospital environment Subculture in increasing concentrations of BKC MIC: 15–30 mg l−1 MIC: >500 mg l−1 for clinical isolate; Reference standard culture strain PAO1: 500 mg l−1 Loughlin et al. (2002)
Three C. jejuni (NCTC11168, ATCC33560 and the K49/4 poultry isolate) and two C. coli (ATCC33559, and the 137 poultry isolate) Subculture in increasing concentrations of BKC MIC: 0.5–2 mg l−1 1–4‐fold increase in MIC; ATCC33559 strain: 4‐fold MIC increase after 15 days of exposure Mavri and Smole Možina (2000)
6 antimicrobial‐susceptible E. coli and 6 antimicrobial‐susceptible non‐typhoidal Salmonella (NTS) isolates Subculture in increasing concentrations of BKC: 0.5 MIC exposure over 12 days MIC: 21–30 mg l−1 for Salmonella and 12–27 mg l−1 for E. coli Post exposure MIC increase: <2‐fold to 2‐fold in one Salmonella and one E. coli Nhung et al. (2015)
L. monocytogenes SLCC2540 Subculture in increasing concentrations of BKC; starting concentration of 0.002 mg l−1; growth in increasing concentration of 0.001 mg l−1 every 48 h

MICL: 0.004 mg l−1

MBC: 0.011 mg l−1

MIC: 0.008 mg l−1

MBC: unchanged

Noll et al. (2020)
81 E. coli from biofilm collected from raw milk line, pasteurizer inlet, outlet and, milk tank of a small scale and commercial scale dairy Subculture in increasing concentrations of BKC; starting with sub‐MIC (well immediately below MIC step of 10 mg l−1) MIC: 50–250 mg l−1 MIC: 70–350 mg l−1; largest increased from 50 to 130 mg l−1 Pagedar et al. (2012)
E. coli veterinary isolates Subculture in increasing concentrations of BKC starting 1/4 MIC for 24 h MIC range from 4 to 64 mg l−1 Only 2/24 isolates showed increased MIC >4‐fold (6‐ and 9‐folds increased). All the others <2‐fold Puangseree et al. (2021)
9 avian and porcine E. coli strains and E. coli ATCC25922 Subculture in increasing concentrations of BKC daily for 7 days MIC: 16–32 mg l−1 2‐fold increase in MIC Soumet et al. (2012)
P. aeruginosa ATCC 10145 and deletion mutants Subculture in increasing concentrations of BKC MIC: 18.2 mg l−1 MIC: 51.2 mg l−1 Tabata et al. (2003)
Two resistant (4 mg l−1) and four sensitive (1 mg l−1) L. monocytogenes strain Subculture in increasing concentrations of BKC (1–10 mg l−1) MIC: 1–4 mg l−1 MIC increased to 5–6 mg l−1 for sensitive strains and to 8 mg l−1 for resistant ones To et al. (2002)
GROWTH IN BKC (sub‐MIC level)
E. faecium Aus0004 and S. aureus HG003 Growth in sub‐inhibitory concentration; 1/2 MIC E. faecium Aus0004 MIC: 4 mg l−1; S. aureus HG003 MIC: 2 mg l−1 ND Dejoies et al. (2021)
49 clonally unrelated isolates of A. baumannii Growth in BKC 0.25 × MIC (10 mg l−1) for 30 days ‐ one clinical isolate only MIC: 1–15.6 mg l−1 ‐ majority at 3.9 and 7.8 mg l−1 2–16‐fold increase Fernández‐Cuenca et al. (2015)
205 L. monocytogenes food isolates Exposure to 0.6 mg l−1 BKC in broth for 24 h at 37°C. MIC range from 0.63 to 5 mg l−1 MIC increased to 4 mg l−1 Guérin et al. (2021)
283 Acinetobacter spp. strains from 97 hospitals Repeated exposure to 1/2 MIC for 72 h MIC: mostly 5–10 mg l−1 MIC: 10–50 mg l−1 Kawamura‐Sato et al. (2018)
S. enterica serovar Typhimurium strains (SL1344 and 14028S) Exposure to during use concentration ‐ 0.015 mg l−1 or 0.004 mg l−1 Salmonella SL1344 MIC: 0.03 mg l−1 14028S MIC: 0.004 mg l−1; MBC 0.003 and 0.008 mg l−1 Salmonella SL1344 MIC: 3 mg l−1 14028S MIC: 0.2 mg l−1; MBC 8 and 20 mg l−1 Knapp et al. (2015)
Burkholderia lata strain 283 Exposure to 50 mg l−1 BKC; 5 min or to mid‐log phase at 20°C MIC: 0.5 mg l−1 No change in MIC Knapp et al. (2013)
A. baumannii standard culture collection strain and mutants Exposure to 32 mg l−1 in agar for 24 h then growth in 16 mg l−1 MIC: 16 mg l−1 MIC: 32 mg l−1 Knauf et al. (2017)
S. aureus laboratory constructs Pre‐exposure test in 5 mg l−1 BKC for 60 min MIC: 4 mg l−1 in parent strain; 1 mg l−1 in ΔnorA; 8 mg l−1 in norA construct; 16 mg l−1 in pCN38‐qacA qacR construct ND (increased expression of norA and qacA) LaBreck et al. (2020)
E. coli ATCC 11775 and E. coli DSM 682 Sub‐MIC growth 5 mg l−1 overnight or 20 mg l−1 during exponential phase MIC: 25 mg l−1 for 1175 and DSM682 Exposure to 5 mg l−1: 1175; MIC 25 mg l−1; DSM682: MIC: 35 mg l−1; exposure to 20 mg l−1 1175; MIC 35 mg l−1; DSM682 MIC: 45 mg l−1 Langsrud et al. (2004)
E. coli CFT073 Exposure to 2 mg l−1 until sufficient increase in OD MIC: 8 mg l−1 ND Ligowska‐Marzeta et al. (2019)
24 coagulase‐negative Staphylococci isolates (12 isolates with decreased susceptibility to CHX and 12 isolates with decreased susceptibility to BKC) Repeated exposures (3 passages) to 1/2 MIC (range 1–4 mg l‐1) BKC for 24 h at 37C MIC range from 2 to 8 mg l−1 and MBC from 2 to 16 mg l−1 2‐fold increase in BKC MIC in 58% of CHX isolates and 83% of BKC isolates

