{"v":1,"ledgerId":"quats","generatedAt":"2026-11-05T21:11:21.219Z","query":"(TITLE:(\"Quaternary Ammonium Compounds\" OR \"BENZALKONIUM CHLORIDE\" OR \"CETRIMONIUM CHLORIDE\" OR \"QUATERNIUM-15\" OR \"68424-85-1\") OR ABSTRACT:(\"Quaternary Ammonium Compounds\" OR \"BENZALKONIUM CHLORIDE\" OR \"CETRIMONIUM CHLORIDE\" OR \"QUATERNIUM-15\" OR \"68424-85-1\")) AND (TOXICITY OR EXPOSURE OR \"ENDOCRINE\" OR \"REPRODUCTIVE\" OR CARCINOGEN* OR \"BIOMONITORING\" OR \"SYSTEMATIC REVIEW\") AND SRC:MED AND LANG:eng","totalPapers":2018,"lastYearPapers":194,"analysed":31,"byFunding":{"independent":17,"industry":1,"mixed":0,"none_declared":0,"unclear":13},"byDesign":{"human":3,"animal":3,"in_vitro":19,"review":0,"other":6},"byFinding":{"concern":18,"no_effect":12,"mixed":1},"gap":{"independent":{"concern":9,"total":17},"industry":{"concern":0,"total":1}},"fundingSources":{"full_text":11,"grant_metadata":13,"abstract":0,"none":7},"newestPublished":"2026-10-24","papers":[{"id":"pmid:42965166","pmid":"42965166","pmcid":"PMC13722060","doi":"10.1016/j.onehlt.2026.101635","title":"Co-occurrence of antimicrobial resistance and reduced disinfectant susceptibility in <i>Campylobacter</i> spp. along the chicken supply chain: A farm-to-fork public health concern.","journal":"One health (Amsterdam, Netherlands)","published":"2026-10-24","design":"in_vitro","finding":"concern","summary":"Campylobacter isolates from a Chinese chicken supply chain showed reduced susceptibility to quaternary ammonium disinfectants, with cetrimonium bromide MICs generally higher than benzalkonium chloride MICs.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"full_text","verified":false},{"id":"pmid:42902348","pmid":"42902348","pmcid":"PMC13681774","doi":"10.1186/s40662-026-00513-0","title":"Blocking IL-6 trans-signaling mitigates benzalkonium chloride-induced inflammation, oxidative imbalance, ER stress, and barrier disruption in human corneal epithelial cells.","journal":"Eye and vision (London, England)","published":"2026-10-20","design":"in_vitro","finding":"concern","summary":"Benzalkonium chloride induced inflammation, oxidative imbalance, endoplasmic reticulum stress, and barrier disruption in human corneal epithelial cells, effects mitigated by blocking IL-6 trans-signaling.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"National Institutes of Health\""],"fundingSource":"full_text","verified":false},{"id":"pmid:42941478","pmid":"42941478","pmcid":"PMC13706067","doi":"10.3390/jcm15207963","title":"Olopatadine in Seasonal Allergic Conjunctivitis: Efficacy, Ocular Surface Safety, and Practical Considerations for Preservative-Free Multidose Therapy.","journal":"Journal of clinical medicine","published":"2026-10-15","design":"other","finding":"mixed","summary":"A narrative review finds direct head-to-head evidence is lacking to show superior ocular surface outcomes for preservative-free compared to benzalkonium chloride-preserved olopatadine formulations.","funding":"industry","conflictOfInterest":false,"fundingEvidence":["industry: \"unrestricted grant\""],"fundingSource":"full_text","verified":false},{"id":"pmid:42823328","pmid":"42823328","pmcid":"","doi":"10.1515/hsz-2026-0159","title":"Trends in optimizing antibacterial cationic amphiphiles.","journal":"Biological chemistry","published":"2026-10-05","design":"other","finding":"concern","summary":"This review summarizes design approaches for antibacterial cationic amphiphiles, including quaternary ammonium compounds, aiming to enhance antibacterial activity while mitigating host-cell toxicity.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"Ministry of\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42916015","pmid":"42916015","pmcid":"PMC13674063","doi":"10.1021/acs.est.6c02828","title":"Predicting Chemical Stressor Effects on Conjugative Plasmid Transfer Rates Using Machine Learning.","journal":"Environmental science & technology","published":"2026-10-01","design":"other","finding":"no_effect","summary":"A machine learning study evaluating chemical stressors found that quaternary ammonium compounds were associated with the inhibition of RP4 conjugative plasmid transfer.