Hospital acquired infection ( HAI) comprises a considerable burden to patients and healthcare delivery globally. Antimicrobial resistant organisms pose an increasing threat, although multiple resistant pathogens are still in the minority. Many global networks and initiatives are addressing this threat with variable degrees of success. Antibiotic resistance control has a high profile but the same is not true for biocide resistance. The many issues relating to biocide resistance are examined, the paradigm with antiseptic use are explored and ways in which biocide resistance could threaten the prevention and control of HAIs are described. Several proposals to inform the need and nature of surveillance, prevention and control measures are made.