It was one of those “good news, bad news” weeks in germ news this week with one story that inspires us to think ‘inside the can’ and another that may force us to change the disinfection cans under our sink.  Both, however, may change the way we look at germs and our fashion of dealing with them.

First, the good news.

The media was all abuzz this week about a new concept in fashion.  Known as Fabrican, it’s literally, fabric in a can.  Developed by the Imperial College London and the Royal College of Art, this novel way of getting dressed takes you out of the closet and into the garage.  Aerosol cans filled with a liquid polymer that binds together once sprayed on the skin to form a nonwoven textile.  In the hands of fashion designers such as Dr. Manuel Torres, the spray can be transformed into haute couture designs.  He recently introduced his vision and creations at the “Science in Style” fashion show earlier this week.

This may be all good for fashion but what does this have to do with germs?

As the Fabrican website declares, there are several potential uses in medicine and general hygiene as the product can be sterilized.  The spray can be used to make completely safe wound dressings, wipes for disinfection and antisepsis, and instant diapers.  In a world full of germs that no one can see, Fabrican may offer the opportunity to have more control over our hygiene and give us another option to stay safe.

Now the bad news.

Even if we have a sterile skin covering, it will do no good if the skin itself isn’t clean. As we all know, germs reside quite nicely on our skin and there are a plethora of antiseptic products available to reduce the amount of germs.  This is particularly important in medicine where skin sterility is a priority for surgery, catheters, and intravenous injections.

Alcohol, tea tree oil, iodine and the practically unpronounceable octenidine dihydrochloride are known as a skin sanitizers but in many medical procedures, another antiseptic, chlorhexidine gluconate, or, CHG, is the product of choice.  CHG is used undiluted to wipe down skin or diluted in bath water and effectively decolonizes the skin of potentially dangerous bacteria, such as MRSA.

Unfortunately, the use of CHG may be in jeopardy.

A paper released earlier this week by Dr. Jonathan Edgeworth suggests that while the use of CHG has helped to reduce the number of patients in hospitals with MRSA infection, there is a dark side to the use of the chemical.  For years, bacteria have housed and spread a collection of genes, known as qacA/B.  These genes produce a set of proteins that help bacteria, such as MRSA, expel CHG from the cell.  The qacA/B genes are found worldwide and in many parts of the world, make up the majority of MRSA strains found in hospitals.  According to Edgeworth, the increased use of CHG for decolonization may help to spread the genes and eventually lead to widespread prevalence of CHG resistant MRSA.  Should this occur, CHG would no longer be an option and other chemicals would have to be used or developed.

But that’s not the worst of the story.  The qacA/B genes also help bacteria evade a commonly used disinfectant family, known as quaternary ammonium compounds, or QACs.  There are literally dozens of products that contain these QACs and they are used in almost every facet of life from household disinfection to disinfection of hospital surfaces.  In a world where the qacA/B genes become rampant, this fashion of disinfection will be turned upside down.

I have to say though, that these trends are only in their infancy and that it will be years before we see Fabrican on our shelves or the loss of QACs as a household disinfectant.  In the case of the latter, there may be no need for concern if the levels of CHG are reduced.  But as in all science, it’s better to have an idea of what may happen in the future, even if it may seem preposterous.  After all, science is not just about data and statistics, it’s also about hypothesizing.  And, as Edward Teller once said: “A hypothesis is a novel suggestion that no one wants to believe.”  And with the information learned this week, I’m sure there will be more hypotheses developing…

…some of which may even come true.

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