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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

Published online by Cambridge University Press:  02 January 2015

John M. Boyce  and
Didier Pittet
John M. Boyce
Affiliation:
Hospital of Saint Raphael, New Haven, Connecticut
Didier Pittet
Affiliation:
University of Geneva, Geneva, Switzerland
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Summary

The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.

Type
Research Article
Information
Infection Control & Hospital Epidemiology , Volume 23 , supplement S12: 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 , December 2002 , pp. S3 - S40
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Rotter, M. Hand washing and hand disinfection [Chapter 87]. In: Mayhall, CG, ed. Hospital Epidemiology and Infection Control. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 1999.Google Scholar
2.Labarraque, AG. Instructions and Observations Regarding the Use of the Chlorides of Soda and Lime. Porter, J, ed. [French] New Haven, CT: Baldwin and Treadway, 1829.Google Scholar
3.Semmelweis, I. Etiology, Concept, and Prophylaxis of Childbed Fever. Carter, KC, ed. 1st ed. Madison, WI: The University of Wisconsin Press, 1983.Google Scholar
4.Coppage, CM. Hand Washing in Patient Care [Motion picture]. Washington, DC: US Public Health Service, 1961.Google Scholar
5.Steere, AC, Mallison, GF. Handwashing practices for the prevention of nosocomial infections. Ann Intern Med 1975;83:683-90.CrossRefGoogle ScholarPubMed
6.Garner, JS, Favero, MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986:7:231–43.Google Scholar
7.Larson, E. Guideline for use of topical antimicrobial agents. Am J Infed Control 1988;16:253-66.CrossRefGoogle ScholarPubMed
8.Larson, EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69.CrossRefGoogle Scholar
9.Hospital Infection Control Practices Advisory Committee (HICPAC). Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 1995;16:105-13.Google Scholar
10.Garner, JS, Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996;17:53–80.CrossRefGoogle ScholarPubMed
11.Pittet, D, Mourouga, P, Perneger, TV, Members of the Infection Control Program. Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130:126-30.CrossRefGoogle ScholarPubMed
12.Boyce, JM. It is time for action: improving hand hygiene in hospitals. Ann Intern Med 1999;130:153-5.CrossRefGoogle ScholarPubMed
13.Selwyn, S. Microbiology and ecology of human skin. Practitioner 1980;224:1059-62.Google ScholarPubMed
14.Price, PB. Bacteriology of normal skin: a new quantitative test applied to a study of the bacterial flora and the disinfectant action of mechanical cleansing. J Infect Dis 1938;63:301-18.CrossRefGoogle Scholar
15.Larson, E. Effects of handwashing agent, handwashing frequency, and clinical area on hand flora. Am J Infect Control 1984;11:76–82.CrossRefGoogle Scholar
16.Maki, D. Control of colonization and transmission of pathogenic bacteria in the hospital. Ann Intern Med 1978;89(Pt 2):777–80.CrossRefGoogle ScholarPubMed
17.Larson, EL, Norton Hughes, CA, Pyrak, JD, Sparks, SM, Cagatay, EU, Bartkus, JM. Changes in bacterial flora associated with skin damage on hands of health care personnel. Am J Infect Control 1998;26:513-21.CrossRefGoogle ScholarPubMed
18.Sprunt, K, Redman, W, Leidy, G. Antibacterial effectiveness of routine hand washing. Pediatrics 1973;52:264-71.CrossRefGoogle ScholarPubMed
19.Food and Drug Administration. Tentative final monograph for healthcare antiseptic drug products; proposed rule. Federal Register 1994;59:31441-52.Google Scholar
20.Lowbury, EJL. Gram-negative bacilli on the skin. Br J Dermatol 1969;81(suppl 1):55–61.Google Scholar
21.Noble, WC. Distribution of the Micrococcaceae. Br J Dermatol 1969;81(suppl 1):27–31.CrossRefGoogle ScholarPubMed
22.McBride, ME, Duncan, WC, Bodey, GP, McBride, CM. Microbial skin flora of selected cancer patients and hospital personnel. J Clin Microbiol 1976;3:14–20.CrossRefGoogle ScholarPubMed
23.Casewell, MW. Role of hands in nosocomial gram-negative infection. In: Maibach, HI, Aly, R, eds. Skin Microbiology: Relevance to Clinical Infection. New York, NY: Springer-Verlag, 1981.Google Scholar
24.Larson, EL, McGinley, KJ, Foglia, AR, Talbot, GH, Leyden, JJ. Composition and anfimicrobic resistance of skin flora in hospitalized and healthy adults. J Clin Microbiol 1986;23:604-8.CrossRefGoogle ScholarPubMed
