Evaluation of the Efficacy of Natural Essential Oil-Based Disinfectants Compared to Conventional Disinfectants for the Disinfection of Hospital Objects: A Literature Review

The sanitization of surfaces and objects in hospital environments is an essential practice for controlling Healthcare-Associated Infections (HAIs), reducing the transmission of potentially harmful pathogens to patients and healthcare professionals. It is estimated that up to 30% of HAIs can be prevented with effective disinfection measures, emphasizing the importance of this practice in clinical settings [1]. The effectiveness of sanitization depends not only on the technique used but also on the properties of the applied disinfectants.

Conventional disinfectants, widely employed, include chemical products such as sodium hypochlorite, isopropyl alcohol, quaternary ammonium compounds, and hydrogen peroxide, all of which demonstrate high antimicrobial efficacy (Brown and Green, 2019). However, prolonged use of these agents can lead to adverse effects, such as microbial resistance, irritation among users, and environmental impact due to improper disposal of chemical waste [2].

Given this scenario, the search for safer, more sustainable, and equally effective alternatives has led to increasing interest in the development of disinfectants based on natural compounds, particularly plant-derived essential oils. These oils contain bioactive compounds such as phenols, aldehydes, and terpenes, known for their antimicrobial, antioxidant, and anti-inflammatory properties [3]. Plant species such as Melaleuca alternifolia (tea tree), Cymbopogon citratus (lemongrass), and Thymus vulgaris (thyme) have emerged as promising sources of natural disinfectants [4,5]. Furthermore, these products exhibit lower toxicity to the environment and greater safety for users, making them particularly attractive for facilities aiming to minimize environmental impact and protect healthcare professionals [6].

However, introducing these disinfectants into hospital environments presents specific challenges. Issues such as formulation standardization, stability under different environmental conditions, and effectiveness against resistant microorganisms still require extensive investigation (Choi et al., 2021). Additionally, direct comparisons with conventional disinfectants are essential to determine whether these natural alternatives can provide the same level of protection against highly resistant pathogens, such as Methicillin-Resistant Staphylococcus Aureus (MRSA), Clostridioides difficile, and other HAI-associated agents [7].

Thus, this research explores the chemical and antimicrobial properties of natural essential oil-based disinfectants, their advantages and limitations compared to conventional disinfectants, and scientific evidence regarding their efficacy on hospital surfaces. This analysis aims to highlight potential benefits and challenges in adopting these alternatives in clinical settings, providing an updated overview of the topic.

Study characterization

A narrative review of scientific literature was used as a methodological tool for this study. This is a qualitative descriptive study that utilized scientific bibliography to present the topic. The developed analysis aimed to capture the most relevant data to provide a critical perspective on the subject.

Methods

The literature review was structured following an extensive search based on the protocol cited by Almeida et al. The synthesis of this article was conducted by formulating a guiding research question. The PICOT acronym was used, corresponding to the Population/Intervention/Comparison/Outcome framework:
I. P: Hospital objects frequently contaminated by pathogens associated with healthcare-associated infections (HAIs).
II. I: Use of natural essential oil-based disinfectants.
III. C: Conventional disinfectants, such as sodium hypochlorite, quaternary ammonium compounds, and isopropyl alcohol.
IV. O: Reduction of microbial load on hospital objects and effectiveness against resistant pathogens.
V. T: Sufficient evaluation period to compare antimicrobial efficacy and potential environmental impacts.

Conducting the investigation

The central research question posed in this study was: “Are disinfectants developed with natural essential oils as effective as conventional disinfectants in reducing microbial load on hospital objects, considering safety and environmental impact aspects?”

The investigation was conducted between October and November 2024 using online databases of scientific articles, such as PubMed, Embase, and Lilacs. The following search terms were used: (“hospital disinfectants” OR “surface disinfection”) AND (“essential oils” OR “natural products”) AND (“conventional disinfectants” OR “chemical disinfectants”) AND (“efficacy” OR “antimicrobial effectiveness”) AND (“infection control” OR “hospital-acquired infections” OR “HAI”).

For this review, a time frame of the last five years was prioritized; however, there were no restrictions when relevant data were identified. Selected studies explicitly addressed comparisons between natural and conventional disinfectants in their titles and abstracts.

Selection parameters

This research prioritized and selected studies published as scientific articles in Portuguese, English, and Spanish. After the initial selection, studies that did not meet the criteria or did not address the central research question were excluded. Approved studies had their most relevant information highlighted to support the objectives of this research.

Presentation of results and data synthesis

Figure 1:Methodology.

After individually reviewing each article, the final literature review was structured to align with the scope of the investigation. Figure 1 illustrates the methodological steps followed. It is noteworthy that ethics committee approval was not required, as all analysed data were publicly available (Figure 1).

