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

## TL;DR

This study found that most chlorine solutions in Beninese hospitals are ineffective due to improper storage and low concentration, risking infection control and antibiotic resistance.

## Contribution

The study identifies specific factors affecting chlorine solution efficacy in resource-limited hospitals and links them to poor disinfection outcomes.

## Key findings

- 88.4% of chlorine solutions had inadequate active chlorine concentrations.
- Bactericidal effectiveness was only 14.6%, with poor performance against Gram-negative and Gram-positive bacteria.
- Inadequate concentration and improper storage were strongly associated with ineffectiveness (OR = 42.5).

## 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.