25.Ehrenkranz, NJ, Alfonso, BC. Failure of bland soap handwash to prevent hand transfer of patient bacteria to urethral catheters. Infect Control Hosp Epidemiol 1991;12:654-62.CrossRefGoogle ScholarPubMed
26.Sanderson, PJ, Weissler, S. Recovery of coliforms from the hands of nurses and patients: activities leading to contamination. J Hosp Infect 1992;21:85–93.Google Scholar
27.Coello, R, Jiménez, J, García, M, et al. Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients. Eur J Clin Microbiol Infect Dis 1994;13:74–81.Google Scholar
28.Sanford, MD, Widmer, AF, Bale, MJ, Jones, RN, Wenzel, RP, Efficient detection and long-term persistence of the carriage of methicillin-resistant Staphylococcus aureus. Clin Inject Dis 1994;19:1123–8.CrossRefGoogle ScholarPubMed
29.Bertone, SA, Fisher, MC, Mortensen, JE. Quantitative skin cultures at Potential catheter sites in neonates. Infect Control Hosp Epidemiol 1994;15:315-8.CrossRefGoogle ScholarPubMed
30.Bonten, MJM, Hayden, MK, Nathan, C, VanVoorhis, J, et al. Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 1996;348:1615-9.Google Scholar
31.Larson, EL, Cronquist, AB, Whittier, S, Lai, L, Lyle, CT, Della Latta, P. Differences in skin flora between inpatients and chronically ill patients. Heart Lung 2000;29:298–305.CrossRefGoogle Scholar
32.Polakoff, S, Richards, IDG, Parker, MT, Iidwell, OM. Nasal and skin carriage of Staphylococcus aureus by patients undergoing surgical operation. J Hyg (Land) 1967;65:559-66.Google ScholarPubMed
33.Leyden, JJ, McGinley, KJ, Nordstrom, KM, Webster, GF. Skin microflora. J Invest Dermatol 1987;88:65s–72s.CrossRefGoogle ScholarPubMed
34.Tuazon, CU, Perez, A, Kishaba, T, Sheagren, JN. Staphylococcus aureus among insulin-injecting diabetic patients. JAMA 1975;231:1272.Google Scholar
35.Kaplowitz, LG, Comstock, JA, Landwehr, DM, Dalton, HP, Mayhall, CG. Prospective study of microbial colonization of the nose and skin and infection of the vascular access site in hemodialysis patients. J Clin Microbiol 1988;26:1257–62.CrossRefGoogle ScholarPubMed
36.Aly, R, Maibach, HI, Shinefield, HR. Microbial flora of atopic dermatitis. Arch Dermatol 1977;113:780-2.CrossRefGoogle ScholarPubMed
37.Kirmani, N, Tuazon, CU, Murray, HW, Parrish, AE, Sheagren, JN. Staphylococcus aureus carriage rate of patients receiving long-term hemodialysis. Arch Intern Med 1978;138:1657-9.CrossRefGoogle ScholarPubMed
38.Goldblum, SE, Ulrich, JA, Goldman, RS, Reed, WP. Nasal and cutaneous flora among hemodialysis patients and personnel: quantitative and qualitative characterization and patterns of staphylococcal carriage. Am J Kidney Dis 1982;11:281-6.CrossRefGoogle Scholar
39.Boelaert, JRVan Landuyt, HW, Gordts, BZ, De Baere, YA, Messer, SA, Herwaldt, IA, Nasal and cutaneous carriage of Staphylococcus aureus in hemodialysis patients: the effect of nasal mupirocin. Infect Control Hosp Epidemiol 1996;17:809-11.CrossRefGoogle Scholar
40.Zimakoff, J, Pedersen, FB, Bergen, L, et al. Staphylococcus aureus carriage and infections among patients in four haemo- and peritoneal-dialysis centres in Denmark. J Hosp Infect 1996;33:289–300.CrossRefGoogle ScholarPubMed
41.Bibel, DJ, Greenbert, JH, Cook, JL. Staphylococcus aureus and the microbial ecology of atopic dermatitis. Can J Microbiol 1997;23:1062-8.CrossRefGoogle Scholar
42.Noble, WC. Dispersal of skin microorganisms. Br J Dermatol 1975;93:477-85.CrossRefGoogle ScholarPubMed
43.Walter, CW, Kundsin, RB, Shilkret, MA, Day, MM. Spread of staphylococci to the environment. Antibiotics Annual 1959:952-7.Google Scholar
44.Boyce, JM, Opal, SM, Chow, JW, et al. Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 1994;32:1148-53.Google Scholar
45.McFarland, LV, Mulligan, ME, Kwok, RYY, Stamm, WE. Nosocomial acquisition of Clostridium difficile infection. NEngl J Med 1989;320:204-10.CrossRefGoogle ScholarPubMed
46.Samore, MH, Venkataraman, L, DeGirolami, PC, Levin, E, Arbeit, RD, Karchmer, AW. Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea. Am J Med 1996;100:32–40.CrossRefGoogle ScholarPubMed
47.Iidwell, OM, Towers, AG, Ballard, J, Gladstone, B. Transfer of microorganisms between nurses and patients in a clean air environment. J Appl Bacterid 1974;37:649-56.Google Scholar
48.Casewell, M, Phillips, I. Hands as route of transmission for Klebsiella species. Br Med J 1977;2:1315-7.CrossRefGoogle ScholarPubMed
49.Hall, CB, Douglas, RG. Modes of transmission of respiratory syncytial virus. J Pediatr 1981;99:100-2.Google Scholar
50.Olsen, RJ, Lynch, P, Coyle, MB, Cummings, J, Bokete, T, Stamm, WE. Examination gloves as barriers to hand contamination in clinical practice. JAMA 1993;270:350-3.CrossRefGoogle ScholarPubMed