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"DFG\""],"fundingSource":"full_text","verified":false},{"id":"pmid:42788729","pmid":"42788729","pmcid":"PMC13729198","doi":"10.1128/spectrum.01055-26","title":"Fungicidal effects of eight disinfectants against resistant <i>Candidozyma auris</i> (formerly <i>Candida auris</i>), <i>Aspergillus fumigatus</i>, and <i>Trichophyton indotineae</i>.","journal":"Microbiology spectrum","published":"2026-09-25","design":"in_vitro","finding":"no_effect","summary":"A commercial benzalkonium chloride solution demonstrated strong fungicidal activity against three drug-resistant fungal pathogens in quantitative suspension tests.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"National Science Foundation\""],"fundingSource":"full_text","verified":false},{"id":"pmid:42767473","pmid":"42767473","pmcid":"","doi":"10.1016/j.jevs.2026.106150","title":"In vitro biofilm-forming ability and antiseptic and antimicrobial susceptibility of bacterial strains derived from surgical-site infections in equine orthopedic surgery.","journal":"Journal of equine veterinary science","published":"2026-09-21","design":"in_vitro","finding":"no_effect","summary":"Benzalkonium chloride exposure for 10 minutes resulted in a 1 to 3 log CFU reduction in Gram-negative bacterial biofilms isolated from equine surgical site infections.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"none","verified":false},{"id":"pmid:42794844","pmid":"42794844","pmcid":"PMC13607820","doi":"10.3390/ijms27188418","title":"Eczema-like Granular Parakeratosis Exhibits Inflammatory Keratinocyte Remodeling and Aberrant Epidermal Differentiation.","journal":"International journal of molecular sciences","published":"2026-09-21","design":"in_vitro","finding":"concern","summary":"Benzalkonium chloride induced interleukin-1-related inflammatory activation and cellular stress responses in HaCaT cells, reflecting features of granular parakeratosis.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"National Natural Science Foundation of China\""],"fundingSource":"full_text","verified":false},{"id":"pmid:42767306","pmid":"42767306","pmcid":"","doi":"10.1016/j.envres.2026.125711","title":"Environmental risks under individual and co-exposure to nisin and cetylpyridinium chloride: From denitrification system disturbance to resistance gene dissemination.","journal":"Environmental research","published":"2026-09-21","design":"in_vitro","finding":"concern","summary":"Cetylpyridinium chloride, alone and combined with nisin, deteriorated denitrification efficiency, reduced cell viability, altered microbial community composition, and increased resistance gene abundance in batch experiments.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"none","verified":false},{"id":"pmid:42800247","pmid":"42800247","pmcid":"","doi":"10.1016/j.aquatox.2026.108031","title":"Time-dependent combined toxicity of four quaternary ammonium compounds to Vibrio qinghaiensis sp.-Q67: a synergistic trend shifting to additive action.","journal":"Aquatic toxicology (Amsterdam, Netherlands)","published":"2026-09-21","design":"in_vitro","finding":"concern","summary":"Exposure to four quaternary ammonium compounds and their mixtures caused toxicity and cellular changes in Vibrio qinghaiensis sp.-Q67, exhibiting time-dependent synergistic to additive effects.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"Department of Education\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42751773","pmid":"42751773","pmcid":"","doi":"10.1177/10807683261486972","title":"mTOR/Autophagy//NF-κB Axis Drives Benzalkonium Chloride-Induced Inflammatory Response in Corneal Epithelial Cells.","journal":"Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics","published":"2026-09-17","design":"in_vitro","finding":"concern","summary":"Short-term benzalkonium chloride exposure in mouse corneal epithelial cells induced inflammatory cytokine production and impaired autophagic flux via mTOR hyperactivation and TLR4/MyD88/NF-κB pathway activation.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"none","verified":false},{"id":"pmid:42714170","pmid":"42714170","pmcid":"PMC13688860","doi":"10.1128/spectrum.01294-26","title":"Genomic characterization of efflux pumps and putative small multidrug resistance (SMR)-like transporters in disinfectant-tolerant coagulase-negative staphylococci from a Vietnamese hospital.","journal":"Microbiology spectrum","published":"2026-09-09","design":"in_vitro","finding":"concern","summary":"Hospital environmental staphylococci isolates displayed elevated tolerance to benzalkonium chloride, multidrug resistance, and disinfectant efflux genes including qacG.