The study conducted in Australia has made some progress in identifying the mechanism by which bacteria can evolve tolerance to alcohol. It has been long thought that ethanol and isopropanol exert germicidal effects by interfering with the functioning of the membrane that surrounds bacteria. Three unique gene mutations in metabolic pathways were detected in the alcohol tolerant specimens from the 139 strains of E. faecium that were screened by the scientists in the report. All three of the genes that were affected involved the transport of carbohydrates into the germs through the bacterial cell wall. These findings suggest that membrane transport channels are very important to the evolution of alcohol-tolerance in these bacteria. Further research will be required to delineate the exact mechanisms by which these mutations provide a survival advantage to the Enterococci harboring them.
In the end, hospitals are unlikely to ditch the widespread use of hand sanitizers, since they have been particularly effective at reducing the incidence of S. aureus infections. In light of the data in support of certain bacteria evolving alcohol tolerance, medical practitioners and administrators will put new emphasis on thorough hand washing over longer periods of time to offset the spread of these infections. An additional measure suggested the incorporation of an additional anti-microbial compound into hand sanitizers called chlorhexidine. Beyond these approaches, scientists and medical doctors may need to begin considering less traditional alternatives to combat the rising threat of antibiotic-resistant and alcohol-tolerant bacterial pathogens.
In the future, it looks like it will be a wise course of action to not rely solely upon hand sanitizers to prevent infections and supplement them with some good ole soap and water.