51.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 1999;159:821-6.CrossRefGoogle ScholarPubMed
52.Fox, MK, Langner, SB, Wells, RW. How good are hand washing practices? Am J Nursing 1974;74:1676-8.Google Scholar
53.Ojajärvi, J. Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing. J Hyg (Land) 1980;85:193–203.CrossRefGoogle ScholarPubMed
54.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;18:622-7.CrossRefGoogle ScholarPubMed
55.Hayden, MK, Blom, DW, Lyle, EA. et al. The risk of hand and glove contamination by healthcare workers (HCWs) after contact with a VRE (+) patient (pt) or the pts environment (env) [Abstract K-1334]. Presented at the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago: American Society for Microbiology, 2001.Google Scholar
56.Scott, E, Bloomfield, SF. The survival and transfer of microbial contamination via cloths, hands and utensils. J Appl Bacteriol 1990;68:271-8.CrossRefGoogle ScholarPubMed
57.Bauer, TM, Ofner, E, Just, HM, Just, H, Daschner, FD. An epidemiological study assessing the relative importance of airborne and direct contact transmission of microorganisms in a medical intensive care unit. J Hosp Infed 1990;15:301-9.Google Scholar
58.Tenorio, AR, Badri, SM, Sahgal, NB, et al. Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant Enterococcus species by health care workers after patient care. Clin Infect Dis 2001;32:826-9.CrossRefGoogle ScholarPubMed
59.Daschner, FD. How cost-effective is the present use of antiseptics? J Hosp Infect 1988;11(suppl A):227–35.CrossRefGoogle ScholarPubMed
60.Khittle, MAEitzman, DV, Baer, H. Role of hand contamination of personnel in the epidemiology of gram-negative nosocomial infections. J Pediatr 1975;86:433-7.Google Scholar
61.Ayliffe, GAI, Babb, JR, Davies, JG, Lilly, HA. Hand disinfection: a comparison of various agents in laboratory and ward studies. J Hosp Infed 1988;11:226M3.Google ScholarPubMed
62.Strausbaugh, LJ, Sewell, DL, Ward, TX, Pfaller, MA, Heitzman, X, Tjoelker, R, High frequency of yeast carriage on hands of hospital personnel. J Clin Microbiol 1994;32:2299-300.CrossRefGoogle ScholarPubMed
63.Marples, RRTowers, AG. A laboratory model for the investigation of contact transfer of micro-organisms. JHyg (Land) 1979;82:237-48.Google Scholar
64.Mackintosh, CAHoffman, PN. An extended model for transfer of microorganisms via the hands: differences between organisms and the effect of alcohol disinfection. JHyg (Land) 1984;92:345-55.Google Scholar
65.Patrick, DRFmdon, G, Miller, TE. Residual moisture determines the level of touch-contact-associated bacterial transfer following hand washing. Epidemiol Infect 1997;119:319-25.CrossRefGoogle ScholarPubMed
66.Larson, E. A causal link between handwashing and risk of infection? Examination of the evidence. Infed Control Hosp Epidemiol 1988;9:28–36.CrossRefGoogle ScholarPubMed
67.Larson, E. Skin hygiene and infection prevention: more of the same or different approaches? Clin Infect Dis 1999;29:1287-94.CrossRefGoogle ScholarPubMed
68.Mortimer, EA Jr, Lipsitz, PJ, Wolinsky, E, Gonzaga, AJ, Rammelkamp, CH Jr. Transmission of staphylococci between newborns. Am J Dis Child 1962;104:289-95.CrossRefGoogle ScholarPubMed
69.Maki, DG. The use of antiseptics for handwashing by medical personnel. J Chemother 1989;1(suppl 1):3–11.CrossRefGoogle ScholarPubMed
70.Massanari, RM, Hierholzer, WJ Jr.A crossover comparison of antiseptic soaps on nosocomial infection rates in intensive care units. Am J Infect Control 1984;12:247-8.Google Scholar
71.Doebbeling, BN, Stanley, GL, Sheetz, CT, et al. Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units. N Engl J Med 1992;327:88–93.CrossRefGoogle ScholarPubMed
72.Webster, J, Faoagali, JL, Cartwright, D. Elimination of methicillin-resistant Staphylococcus aureus from a neonatal intensive care unit after hand washing with triclosan. J Paediatr Child Health 1994;30:59–64.CrossRefGoogle ScholarPubMed
73.Zafar, AB, Buder, RC, Reese, DJ, Gaydos, IA, Mennonna, PA, Use of 0.3% triclosan (Bacti-Stat*) to eradicate an outbreak of methicillin-resistant Staphylococcus aureus in a neonatal nursery. Am J Infed Control 1995;23:200-8.CrossRefGoogle Scholar
74.Pittet, D, Hugonnet, S, Harbarth, S, Mourouga, P, Sauvan, V, Touveneau, S. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356:1307-12.Google Scholar
75.Larson, EL, Early, E, Cloonan, ESugrue, S, Parides, M. An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med 2000;26:14–22.Google Scholar