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"none","verified":false},{"id":"pmid:42702003","pmid":"42702003","pmcid":"","doi":"10.1080/14786419.2026.2728112","title":"Green propolis with hyaluronic acid mitigates benzalkonium chloride-induced ocular surface injury in mice.","journal":"Natural product research","published":"2026-09-06","design":"animal","finding":"concern","summary":"Benzalkonium chloride exposure caused ocular surface injury, decreased tear production, and induced corneal epithelial detachment in mice, which was mitigated by green propolis with hyaluronic acid.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"none","verified":false},{"id":"pmid:42695656","pmid":"42695656","pmcid":"","doi":"10.1080/1040841x.2026.2726233","title":"Quaternary ammonium compounds: outdated or relevant antiviral agents? A narrative review of QAC efficacy against enveloped and non-enveloped viruses.","journal":"Critical reviews in microbiology","published":"2026-09-04","design":"other","finding":"no_effect","summary":"A narrative review of 64 studies found quaternary ammonium compounds highly effective against enveloped viruses, while efficacy against non-enveloped viruses varied depending on viral family and conditions.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42914316","pmid":"42914316","pmcid":"","doi":"10.1016/j.foodres.2026.120582","title":"Predictive modeling of disinfectant efficacy: Integrating bacterial inactivation kinetics with human health risk assessment.","journal":"Food research international (Ottawa, Ont.)","published":"2026-09-04","design":"other","finding":"concern","summary":"A predictive modeling framework integrated benzalkonium chloride bacterial inactivation kinetics with risk assessment, finding inhalation-based usage limits to be more restrictive than oral and dermal limits.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"Ministry of\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42695547","pmid":"42695547","pmcid":"PMC13543762","doi":"10.1111/myc.70216","title":"Antifungal Susceptibility Profile and Biocide Tolerance in Clinically Relevant Yeasts: Implications for Therapy and Hospital Infection Control.","journal":"Mycoses","published":"2026-09-01","design":"in_vitro","finding":"no_effect","summary":"Clinical yeast isolates demonstrated high tolerance to 5% benzalkonium chloride, exhibiting minimal inhibition zones in disk diffusion testing.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"University of Juiz de Fora (UFJF) and Cortes Villela Laboratory. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; Fundação de Amparo à Pesquisa do Estado de Minas Gerais; Fund\""],"fundingSource":"full_text","verified":false},{"id":"pmid:42765083","pmid":"42765083","pmcid":"PMC13590196","doi":"10.14202/vetworld.2026.3836-3849","title":"Reduced susceptibility to triclosan and proposed epidemiological cut-off values for disinfectants and heavy metals in Escherichia coli isolated from Thai tilapia farms: Implications for One Health antimicrobial resistance surveillance.","journal":"Veterinary world","published":"2026-08-30","design":"in_vitro","finding":"no_effect","summary":"Escherichia coli isolates from Thai tilapia farms exhibited unimodal minimum inhibitory concentration distributions consistent with wild-type susceptibility to benzalkonium chloride.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"University\""],"fundingSource":"full_text","verified":false},{"id":"pmid:42795455","pmid":"42795455","pmcid":"PMC13609756","doi":"10.3390/microorganisms14091873","title":"Virus-Dependent Relative Contributions of Citric Acid and Benzalkonium Chloride to the Virucidal Efficacy of Combination Disinfectants.","journal":"Microorganisms","published":"2026-08-24","design":"in_vitro","finding":"no_effect","summary":"Benzalkonium chloride was the primary determinant of avian influenza virus inactivation in combination disinfectants, while contributing minimally to foot-and-mouth disease virus inactivation.