The use of essential oil-based natural disinfectants has gained increasing attention in hospital environments as an alternative to conventional disinfectants due to their antimicrobial efficacy and lower environmental impact. In a study conducted by Silva et al. [8], the antimicrobial activity of Melaleuca alternifolia essential oil was analysed in comparison with conventional disinfectants such as isopropyl alcohol and sodium hypochlorite. The oil showed superior efficacy in inhibiting the growth of Staphylococcus aureus and Escherichia coli, pathogens frequently found in hospital settings. The results indicate that natural disinfectants can be as effective as conventional ones while presenting lower toxicity and greater biodegradability [9].

Furthermore, studies by Andrade et al. [10] highlight the use of essential oils in combination with nanoparticles to enhance antimicrobial efficacy. In this context, it was observed that incorporating Cymbopogon citratus into disinfectant formulations increased the product’s ability to eradicate Pseudomonas aeruginosa and Candida albicans, pathogens that are difficult to eliminate due to their resistance to many conventional treatments. The combination of natural compounds with nanotechnology represents a significant advancement in the search for effective and less aggressive alternatives to traditional chemical treatments.

According to the study by Gonçalves et al. [11], Melaleuca alternifolia oil also demonstrated efficacy against fungi of the Candida genus, which are responsible for a large portion of hospital fungal infections. This reinforces the potential of essential oils in preventing multifactorial infections in healthcare environments, especially those caused by multidrug-resistant pathogens. However, despite the promising evidence, it is important to emphasize that the use of natural disinfectants does not replace traditional asepsis and sterilization practices. Instead, they can complement already established strategies, offering an alternative to reduce the use of aggressive chemical substances and contributing to the sustainability of the hospital environment. Additionally, essential oils may be advantageous in terms of cost-effectiveness and reduced formation of toxic residues [12].

The results of the reviewed studies demonstrate the promising potential of essential oil-based disinfectants in combating hospital infections, particularly due to their antimicrobial efficacy and lower toxicity risks. These compounds have proven effective against a wide range of pathogens, including those resistant to conventional antibiotics, and offer additional benefits such as biodegradability and low environmental impact [13]. However, further clinical studies are necessary to validate these findings on a large scale and enhance the application of these disinfectants in hospital settings, always in combination with traditional hygiene practices.

The authors thank the Integrated Platform Carlos Chagas (CNPq), the Brazilian Hospital Services Company (EBSERH), the University Hospital Júlio Bandeira (HUJB), and the Technological Initiation Program (PIT) for all academic support during the development of this study.

1. Smith JR (2021) Prevention of hospital infections through effective disinfection measures. Journal of Clinical Infectious Diseases 59(2): 99-103.
2. Jones RP (2020) Adverse effects of prolonged use of conventional disinfectants: Microbial resistance and environmental impacts. Environmental Health Perspectives 128(7): 370-375.
3. Garcia AS (2018) Antimicrobial and antioxidant properties of essential oils. Journal of Medicinal Plants Research 12(7): 1289-1296.
4. Leal JC (2022) Antimicrobial efficacy of Cymbopogon citratus (lemongrass) essential oil. Journal of Applied Microbiology 44(3): 209-218.
5. Lee TS (2022) Essential oils as alternatives to conventional disinfectants in hospital environments. Journal of Medicinal Chemistry 55(4): 1125-1133.
6. Martinez FL, Alvarez AP (2023) Safety and biodegradability properties of natural disinfectants. Environmental Toxicology 59(5): 118-126, 2023.
7. Jansen G (2023) Comparison of conventional and essential oil-based disinfectants in hospital environments. Journal of Hospital Infection Control 31(2): 103-112.
8. Silva RD (2017) Comparison of the antimicrobial activity of Melaleuca alternifolia essential oil with conventional disinfectants. Revista Brasileira de Microbiologia 48(1): 12-20.
9. Reuter JA (2010) Antimicrobial efficacy of essential oils against resistant pathogens. International Journal of Antimicrobial Agents 37: 207-213.
10. Andrade AD (2019) Use of essential oils combined with nanoparticles to enhance antimicrobial efficacy. Revista Brasileira de Farmacologia 35(2): 58-63.
11. Gonçalves AF (2018) Melaleuca alternifolia oil efficacy against fungi of the Candida Revista Brasileira de Terapias Naturais 19(1): 45-51.
12. Mazzuca G (2020) Sustainability and environmental impact of essential oil-based disinfectants compared to conventional chemical agents. Environmental Science and Technology 54(6): 7891-7902.
13. Burt S (2004) Essential oils: Their antibacterial properties and potential applications in foods-a review. International Journal of Food Science and Technology 94(3): 223-253.