76.Fridkin, SK, Pear, SM, Williamson, TH, Galgiani, JN, Jarvis, WR. The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996;17:150-8.Google ScholarPubMed
77.Vicca, AENursing staff workload as a determinant of methicillin-resistant Staphylococcus aureus spread in an adult intensive therapy unit. J Hosp Wed 1999;43:109-13.Google Scholar
78.Harbarth, S, Sudre, P, Dharan, S, Cadenas, M, Pittet, D. Outbreak of Enterobader cloacae related to understaffing, overcrowding, and poor hygiene practices. Infed Control Hosp Epidemiol 1999;20:598–603.CrossRefGoogle ScholarPubMed
79.European Committee for Standardization. Chemical Disinfedants and Antiseptics—Hygienic Handrub—Test Method and Requirements (phase2/step2) [European standard EN 1500]. Brussels, Belgium: Central Secretariat 1997.Google Scholar
80.Kramer, ARudolph, P, Kampf, G, Pittet, D. Limited efficacy of alcohol-based hand gels. Lancet 2002;359:1489-90.CrossRefGoogle ScholarPubMed
81.Sattar, SAAbebe, M, Bueti, AJ, Jampani, H, Newman, J, Hua, S. Activity of an alcohol-based hand gel against human adeno-, rhino-, and rotaviruses using the fingerpad method. Infect Control Hosp Epidemiol 2000;21:516-9.CrossRefGoogle ScholarPubMed
82.Wolff, MH, Schmitt, J, Rahaus, M, König, A. Hepatitis A virus: a test method for virucidal activity. J Hosp Infect 2001;48(suppl A):S18–S22.Google ScholarPubMed
83.Steinmann, J. Some principles of virucidal testing. J Hosp Infect 2001;48(suppl A):S15–S17.Google Scholar
84.Gould, D, Ream, E. Assessing nurses' hand decontamination performance. Nursing Times 1993;89:47–50.Google ScholarPubMed
85.Quraishi, ZAMcGuckin, M, Biais, FX. Duration of handwashing in intensive care units: a descriptive study. Am J Infed Control 1984;11:83-7.Google Scholar
86.Lund, S, Jackson, J, Leggett, J, Hales, L, Dworkin, R, Gilbert, D. Reality of glove use and handwashing in a community hospital. Am J Infed Control 1994;22:352-7.Google Scholar
87.Meengs, MR, Giles, BK, Chisholm, CD, Cordell, WH, Nelson, DR. Hand washing frequency in an emergency department. Ann Emerg Med 1994;23:1307-12.Google Scholar
88.Larson, E, McGeer, A, Quraishi, ZA, et al. Effect of an automated sink on handwashing practices and attitudes in high-risk units. Infect Control Hosp Epidemiol 1991;12:422-8.Google Scholar
89.Broughall, JM, Marshman, C, Jackson, B, Bird, P. An automatic monitoring system for measuring handwashing frequency. J Hosp Infect 1984;5:447-53.CrossRefGoogle ScholarPubMed
90.Ojajärvi, J, Mäkelä, R, Rantasalo I. Failure of hand disinfection with frequent hand washing: a need for prolonged field studies. J Hyg (Land) 1977;79:107-19.CrossRefGoogle ScholarPubMed
91.Larson, EL, Eke, PI, Wilder, MP, Laughon, BE. Quantity of soap as a variable in handwashing. Infect Control 1987;8:371-5.Google Scholar
92.Larson, E, Leyden, JJ, McGinley, KJ, Grove, GL, Talbot, GH. Physiologic and microbiologic changes in skin related to frequent handwashing. Infect Control 1986;7:59–63.Google Scholar
93.Larson, EL, Eke, PI, Laughon, BE. Efficacy of alcohol-based hand rinses under frequent-use conditions. Antimicrob Agents Chemother 1986;30:542-4.Google Scholar
94.Larson, EL, Laughon, BE. Comparison of four antiseptic products containing Chlorhexidine gluconate. Antimicrob Agents Chemother 1987;31:1572-4.Google Scholar
95.Meers, PD, Yeo, GA. Shedding of bacteria and skin squames after handwashing. J Hyg (Land) 1978;81:99–105.Google Scholar
96.Winnefeld, M, Richard, MA, Drancourt, M, Grobb, JJ. Skin tolerance and effectiveness of two hand decontamination procedures in everyday hospital use. Br J Dermatol 2000;143:546-50.Google Scholar
97.Maki, DG, Zilz, MA, Alvarado, CJ. Evaluation of the antibacterial efficacy of four agents for handwashing. In: Nelson, JC, Grassi, C, eds. Current chemotherapy and infectious disease proceedings of the 11th International Congress on Chemotherapy and the 19th ICACC. Washington, DC: American Society for Microbiology, 1979.Google Scholar
98.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;21:442-8.CrossRefGoogle ScholarPubMed
99.Sartor, C, Jacomo, V, Duvivier, C, Tissot-Dupont, H, Sambuc, R, Drancourt, M. Nosocomial Serratia marcescens infections associated with extrinsic contamination of a liquid nonmedicated soap. Infect Control Hosp Epidemiol 2000;21:196-9.CrossRefGoogle ScholarPubMed
100.Walter, CW. Editorial: disinfection of hands. Am J Surg 1965;109:691-3.Google Scholar
