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Comparison of Waterless Hand Antisepsis Agents at Short Application Times: Raising the Flag of Concern

Published online by Cambridge University Press:  02 January 2015

Sasi Dharan ,
Stéphane Hugonnet ,
Hugo Sax  and
Didier Pittet
Sasi Dharan
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
Stéphane Hugonnet
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
Hugo Sax
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
Didier Pittet*
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
*
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, 1211 Geneva 14, Switzerland
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Abstract

Objective:

Although alcohol-based hand rinses and gels have recommended application times of 30 to 60 seconds, healthcare workers usually take much less time for hand hygiene. We compared the efficacies of four alcohol-based hand rubs produced in Europe (hand rinses A, B, and C and one gel formulation) with the efficacy of the European Norm 1500 (EN 1500) reference waterless hand antisepsis agent (60% 2-propanol) at short application times.

Design:

Comparative crossover study.

Setting:

Infection Control Program laboratory of a large tertiary-care teaching hospital.

Participants:

Twelve healthy volunteers.

Intervention:

Measurement of residual bacterial counts and log reduction factors following inoculation of fingertips with Staphylococcus aureus American Type Culture Collection (ATCC) 6538, Pseudomonas aeruginosa ATCC 15442, and a clinical isolate of Enterococcus faecalis.

Results:

All hand rinses satisfied EN 1500 standards following a single application for 15 and 30 seconds, but reduction factors for the gel formulation were significantly lower for all tested organisms (all P < .025).

Conclusions:

Under stringent conditions similar to clinical practice, all three hand rinses proved to be more efficacious than the marketed alcohol-based gel in reducing bacterial counts on hands. Further studies are necessary to determine the in vivo efficacy of alcohol-based gels and whether they are as efficacious as alcohol-based rinses in reducing the transmission of nosocomial infections.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 3 , March 2003 , pp. 160 - 164
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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References

1.Pittet, D, Tarara, D, Wenzel, RP. Nosocomial bloodstream infection in critically ill patients: excess length of stay, extra costs and attributable mortality. JAMA 1994;271:1598–1601.CrossRefGoogle ScholarPubMed
2.Simmons, B, Bryant, J, Neiman, K, Spencer, L, Arheart, K. The role of handwashing in prevention of endemic intensive care unit infections. Infect Control Hosp Epidemiol 1990;11:589–594.CrossRefGoogle ScholarPubMed
3.Pittet, D, Hugonnet, S, Harbarth, S, et al.Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356:1307–1312.CrossRefGoogle ScholarPubMed
4.Pittet, D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol 2000;21:381–386.CrossRefGoogle ScholarPubMed
5.Pittet, D, Mourouga, P, Perneger, TV, Infection Control Program. Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130:126–130.CrossRefGoogle ScholarPubMed
6.Boyce, JM. It is time for action: improving hand hygiene in hospitals. Ann Intern Med 1999;130:153–155.CrossRefGoogle ScholarPubMed
7.Voss, A, Widmer, AF. No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance? Infect Control Hosp Epidemiol 1997;18:205–208.CrossRefGoogle ScholarPubMed
8.Semmelweis, I. Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers. Pest, Wien und Leipzig: C. A. Hartleben's Verlag-Expedition; 1861:1–544.Google Scholar
9.Rotter, M. Hand washing and hand disinfection. In: Mayhall, CG, ed. Hospital Epidemiology and Infection Control, 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1999:1339–1355.Google Scholar
10.Larson, E. Skin hygiene and infection prevention: more of the same or different approaches? Clin Infect Dis 1999;29:1287–1294.CrossRefGoogle ScholarPubMed
11.Zaragosa, M, Salles, M, Gomez, J, Bayas, JM, Trilla, A. Handwashing with soap or alcoholic solutions? A randomised clinical trial of its effectiveness. Am J Infect Control 1999;27:258–261.CrossRefGoogle Scholar
12.Boyce, JM, Pittet, D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR 2002;51(RR-16):1–45.Google ScholarPubMed
13.Hugonnet, S, Perneger, TV, Pittet, D. Alcohol-based handrub improves compliance with hand hygiene in intensive care units. Arch Intern Med 2002;162:1037–1043.CrossRefGoogle ScholarPubMed
14.Rotter, ML, Koller, WNeumann, R. The influence of cosmetic additives on the acceptability of alcohol-based hand disinfectants. J Hosp Infect 1991;18:57–63.CrossRefGoogle ScholarPubMed
15.Boyce, JM, Kelliher, S, Vallande, N. Skin irritation and dryness associated with two hand hygiene regimens: soap and water handwashing versus hand antisepsis with an alcoholic hand gel. Infect Control Hosp Epidemiol 2000;21:442–448.CrossRefGoogle ScholarPubMed
16.Frantz, SW, Haines, KA, Azar, CG, Ward, JI, Homan, SM, Roberts, RB. Chlorhexidine gluconate (CHG) activity against clinical isolates of van-comycin-resistant Enterococcus faecium (VREF) and the effects of moisturizing agents on CHG residue accumulation on the skin. J Hosp Infect 1997;37:157–164.CrossRefGoogle ScholarPubMed
17.Ayliffe, GAJ, Babb, JR, Quoraishi, AH. A test for “hygienic” hand disinfection. J Clin Pathol 1978;31:923–928.CrossRefGoogle ScholarPubMed
18.European Committee for Standardization. EN 1500, Chemical Disinfectants and Antiseptics—Hygienic Handrub: Test Method and Requirements (Phase 2, Step 2). Brussels, Belgium; 1997.Google Scholar
19.Kramer, A, Rudolph, RKampf, G, Pittet, D. Limited efficacy of alcohol-based hand gels. Lancet 2002;359:1489–1490.CrossRefGoogle ScholarPubMed
20.Larson, E, Aiello, A, Bastyr, J, et al.Assessment of two hand hygiene regimens for intensive care unit personnel. Crit Care Med 2001;29:944–975.CrossRefGoogle ScholarPubMed
21.Trick, W, Weinstein, R. Hand hygiene for intensive care unit personnel: rub it in. Crit Care Med 2001;29:1083–1084.CrossRefGoogle ScholarPubMed
22.Pittet, D, Dharan, S, Touveneau, S, Sauvan, V, Perneger, TV. Bacterial contamination of the hands of hospital staff during routine patient care. Arch Intern Med 2000;159:821–826.CrossRefGoogle Scholar
23.American Society for Testing Materials. ASTM E 1174-00: Standard Test Method for Evaluation of Health Care Personnel or Consumer Handwash Formulations. West Conshohocken, PA: American Society for Testing Materials; 2000.Google Scholar
24.Boyce, J. Antiseptic technology: access, affordability and acceptance. Emerg Infect Dis 2001;7:231–233.CrossRefGoogle ScholarPubMed
25.Pittet, D. Improving adherence to hand hygiene practice: a multidisci-plinary approach. Emerg Infect Dis 2001;7:234–240.CrossRefGoogle Scholar
26.Pittet, D, Kramer, AAlcohol-based hand gels and hand hygiene in hospitals: author reply. Lancet 2002;360:1511.CrossRefGoogle Scholar