Marzoli et al. (2021)

L monocytogenes; food and veterinary isolates Repeated exposure to 10 mg l−1 BKC MIC: 10 mg l−1 MIC: 30 mg l−1 Rakic‐Martinez et al. (2011)
Salmonella Enteritidis NCTC13349 and one food isolate Exposure to 1/2 MBEC (400 mg l−1 BKC) for 6 days every other day MBEC: NCTC13349 800 mg l−1 MBEC isolate: 1600 mg l−1 ND Romeu et al. (2020)
S. maltophilia D457, and isogenic mutant D457R, overexpressing SmeDEF Growth on agar containing 128 mg l−1 BKC MIC: 128 mg l−1 MIC: 256 mg l−1 Sánchez et al. (2015)
Three aerobic communities from water effluent. BKCs unexposed (DP, fed a mixture of dextrin/peptone), BKCs exposed (DPB, fed a mixture of dextrin/peptone and BKCs) and BKCs enriched (B, fed only BKCs). BKC concentration 50 mg l−1 Exposure of community to 50 mg l−1 for 4 years ND DPB MIC: 250 mg l−1, B MIC: 460 mg l−1 Tandukar et al. (2013)
P. aeruginosa ATCC27853 Repeated (10 cycles) exposure to BKC MIC: 80 mg l−1 MIC: Max 150 mg l−1 Voumard et al. (2020)

Note: term resistant/resistance as reported in the paper but does not correspond to the definition of resistance used in the main document.

Abbreviations: BKC, Benzalkonium chloride, ND, not determined; TRI, triclosan.