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31 December 2025

Stability and Efficacy of Chlorinated Disinfectants in Beninese Hospitals: Issues for the Prevention and Control of Infections and Antibiotic Resistance

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1
Clinique Universitaire d’Hygiène Hospitalière (CUHH), Centre National Hospitalier Universitaire—Hubert Koutoukou Maga (CNHU-HKM), Cotonou 01 BP 386, Benin
2
Institut Régional de Santé Publique (IRSP)—Comlan Alfred QUENUM, Université d’Abomey-Calavi (UAC), Ouidah 01 BP 384, Benin
3
École Polytechnique d’Abomey-Calavi (EPAC), Université d’Abomey-Calavi, Abomey-Calavi 01 BP 2009, Benin
*
Author to whom correspondence should be addressed.
This article belongs to the Special Issue Innovative Approaches to Combat Infectious Diseases in Low and Middle Income Countries (LMICs): Epidemiology, Diagnosis, and Interventions

Abstract

In hospitals with limited resources, chlorine solutions are commonly used for biocleaning. The effectiveness of these solutions depends on the concentration of active chlorine and how they are prepared and stored. A study conducted in six University Hospitals in Benin from 10 March to 11 July 2025 aimed to evaluate the stability of active chlorine and the bactericidal efficacy of chlorine solutions used for disinfecting hospital environments. A total of 103 samples were analyzed using iodometric titration following the AFNOR (Association Française de Normalisation) standard NF EN ISO 7393-3 (2000) and WHO (World Health Organization) recommendations. Bactericidal activity was tested on multi-resistant hospital strains using the germ carrier method based on the standard NF T72-281. The study revealed that 88.4% of the solutions had inadequate active chlorine concentrations. Overall, the bactericidal activity was low, with only 14.6% effectiveness compared to 85.4% ineffectiveness. Ineffectiveness was particularly pronounced against Gram-negative bacilli, with 79.6% ineffectiveness and 20.4% effectiveness. Similarly, Gram-positive cocci showed a high level of ineffectiveness, reaching 84.5%, corresponding to 15.5% effectiveness. A significant association was observed between compliance with active chlorine concentrations and bactericidal effectiveness, with an OR of 42.5 and a p-value below 0.000001. Factors contributing to inefficiency included storage without light protection, use of transparent containers, storage for more than two days, inadequate active chlorine concentration, and incorrect pH levels. These issues compromise hospital disinfection and contribute to the persistence of multi-resistant bacteria in the hospital environment.

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