101.Gravens, DL, Butcher, HR Jr, Ballinger, WF, Dewar, NE. Septisol antiseptic foam for hands of operating room personnel: an effective antibacterial agent. Surgery 1973;73:360-7.Google Scholar
102.Eitzen, HE, Ritter, MAFrench, MLV, Gioe, TJ. A microbiological in-use comparison of surgical hand-washing agents. J Bone Joint Surg Am 1979;61-A403-6.CrossRefGoogle ScholarPubMed
103.Minakuchi, K, Yamamoto, Y, Matsunaga, K, et al. The antiseptic effect of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution. Postgrad Med J 1993;69(suppl 3):S23–S26.Google Scholar
104.Babb, JR, Davies, JG, Ayliffe, GAJ. A test procedure for evaluating surgical hand disinfection. J Hosp Infect 1991;18(suppl B):41–9.Google Scholar
105.Bellamy, K, Alcock, R, Babb, JR, Davies, JG, Ayliffe, GA. A test for the assessment of ‘hygienic’ hand disinfection using rotavirus. J Hosp Infect 1993;24:201-10.Google Scholar
106.Ayliffe, GAJ, Babb, JR, Quoraishi, AH. A test for ‘hygienic’ hand disinfection. J Clin Pathol 1978;31:923-8.Google Scholar
107.Lilly, HALowbury, EJL, Wilkins, MD. Detergents compared with each other and with antiseptics as skin ‘degerming’ agents. J Hyg (Lend) 1979;82:89–93.Google Scholar
108.Ulrich, JAClinical study comparing hibistat (0.5% Chlorhexidine gluconate in 70% isopropyl alcohol) and betadine surgical scrub (7.5% povidone-iodine) for efficacy against experimental contamination of human skin. Curr Ther Res 1982;31:27–30.Google Scholar
109.Bartzokas, CAGibson, MF, Graham, R, Pinder, DC. A comparison of triclosan and Chlorhexidine preparations with 60 per cent isopropyl alcohol for hygienic hand disinfection. J Hosp Infect 1983;4:245-55.Google Scholar
110.Rotter, ML, Koller, W, Wewalka, G, Werner, HP, Ayliffe, GAJ, Babb, JREvaluation of procedures for hygienic hand-disinfection: controlled parallel experiments on the Vienna test model. J Hyg (Land) 1986;96:27–37.Google Scholar
111.Kjrlen, H, Andersen, BM. Handwashing and disinfection of heavily contaminated hands—effective or ineffective? J Hosp Infect 1992;21:61–71.Google Scholar
112.Namura, S, Nishijima, S, Asada, Y. An evaluation of the residual activity of antiseptic handrub lotions: an ‘in use’ setting study. J Dermatol 1994;21:481-5.Google Scholar
113.Jarvis, JD, Wynne, CD, Enwright, L, Williams, JD. Handwashing and antiseptic-containing soaps in hospital. J Clin Path 1979;32:732-7.Google Scholar
114.Pereira, LJ, Lee, GM, Wade, KJ. An evaluation of five protocols for surgical handwashing in relation to skin condition and microbial counts. J Hosp Infect 1997;36:49–65.CrossRefGoogle ScholarPubMed
115.Larson, EL, Butz, AM, Gullette, DL, Laughon, BA. Alcohol for surgical scrubbing? Infect Control Hosp Epidemiol 1990;11:139-43.Google Scholar
116.Aly, RMaibach, HI. Comparative study on the antimicrobial effect of 0.5% Chlorhexidine gluconate and 70% isopropyl alcohol on the normal flora of hands. Appl Environ Microbiol 1979;37:610-3.Google Scholar
117.Galle, PC, Homesley, HD, Rhyne, AL, Reassessment of the surgical scrub. Surg Gynecol Obstet 1978;147:215-8.Google Scholar
118.Rosenberg, AAlatary, SD, Peterson, AF. Safety and efficacy of the antiseptic Chlorhexidine gluconate. Surg Gynecol Obstet 1976;143:789-92.Google ScholarPubMed
119.Ayliffe, GAJ, Babb, JR, Bridges, K, et al. Comparison of two methods for assessing the removal of total organisms and pathogens from the skin. J Hyg (Land) 1975;75:259-74.Google Scholar
120.Larson, EL, Morton, HE. Alcohols [Chapter 11]. In: Block, SS, ed. Disinfection, Sterilization and Preservation. 4th ed. Philadelphia, PA, Lea and Febiger, 1991:642-54.Google Scholar
121.Price, PB. Ethyl alcohol as a germicide. Arch Surg 1939;38:528-42.Google Scholar
122.Harrington, C, Walker, H. The germicidal action of alcohol. Boston Medical and Surgical Journal 1903;148:548-52.CrossRefGoogle Scholar
123.Price, PB. New studies in surgical bacteriology and surgical technic. JAMA 1938;111:1993-6.CrossRefGoogle Scholar
124.Coulthard, CE, Sykes, G. The germicidal effect of alcohol with special reference to its action on bacterial spores. Pharmaceutical Journal 1936;137:79–81.Google Scholar
125.Pohle, WD, Stuart, LS. The germicidal action of cleaning agents— a study of a modification of Price's procedure. J Infect Dis 1940;67:275–81.Google Scholar
126.Gardner, AD. Rapid disinfection of clean unwashed skin: further experiments. Lancet 1948:760-3.CrossRefGoogle ScholarPubMed
127.Sakuragi, T, Yanagisawa, K, Dan, K, Bactericidal activity of skin disinfectants on methicillin-resistant Staphylococcus aureus. Anesth Analg 1995;81:555-8.Google Scholar
