Most outbreaks associated with contaminated antiseptics and disinfectants had been attributed to user errors, as identified in our previous review in 2007. Although numerous regulations and guidelines have been established for proper use of antiseptics and disinfectants since then, such outbreaks continue to occur. To address this issue, we conducted a literature review of outbreaks and pseudo-outbreaks linked to contaminated antiseptics and disinfectants, aiming to update the outbreak characteristics and propose new prevention strategies.

We searched the published literature from 2006 to 2024 via the PubMed database.

Among 2,307 publications identified, twenty-one outbreaks and 4 pseudo-outbreaks were reviewed. Among the outbreaks, seventeen (81%) were linked to antiseptics including chlorhexidine or low-level disinfectants including quaternary ammonium compounds. A median of 12 individuals (range: 3–256) developed infections, including ventilator-associated pneumonia, skin and soft tissue infections, or catheter-related infections, resulting from direct use of contaminated mouthwashes and skin antiseptics on patients, leading to 55 fatalities. Thirteen (62%) outbreaks were attributed to intrinsically contaminated products, which led to product recall and regulatory changes. Seven (33%) were linked to extrinsically contaminated antiseptics or disinfectants, all associated with improper practices in preparation and storage. Control measures included use of sterile water for preparation, disinfection or replacement of dispensers and containers, and prohibition of using solutions prepared in the hospital laboratory.

To avoid outbreaks associated with contaminated antiseptics and disinfectants, healthcare personnel should understand the risks of contaminated antiseptics and disinfectants, and prevention strategies to avoid extrinsic contamination.

This study aimed to investigate and contain a cluster of invasive candidiasis cases caused by fluconazole-resistant Candida parapsilosis (FRC) in a neonatal intensive care unit.

Active surveillance was initiated. Direct observations of hand-hygiene compliance (HHC) among staff were conducted before and after the implementation of hand-hygiene (HH) education. Thirty-five environmental cultures were obtained. Phylogenetic analysis of FRC was performed using Fourier-transform infrared spectroscopy and microsatellite genotyping.

A total of 14 patients (mean birth weight = 860 g, gestational age = 25 weeks) infected with FRC were identified using the fully automated analyzer, including 5 with clinical infection (three with catheter-related bloodstream infection, one with cutaneous infection, and one with fatal peritonitis) and 9 with colonization. The HHC rate in nurses before performing a sterile or aseptic procedure significantly improved after the HH education (P < .05). Sinks near the patients were contaminated with FRC. All FRC strains were confirmed to be susceptible to fluconazole using the CLSI method, and the microdilution procedure indicated a trailing effect. Phylogenetic analysis showed that all the fluconazole-trailing isolates from patients were clustered together and had the same genotype. Sinks were successfully decontaminated using accelerated hydrogen peroxide and drainage pipes were replaced. Ultraviolet-C decontamination was applied in the milk preparation room. No new cases were detected after the education and disinfection interventions.

Sinks are an important reservoir of C. parapsilosis. Active surveillance, environmental hygiene, and constant staff education on maintaining a high level of HHC are necessary to limit the spread of C. parapsilosis.

Obesity is a risk factor for psychiatric diseases. Recently, a number of single nucleotide polymorphisms (SNPs) have been shown to be related to body mass index (BMI). In this study, we investigated the association of BMI-related SNPs with psychiatric diseases and one of their endophenotypes, memory performance, in a Japanese population.

The subjects were 1624 patients with one of three psychiatric diseases (799 patients with major depressive disorder, 594 with schizophrenia, and 231 with bipolar disorder) and 1189 healthy controls. Memory performance was assessed using the Wechsler Memory Scale – Revised (WMS-R). Genomic DNA was prepared from venous blood and used to genotype 23 BMI-related SNPs using the TaqMan 5′-exonuclease allelic discrimination assay. We then analysed the relationships between the SNPs and psychiatric disease and various subscales of the WMS-R.

Three SNPs (rs11142387, rs12597579, and rs6548238) showed significant differences in the genotype or allele frequency between patients with any psychiatric diseases and controls. Furthermore, six SNPs (rs11142387, rs12597579, rs2815752, rs2074356, rs4776970, and rs2287019) showed significant differences in at least one subscale of the WMS-R depending on the genotypes of the healthy controls. Interestingly, rs11142387 near the Kruppel-like factor 9 (KLF9) was significantly associated with psychiatric disease and poor memory function.

We identified three and six BMI-related SNPs associated with psychiatric disease and memory performance, respectively. In particular, carrying the A allele of rs11142387 near KLF9 was found to be associated with psychiatric disease and poor memory performance, which warrants further investigations.