Antiseptic "resistance": real or perceived threat?

Biocides (antiseptics, disinfectants, preservatives, and sterilants) are critical components of intervention strategies used in clinical medicine for preventing the dissemination of nosocomial diseases. Biocides are also used in community environments for personal hygiene and to prevent cross-contamination with foodborne pathogens. In vitro studies suggest that exposure to biocides results in reduced susceptibility to antibiotics and biocides by intrinsic or acquired mechanisms of resistance. In addition, microorganisms have adapted to biocide exposure by acquiring plasmids and transposons that confer biocide resistance, the same survival strategies to disseminate acquired mechanisms of resistance to biocides as they have for resistance to antibiotics. The scientific community must weigh the risks and benefits of using biocides in clinical and community environments, to determine whether additional precautions are needed to guide biocide development and use. At present, insufficient scientific evidence exists to weigh these risks, and additional research is needed to allow appropriate characterization of risks in clinical and community environments.