128.Kampf, G, Jarosch, R, Rüden, H. Limited effectiveness of Chlorhexidine based hand disinfectants against methicillin-resistant Staphylococcus aureus (MRSA). J Hosp Infect 1998;38:297–303.Google Scholar
129.Kampf, G, Höfer, M, Wendt, C. Efficacy of hand disinfectants against vancomycin-resistant enterococci in vitro. J Hosp Infect 1999;42:143-50.Google Scholar
130.Platt, J, Bucknall, RA. The disinfection of respiratory syncytial virus by iso-propanol and a chlorhexidine-detergent handwash. J Hosp Infect 1985;6:89–94.Google Scholar
131.Krilov, LR, Harkness, SH. Inactivation of respiratory syncytial virus by detergents and disinfectants. Pediatr Infect Dis 1993;12:582-4.Google Scholar
132.Sattar, SATetro, J, Springthorpe, VS, Giulivi, A. Preventing the spread of hepatitis B and C viruses: where are germicides relevant? Am J Infect Control 2001;29:187-97.Google Scholar
133.Woolwine, JD, Gerberding, JL. Effect of testing method on apparent activities of antiviral disinfectants and antiseptics. Antimicrob Agents Chemother 1995;39:921-3.CrossRefGoogle ScholarPubMed
134.Pfflsbury, DM, Iivingood, CS, Nichols, AC. Bacterial flora of the normal skin: report on the effect of various ointment and solutions, with comments on the clinical significance of this study. Arch Dermatol 1942;45:61–80.Google Scholar
135.Lowbury, EJL, Lilly, HA, Ayliffe, GAJ. Preoperative disinfection of surgeons' hands: use of alcoholic solutions and effects of gloves on skin flora. Br Med J 1974;4:369-72.Google Scholar
136.Lilly, HA, Lowbury, EJL, Wilkins, MD, Zaggy, A. Delayed antimicrobial effects of skin disinfection by alcohol. JHyg (Land) 1979;82:497–500.Google Scholar
137.Ansali, SASpringthorpe, VS, Sattar, SATostowaryk, W, Wells, GA. Comparison of cloth, paper, and warm air drying in eliminating viruses and bacteria from washed hands. Am J Infect Control 1991;19:243-9.CrossRefGoogle Scholar
138.Ansati, SASattar, SA. Springthorpe, VS, Wells, GA. Tostowaryk, W. In vivo protocol for testing efficacy of hand-washing agents against viruses and bacteria: experiments with rotavirus and Escherichia coli. Appl Environ Microbiol 1989;55:3113-8.CrossRefGoogle Scholar
139.Steinmann, J, Nehrkorn, R, Meyer, A, Becker, K. Two in-vivo protocols for testing virucidal efficacy of handwashing and hand disinfection. Zentralbl Hyg Umuieltmed 1995;196:425-36.Google Scholar
140.Mbithi, JN, Springthorpe, VS, Sattar, SA, Comparative in vivo efficiencies of hand-washing agents against hepatitis A virus (HM-175) and poliovirus type 1 (Sabin). Appi Environ Microbiol 1993;59:3463-9.CrossRefGoogle ScholarPubMed
141.Schurmann, W, Eggers, HJ. Antiviral activity of an alcoholic hand disinfectant: comparison of the in vitro suspension test with in vivo experiments on hands, and on individual fingertips. Antiviral Res 1983;3:25–41.Google Scholar
142.Larson, E, Bobo, L. Effective hand degerming in the presence of blood. J Emerg Med 1992;10:7–11.Google Scholar
143.Dineen, P, Hildick-Smith, G. Antiseptic care of the hands [Chapter 21]. In: Maibach, HI, Hildick-Smith, G, eds. Skin Bacteria and Their Role in Infection. New York: McGraw-Hill, 1965.Google Scholar
144.Lilly, HALowbury, EJL. Transient skin flora: their removal by cleansing or disinfection in relation to their mode of deposition. J Clin Path 1978;31:919-22.Google Scholar
145.Rotter, M, Koller, W, Wewalka, G. Povidone-iodine and Chlorhexidine glu-conate-containing detergents for disinfection of hands. J Hosp Infect 1980;1:149-58.CrossRefGoogle ScholarPubMed
146.Rotter, ML. Hygienic hand disinfection. Infect Control 1984;1:18–22.Google Scholar
147.Blech, MF, Hartemann, R, Paquin, JL. Activity of non antiseptic soaps and ethanol for hand disinfection. Zentralbl Bakteriol Hyg [B] 1985;181:496–512.Google ScholarPubMed
148.Leyden, JJ, McGinley, KJ, Kaminer, MS, et al. Computerized image analysis of full-hand touch plates: a method for quantification of surface bacteria on hands and the effect of antimicrobial agents. J Hosp Infect 1991;18(suppl B):13–22.CrossRefGoogle ScholarPubMed
149.Rotter, ML, Koller, W. Test models for hygienic handrub and hygienic handwash: the effects of two different contamination and sampling techniques. J Hosp Infect 1992;20:163-71.Google Scholar
150.Zaragoza, M, Salles, M, Gomez, J, Bayas, JM, Trilla, A. Handwashing with soap or alcoholic solutions? A randomized clinical trial of its effectiveness. Am J Infect Control 1999;27:258-61.CrossRefGoogle ScholarPubMed
151.Paulson, DS, Fendler, EJ, Dolan, MJ, Williams, RA. A close look at alcohol gel as an antimicrobial sanitizing agent. Am J Infect Control 1999;27:332-8.Google Scholar
