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Effectiveness of Hand-Cleansing Agents for Removing Methicillin-Resistant Staphylococcus aureus From Contaminated Hands

Published online by Cambridge University Press:  02 January 2015

Marcio Guilhermetti ,
Silvio Evandro Daniel Hernandes ,
Yoshiaki Fukushigue ,
Lourdes Botelho Garcia  and
Celso Luíz Cardoso
Marcio Guilhermetti
Affiliation:
Department of Clinical Analyses, State University of Maringá, Maringá, Paraná, Brazil
Silvio Evandro Daniel Hernandes
Affiliation:
Department of Medicine, State University of Maringá, Maringá, Paraná, Brazil
Yoshiaki Fukushigue
Affiliation:
Department of Statistics, State University of Maringá, Maringá, Paraná, Brazil
Lourdes Botelho Garcia
Affiliation:
Department of Clinical Analyses, State University of Maringá, Maringá, Paraná, Brazil
Celso Luíz Cardoso*
Affiliation:
Department of Clinical Analyses, State University of Maringá, Maringá, Paraná, Brazil
*
Laboratory of Microbiology, Department of Clinical Analyses, State University of Maringá, 5790 Colombo Ave, 87020-900 Maringá, Paraná, Brazil
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Abstract

Objective:

The effectiveness of hand-cleansing agents in removing a hospital strain of methicillin-resistant Staphylococcus aureus from artificially contaminated hands of five volunteers was studied.

Design:

The products used were plain liquid soap, ethyl alcohol 70% (by weight), 10% povidone-iodine liquid soap (PVP-I), and chlorhexidine gluconate (4%) detergent. The experiments were performed using a Latin square statistical design, with two 5×4 randomized blocks. The removal rates of S aureus cells from contaminated fingertips were estimated by analysis of variance, the response variable being the log10 reduction factor (RF), ie, log10 of the initial counts minus log10 of the final counts. In the first and second blocks, the fingertips of the volunteers were contaminated in mean with 3.76 log10 colony-forming units ([CFU] light-contamination hand) and 6.82 log10 CFU (heavy-contamination hand), respectively.

Results:

In the first block, there were significant differences between treatments (P<.05). The 10% PVP-I (RF, 3.76) and 70% ethyl alcohol (RF, 3.51) had significantly higher removal rates than plain liquid soap (RF, 1.96) and 4% chlorhexidine (RF, 1.91). In the second block, 10% PVP-I (RF, 4.39) and 70% ethyl alcohol (RF, 3.27) also were significantly more effective than plain liquid soap (RF, 1.77) and 4% chlorhexidine (RF, 1.37; P<.05). Plain liquid soap was significantly more effective than chlorhexidine (4%) detergent.

Conclusions:

The results suggest that 10% PVP-I and 70% ethyl alcohol may be the most effective hand-cleansing agents for removing methicillin-resistant S aureus strain from either lightly or heavily contaminated hands.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 2 , February 2001 , pp. 105 - 108
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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References