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"full_text","verified":false},{"id":"pmid:42637895","pmid":"42637895","pmcid":"","doi":"10.1038/s41372-026-02884-7","title":"Prenatal occupational exposure to quaternary ammonium compounds and birthweight: findings from a pilot study using meconium as a biological matrix.","journal":"Journal of perinatology : official journal of the California Perinatal Association","published":"2026-08-24","design":"human_cohort","finding":"concern","summary":"A pilot study of 74 mother-infant dyads found cumulative meconium quaternary ammonium compound levels were associated with increased odds of reduced birthweight.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42603578","pmid":"42603578","pmcid":"","doi":"10.1016/j.actbio.2026.08.024","title":"Quaternary ammonium compound-based ionic liquid with microwave responsiveness for treating deep tissue infections without compromising biocompatibility.","journal":"Acta biomaterialia","published":"2026-08-15","design":"animal","finding":"no_effect","summary":"A quaternary ammonium compound-based ionic liquid formulated into microneedles demonstrated high bactericidal efficacy with negligible mammalian cytotoxicity and reduced inflammation in a mouse abscess model.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"National Natural Science Foundation of China\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42549928","pmid":"42549928","pmcid":"PMC13532204","doi":"10.1128/spectrum.00556-26","title":"Phosphonium-based disinfectants are as effective as best-in-class quaternary ammonium compounds in the eradication of established biofilms in antibiotic-resistant bacteria.","journal":"Microbiology spectrum","published":"2026-08-04","design":"in_vitro","finding":"no_effect","summary":"Quaternary ammonium compounds and quaternary phosphonium compounds were evaluated and demonstrated comparative efficacy in eradicating biofilms formed by antibiotic-resistant bacterial pathogens.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"NIH\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42454727","pmid":"42454727","pmcid":"","doi":"10.1177/10807683261466785","title":"Beyond Acute Cytotoxicity: A Repair-Exhaustion Framework for Chronic Sublethal Benzalkonium Chloride Toxicity in Repeated Ophthalmic Exposure.","journal":"Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics","published":"2026-07-15","design":"other","finding":"concern","summary":"Repeated low-dose exposure to benzalkonium chloride causes barrier dysfunction, energy depletion, inflammation, and impaired ocular tissue repair.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"NIH\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42398392","pmid":"42398392","pmcid":"","doi":"10.1016/j.bioorg.2026.110198","title":"Benzalkonium chloride disrupts human placental progesterone synthesis via locking NAD<sup>+</sup> pocket in 3β-Hydroxysteroid dehydrogenase 1 and rat homolog: docking evidence and 3D-QSAR, and experiment risk assessment.","journal":"Bioorganic chemistry","published":"2026-07-01","design":"in_vitro","finding":"concern","summary":"C12-C18 benzalkonium chlorides inhibited human and rat placental 3β-hydroxysteroid dehydrogenases and suppressed progesterone biosynthesis in JAr placental cells.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"National Natural Science Foundation of China\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42331247","pmid":"42331247","pmcid":"","doi":"10.1016/j.envpol.2026.128615","title":"Quaternary ammonium compounds in paired indoor dust and human urine: suspect screening and exposure associations.","journal":"Environmental pollution (Barking, Essex : 1987)","published":"2026-06-22","design":"human_cross_sectional","finding":"no_effect","summary":"Analysis of paired Chinese indoor dust and urine samples identified multiple quaternary ammonium compounds and found dust BAC concentrations correlated with urinary carboxyl metabolites.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"National Natural Science Foundation of China\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42189131","pmid":"42189131","pmcid":"","doi":"10.1177/10807683261454329","title":"Integrative Mechanistic Insights into Benzalkonium Chloride-Induced Cytotoxicity in Human Corneal Epithelial Cells.","journal":"Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics","published":"2026-05-26","design":"in_vitro","finding":"concern","summary":"Benzalkonium chloride induced dose-dependent cytotoxicity in human corneal epithelial cells, characterized by oxidative stress, DNA damage, lipid peroxidation, ferroptosis-related events, apoptosis, and inflammatory signaling.