Antiseptics: sometimes the cause of infection.

In late 2013, the US Food and Drug Administration (FDA) issued a warning about the possibility of bacterial contamination of antiseptic solutions (1). Many infections caused by contaminated antiseptic solutions have been reported (1). The consequences ranged from localised infection at an injection site, to deep infections and even fatal septicaemia. The FDA analysed a series of reports including 4 deaths, 5 wound infections, 7 cases of peritonitis, 10 cases of septic arthritis, 14 catheter infections, 16 injection site infections, and 32 cases of bacteraemia. These infections were confirmed to have been caused by a contaminated antiseptic solution. The products involved included all of the commonly used antiseptic agents: alcohol, iodophores, chlorhexidine, and quaternary ammonium compounds. The microorganisms involved were a variety of bacteria and mycobacteria (1). The microorganisms were usually introduced into the antiseptic by diluting it with contaminated water, by inappropriate handling, or by storing it under non-sterile conditions. In a few cases, contamination occurred during the manufacturing process.