Evaluating the Effectiveness of Benzalkonium Chloride on Gram-Positive and Gram-Negative Bacteria in Iran: A Systematic Review

Today, biocides have become an integral part of the industrialized world and are invaluable compounds in the control of human and animal pathogens. Benzalkonium chloride (BCC), a biocidal agent, is widely used in hospitals and healthcare facilities, as well as household settings, farms, and food industries. BCC is a quaternary ammonium compound that can denature cytoplasmic membrane proteins. This paper aims to review evaluated studies on the minimum inhibitory concentration of benzalkonium chloride on Gram-positive and Gram-negative bacteria isolated in healthcare centers in Iran.

The data of this systematic review study was collected from national and international databases, including Web of Science, Science Direct, EMBASE, Scopus, PubMed/Medline, Google Scholar, SID, and Magiran, using appropriate Persian and English keywords without time limitation for searching. After filtration based on the Inclusion and exclusion criteria, 15 articles were entered into our study.

Overall, 15 studies were identified. 7 studies were included in Gram-positive bacteria and the other 8 were included in Gram-negative bacteria. Most studies were related to Staphylococcus aureus (5) and Pseudomonas aeruginosa (3). Also, the highest and the lowest reported inhibitory concentration was 1024 µg/ml for Pseudomonas aeruginosa and 0.25 µg/ml for Staphylococcus aureus.

Different results of the minimum inhibitory concentration of benzalkonium chloride have been reported in Iran, particularly for Gram-negative bacteria. As a result, it is suggested that more studies be conducted in all provinces based on the common biocide agents used on resistant bacteria causing hospital infections regularly.