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"none","verified":false},{"id":"pmid:42184956","pmid":"42184956","pmcid":"PMC13671866","doi":"10.3341/kjo.2026.0002","title":"Comparison of Preservative-Free and Preserved Latanoprost in Primary Open-Angle Glaucoma: A Randomized Cross-Over Study.","journal":"Korean journal of ophthalmology : KJO","published":"2026-05-22","design":"human_rct","finding":"concern","summary":"Benzalkonium chloride-preserved latanoprost shortened tear break-up time, worsened conjunctival staining, and increased ocular symptoms compared to preservative-free latanoprost in a randomized cross-over trial.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"full_text","verified":false},{"id":"pmid:42155800","pmid":"42155800","pmcid":"","doi":"10.1016/j.tox.2026.154504","title":"Synergistic cytotoxicity of benzalkonium chloride and didecyldimethylammonium chloride mixtures revealed by stress granule formation.","journal":"Toxicology","published":"2026-05-19","design":"in_vitro","finding":"concern","summary":"Combined exposure to benzalkonium chloride and didecyldimethylammonium chloride synergistically decreased cell viability and amplified stress granule assembly and endoplasmic reticulum stress in human A549 cells.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"Ministry of\""],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42126177","pmid":"42126177","pmcid":"PMC13532584","doi":"10.1111/jfd.70206","title":"Comparative In vitro Evaluation of Widely Used Aquaculture Disinfectants Against Major Marine Bacterial Fish Pathogens.","journal":"Journal of fish diseases","published":"2026-05-13","design":"in_vitro","finding":"no_effect","summary":"An in vitro study evaluated eight disinfectants against three marine fish pathogens, identifying benzalkonium chloride and iodophor as the most effective disinfectants based on integrated activity scoring.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"grant_metadata","verified":false},{"id":"pmid:42694145","pmid":"42694145","pmcid":"PMC13538302","doi":"10.1007/s43188-026-00353-z","title":"Skin absorption and metabolism of [<sup>14</sup>C]-labeled C12-benzalkonium chloride (C12-BKC) in ex vivo porcine ear skin using UPLC-β-RAM analysis.","journal":"Toxicological research","published":"2026-05-04","design":"in_vitro","finding":"no_effect","summary":"C12-benzalkonium chloride applied to ex vivo porcine ear skin permeated predominantly as intact parent compound with negligible cutaneous biotransformation.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"Ministry of\""],"fundingSource":"full_text","verified":false},{"id":"pmid:42025447","pmid":"42025447","pmcid":"","doi":"10.1177/10807683261441060","title":"Investigation of Corneal Epithelial Tight Junction Disruption and Barrier Function Impairment Induced by Benzalkonium Chloride.","journal":"Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics","published":"2026-04-23","design":"animal","finding":"concern","summary":"Topical instillation of benzalkonium chloride in rabbits decreased corneal resistance and disrupted corneal epithelial tight junctions, impairing barrier function.","funding":"unclear","conflictOfInterest":false,"fundingEvidence":[],"fundingSource":"none","verified":false},{"id":"pmid:41680091","pmid":"41680091","pmcid":"","doi":"10.1177/10962964261425154","title":"Antiseptic Susceptibility and Sub-Inhibitory Concentration-Induced Biofilm Response in <i>Staphylococcus epidermidis</i> from Abdominal Surgical Site Skin.","journal":"Surgical infections","published":"2026-02-12","design":"in_vitro","finding":"concern","summary":"Sub-inhibitory benzalkonium chloride exposure and presence of efflux genes were associated with increased antiseptic tolerance and enhanced biofilm formation in clinical Staphylococcus epidermidis isolates.","funding":"independent","conflictOfInterest":false,"fundingEvidence":["public: \"Provincial\""],"fundingSource":"grant_metadata","verified":false}],"model":"gemini-3.8-flash","run":{"aiCalls":39,"cachedPapers":0,"offTopic":8,"inputTokens":26870,"outputTokens":5312}}