152.Cardoso, CL, Pereira, HH, Zequim, JC, Guilhermetti, M. Effectiveness of hand-cleansing agents for removing Acinetobader baumannii strain from contaminated hands. Am J Infect Control 1999;27:327-31.Google Scholar
153.Casewell, MW, Law, MM, Desai, N. A laboratory model for testing agents for hygienic hand disinfection: handwashing and Chlorhexidine for the removal of Klebsiella. J Hosp Infect 1988;12:163-75.CrossRefGoogle ScholarPubMed
154.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;18:211-8.Google Scholar
155.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;22:224-7.Google Scholar
156.Lowbury, EJL, Lilly, HA. Disinfection of the hands of surgeons and nurses. Br Med J 1960;1:5184.Google Scholar
157.Berman, RE, Knight, RA. Evaluation of hand antisepsis. Arch Environ Health 1969;18:781-3.CrossRefGoogle ScholarPubMed
158.Rotter, ML, Simpson, RA, Koller, W. Surgical hand disinfection with alcohols at various concentrations: parallel experiments using the new proposed European standards method. Infect Control Hosp Epidemiol 1998;19:778-81.CrossRefGoogle ScholarPubMed
159.Hobson, DW, Woller, W, Anderson, L, Guthery, E. Development and evaluation of a new alcohol-based surgical hand scrub formulation with persistent antimicrobial characteristics and brushless application. Am J Infect Control 1998;26:507-12.Google Scholar
160.Jones, MV, Rowe, GB, Jackson, B, Pritchard, NJ. The use of alcoholic paper wipes for routine hand cleansing: results of trials in two hospitals. J Hosp Infect 1986;8:268-74.Google Scholar
161.Butz, AM, Laughon, BE, Gullette, DL, Larson, EL. Alcohol-impregnated wipes as an alternative in hand hygiene. Am J Infect Control 1990;18:70-6.Google Scholar
162.Ojajärvi, J. Handwashing in Finland. J Hosp Infect 1991;18(suppl B):35–40.CrossRefGoogle ScholarPubMed
163.Newman, JLSeitz, JC. Intermittent use of an antimicrobial hand gel for reducing soap-induced irritation of health care personnel. Am J Infect Control 1990;18:194–200.Google Scholar
164.Rotter, MLKoller, W, Neumann, R. The influence of cosmetic additives on the acceptability of alcohol-based hand disinfectants. J Hosp Infect 1991;18 (suppl B):57–63.CrossRefGoogle ScholarPubMed
165.Larson, ELAello, AE, Heilman, JM, et al. Comparison of different regimens for surgical hand preparation. AORN J 2001;73:412-20.Google Scholar
166.Larson, EL, Aello, AE, Bastyr, J, et al. Assessment of two hand hygiene regimens for intensive care unit personnel. Crit Care Med 2001;29; 944–51.Google Scholar
167.Ophaswongse, S, Maibach, HI. Alcohol dermatitis: allergic contact dermatitis and contact urticaria syndrome: a review. Contad Dermatitis 1994;30:1–6.Google Scholar
168.Rilliet, AHunziker, N, Brun, R. Alcohol contact urticaria syndrome (immediate-type hypersensitivity): case report. Dermatologica 1980;161:361-4.Google Scholar
169.Widmer, AEReplace hand washing with use of a waterless alcohol hand rub? Clin Infect Dis 2000;31:13fr43.Google Scholar
170.Bryant, KA, Pearce, J, Stover, B. Flash fire associated with the use of alcc-hoi-based antiseptic agent [Letter]. Am J Infect Control 2002;30:256-7.Google Scholar
171.Hsueh, PRTeng, LJ, Yang, PC, Pan, HL, Ho, SW, Luh, KT. Nosocomial pseu-doepidemic caused by Bacillus cereus traced to contaminated ethyl alcohol from a liquor factory. J Clin Microbiol 1999;37:2280-4.Google Scholar
172.Denton, GW. Chlorhexidine [Chapter 16]. In: Block, SS, ed. Disinfedion, Sterilization and Preservation. 4th ed. Philadelphia, PA. Lea and Febiger, 1991.Google Scholar
173.Narang, HK, Codd, AA. Action of commonly used disinfectants against enteroviruses. J Hosp Infect 1983;4:209-12.Google Scholar
174.Walsh, B, Blakemore, PH, Drabu, YJ. The effect of handcream on the antibacterial activity of Chlorhexidine gluconate. J Hosp Infect 1987;9:30-3.CrossRefGoogle ScholarPubMed
175.Lowbury, EJLLilly, HA. Use of 4% Chlorhexidine detergent solution (Hibiscrub) and other methods of skin disinfection. Br Med J 1973;1:510-5.Google Scholar
176.Paulson, DS. Comparative evaluation of five surgical hand scrub preparations. AORN J 1994;60:246-56.Google Scholar
177.Stingerli, LLapomarda, V, Lisi, R. Occupational hand dermatitis in hospital environments. Contact Dermatitis 1995;33:172-6.Google Scholar
178.Marrie, TJ, Costerton, JW. Prolonged survival of Serratia marcescens in Chlorhexidine. Appl Environ Microbiol 1981;42:1093-102.Google Scholar
