Outbreaks Associated with Contaminated Antiseptics and Disinfectants

The Centers for Disease Control and Prevention (CDC) has estimated that health care-associated infections account for an estimated 1. 7 million infections, 99, 000 deaths, and 4. 5 billion in excess health care costs annually (16). The key interventions used to control health care-associated infections include surveillance (27, 33), isolation of patients with communicable diseases (26) or multidrug-resistant pathogens (81), proper skin antisepsis prior to invasive procedures and hand hygiene by health care workers (12), and appropriate disinfection and sterilization of medical devices and environmental surfaces (73, 75, 79). Multiple nosocomial outbreaks have resulted from inadequate antisepsis or disinfection. Inadequate skin antisepsis may result from a lack of intrinsic antimicrobial activity of the antiseptic, a resistant pathogen, overdilution of the antiseptic, or the use of a contaminated antiseptic. The inadequate disinfection of medical devices or environmental surfaces may result from a lack of intrinsic antimicrobial activity of the disinfectant, an incorrect choice of a disinfectant, a resistant pathogen, overdilution of the disinfectant, an inadequate duration of disinfection, a lack of contact between the disinfectant and the microbes, or the use of a contaminated disinfectant. Editorials have noted that contaminated antiseptics and disinfectants have been the occasional vehicles of hospital infections for more than 50 years (20, 72, 76). This paper concisely reviews nosocomial outbreaks associated with the use of a microbiologically contaminated germicide and focuses on the currently recommended germicides.