1. Ayliffe, GA. The progressive intercontinental spread of methicillin-resistant Staphylococcus aureus . Clin Infect Dis 1997;24(suppl 1):S74–S79.CrossRefGoogle ScholarPubMed
2. Panlilio, AL, Culver, DH, Gaynes, RP, Banerjee, S, Henderson, TS, Tolson, JS, et al. Methicillin-resistant Staphylococcus aureus in US hospitals, 1975-1991. Infect Control Hosp Epidemiol 1992;13:582–586.Google ScholarPubMed
3. Voss, A, Milatovic, D, Wallrauch-Schwarz, C, Rosdahl, VT, Braveny, I. Methicillin-resistant Staphylococcus aureus in Europe. Eur J Clin Microbiol Infect Dis 1994;13:50–55.Google Scholar
4. Wenzel, RP, Nettleman, MD, Jones, RN, Pfaller, MA. Methicillin-resistant Staphylococcus aureus: implications for the 1990s and effective control measures. Am J Med 1991;91(suppl 3B):221S–227S.Google Scholar
5. Boyce, JM, Potter-Bynoe, G, Chenevert, C, King, T. Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications. Infect Control Hosp Epidemiol 1997;18:622–627.Google Scholar
6. Cookson, B, Peters, B, Webster, M, Phillips, I, Rahman, M, Noble, W. Staff carriage of epidemic methicillin-resistant Staphylococcus aureus . J Clin Microbiol 1989;27:1471–1476.Google Scholar
7. Layton, MC, Perez, M, Heald, P, Patterson, JE. An outbreak of mupirocin-resistant Staphylococcus aureus on a dermatology ward associated with an environmental reservoir. Infect Control Hosp Epidemiol 1993;14:369–375.Google Scholar
8. Thompson, RL, Cabezudo, I, Wenzel, RP. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus . Ann Intern Med 1982;97:309–317.Google Scholar
9. Boyce, JM. Methicillin-resistant Staphylococcus aureus in hospitals and long-term care facilities: microbiology, epidemiology, and preventive measures. Infect Control Hosp Epidemiol 1992;13:725–737.Google Scholar
10. Mulligan, ME, Murray-Leisure, KA, Ribner, BS, Standiford, HC, John, JF, Korvick, JA, et al. Methicillin-resistant Staphylococcus aureus: a consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. Am J Med 1993;94:313–328.Google Scholar
11. Crossley, K, Landesman, B, Zaske, D. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides, II: epidemiologic studies. J Infect Dis 1979;139:280–287.Google Scholar
12. Huang, Y, Oie, S, Kamiya, A. Comparative effectiveness of hand-cleansing agents for removing methicillin-resistant Staphylococcus aureus from experimentally contaminated fingertips. Am J Infect Control 1994;22:224–227.Google Scholar
13. Ayliffe, GA, Babb, JR, Davies, JG, Lilly, HA. Hand disinfection: a comparison of various agents in laboratory and ward studies. J Hosp Infect 1988;11:226–243.Google Scholar
14. Ehrenkranz, NJ. Bland soap handwash or hand antisepsis? The pressing need for clarity. Infect Control Hosp Epidemiol 1992;13:299–301.CrossRefGoogle ScholarPubMed
15. Ehrenkranz, NJ, Alfonso, BC. Failure of hand soap handwash to prevent hand transfer of patient bacteria to urethral catheters. Infect Control Hosp Epidemiol 1991;12:654–662.Google Scholar
16. Kloos, WE, Bannerman, TL. Staphylococcus and Micrococcus . In: Murray, PR, Baron, EJ, Pfaller, MA, Tenover, FC, Yolken, RH, eds. Manual of Clinical Microbiology. 6th ed. Washington DC: ASM Press; 1995:282–298.Google Scholar
17. National Committee for Clinical Laboratory Standards. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. Approved Standard M7-A3. Villanova, PA: NCCLS; 1993.Google Scholar
18. Miles, AA, Misra, SS, Irwin, JO. The estimation of the bactericidal power of the blood. J Hyg 1938;38:732–749.Google Scholar
19. Ayliffe, GA, Babb, JR, Quoraishi, AH. A test for “hygienic” hand disinfection. J Clin Pathol 1978;31:923–928.Google Scholar
20. Lowbury, EJ. Assessing the effectiveness of antimicrobial agents applied to living tissues. J Pharm Belg 1981;36:298–302.Google Scholar
21. Lilly, HA, Lowbury, EJ. Transient skin flora: their removal by cleansing or disinfection in relation to their mode of deposition. J Clin Pathol 1978;31:919–922.Google Scholar
22. Larson, E. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251–269.Google Scholar
23. Peacock, JE Jr Marsik, FJ, Wenzel, RP. Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital. Ann Intern Med 1980;93:526–532.Google Scholar
24. Reybrouck, G. Handwashing and hand disinfection. J Hosp Infect 1986;8:5–23.Google Scholar
25. Simmons, B. Guidelines for hospital environmental control. Infect Control 1981;2:131–146.Google Scholar
26. Steere, AC, Mallison, GF. Handwashing practices for the prevention of nosocomial infections. Ann Intern Med 1975;83:683–690.Google Scholar
27. Guerra, A, Guilhermetti, M, Levy, CE, Cardoso, CL. Avaliação da sobrevivência de amostras de S aureus resistentes e sensíveis a oxacilina artificialmente aplicadas nas mãos. IV Encontro de Iniciação Científica CNPq/UEM-VEL-VEPG. Maringá, PR, Brazil; 1995:264. Resumo.Google Scholar
28. Haley, CE, Marling-Cason, M, Smith, JW, Luby, JP, Mackowiak, PA. Bactericidal activity of antiseptics against methicillin-resistant Staphylococcus aureus . J Clin Microbiol 1985;21:991–992.Google Scholar
29. McLure, AR, Gordon, J. In-vitro evaluation of povidone-iodine and chlorhexidine against methicillin-resistant Staphylococcus aureus . J Hosp Infect 1992;21:291–299.Google Scholar
30. Irizarry, L, Merlin, T, Rupp, J, Griffith, J. Reduced susceptibility of methicillin-resistant Staphylococcus aureus to cetylpyridinium chloride and chlorhexidine. Chemotherapy 1996;42:248–252.Google Scholar
31. Kampf, G, Jarosch, R, Ruden, H. Limited effectiveness of chlorhexidine based hand disinfectants against methicillin-resistant Staphylococcus aureus (MRSA). J Hosp Infect 1998;38:297–303.Google Scholar
32. McDonnell, G, Russell, AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12:147–179.Google Scholar
33. Wade, JJ, Desai, N, Casewell, MW. Hygienic hand disinfection for the removal of epidemic vancomycin-resistant Enterococcus faecium and gentamicin-resistant Enterobacter cloacae . J Hosp Infect 1991;18:211–218.Google Scholar
34. Goroncy-Bermas, P, Schouten, MA, Voss, A. Effectiveness of non-medicated soap, chlorhexidine, and an alcohol-based hand disinfectant against multiple-resistant gram-positive microorganisms. In: Program With Abstracts-On-Disk From the Ninth Annual Meeting of the Society for Healthcare Epidemiology of America. April 1999; San Francisco, CA. Abstract 75.Google Scholar
35. Babb, JR, Davies, JG, Ayliffe, GA. A test procedure for evaluating surgical hand disinfection. J Hosp Infect 1991;18(suppl B):41–49.Google Scholar