179.McAllister, TALucas, CE, Mocan, H, et al. Serratia marcescens outbreak in a paediatric oncology unit traced to contaminated Chlorhexidine. Scott Med J 1989;34:525-8.Google Scholar
180.Vigeant, P, Loo, VG, Bertrand, C, et al. An outbreak of Serratia marcescens infections related to contaminated Chlorhexidine. Infect Control Hosp Epidemiol 1998;19:791-4.Google Scholar
181.Vu-Thien, H, Darbord, JC, Moissenet, D, et al. Investigation of an outbreak of wound infections due to Alcaligenes xylosoxidans transmitted by Chlorhexidine in a burns unit. Eur J Clin Microbiol 1998;17:724-6.Google Scholar
182.Larson, E, Talbot, GH. An approach for selection of health care personnel handwashing agents. Infect Control 1986;7:419-24.Google Scholar
183.Davies, J, Babb, JR, Ayliffe, GAJ, Wilkins, MD. Disinfection of the skin of the abdomen. Br J Surg 1978;65:855-8.Google Scholar
184.Larson, E, Mayur, K, Laughon, BAInfluence of two handwashing frequencies on reduction in colonizing flora with three handwashing products used by health care personnel. Am J Infect Control 1988;17:83-8.Google Scholar
185.Soulsby, ME, Barnett, JB, Maddox, S. Brief report the antiseptic efficacy of chlorxylenol-containing vs. Chlorhexidine gluconate-containing surgical scrub preparations. Infect Control 1986;7:223-6.Google Scholar
186.Aly, R, Maibach, HI. Comparative antibacterial efficacy of a 2-minute surgical scrub with Chlorhexidine gluconate, povidone-iodine, and chlorox-ylenol sponge-brushes. Am J Infect Control 1988;16:173-7.Google Scholar
187.Archibald, LK, Cori, A, Shah, B, et al. Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap. Infect Control Hosp Epidemiol 1997;18:704-9.Google Scholar
188.Lowbury, EJL, Lilly, HA, Bull, JR. Disinfection of hands: removal of resident bacteria. Br Med J 1963;1:1251-6.Google Scholar
189.Kundsin, RB, Walter, CW. The surgical scrub—practical consideration. Arch Surg 1973;107:75-7.Google Scholar
190.Lockhart, J. How toxic is hexachlorophene? Pediatrics 1972;50:229-35.Google Scholar
191.Shuman, RM, Leech, RW, Alvord, EC Jr.Neurotoxicity of hexachlorophene in humans: II. a clinicopathological study of 46 premature infants. Arch Neurol 1975;32:320-5.CrossRefGoogle Scholar
192.Dixon, RE, Kaslow, RA, Mallison, GF, Bennett, JV. Staphylococcal disease outbreaks in hospital nurseries in the United States—December 1971 through March 1972. Pediatrics 1973;51:413-6.Google Scholar
193.Kaslow, RA, Dixon, RE, Martin, SM, et al. Staphylococcal disease related to hospital nursery bathing practices—a nationwide epidemiologic investigation. Pediatrics 1973;51:418-29.CrossRefGoogle ScholarPubMed
194.American Academy of Pediatrics, American College of Obstetricians and Gynecologists. Guidelines for Perinatal Care. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics; Washington, DC: American Academy of Obstetricians and Gynecologists, 1997.Google Scholar
195.Gottardi, W. Iodine and iodine compounds [Chapter 8]. In: Block, SS, ed. Disinfection, Sterilization and Preservation. 4th ed. Philadelphia, PA. Lea and Febiger; 1991.Google Scholar
196.Anderson, RLIodophor antiseptics: intrinsic microbial contamination with resistant bacteria. Infect Control Hosp Epidemiol 1989;10:443-6.CrossRefGoogle ScholarPubMed
197.Goldenheim, PD. In vitro efficacy of povidone-iodine solution and cream against methicillin-resistant Staphylococcus aureus. Postgrad Med J 1993;69(suppl 3):S62–S65.Google Scholar
198.Traoré, O, Fayard, SF, Laveran, H. An in-vitro evaluation of the activity of povidone-iodine against nosocomial bacterial strains. J Hosp Infect 1996;34:217-22.Google Scholar
199.McLure, AR, Gordon, J. In-vitro evaluation of povidone-iodine and Chlorhexidine against methicillin-resistant Staphylococcus aureus. J Hosp Infect 1992;21:291-9.Google Scholar
200.Davies, JG, Babb, JR, Bradley, CR, Ayliffe, GAJ. Preliminary study of test methods to assess the virucidal activity of skin disinfectants using poliovirus and bacteriophages. J Hosp Infed 1993;25:125-31.Google Scholar
201.Rotter, MLHand washing and hand disinfection [Chapter 79]. In: Mayhall, CG, ed. Hospital Epidemiology and Infection Control. Baltimore, MD: Williams & Wilkins, 1996.Google Scholar
202.Wade, JJ, Casewell, MW. The evaluation of residual antimicrobial activity on hands and its clinical relevance. J Hosp Infect 1991;18(suppl B):23–8.Google Scholar
203.Aly, RMaibach, HI. Comparative evaluation of Chlorhexidine gluconate (Hibiclens®) and povidone-iodine (E-Z Scrub®) sponge/brushes for presurgical hand scrubbing. Curr Ther Res 1983;34:740-5.Google Scholar
204.Herruzo-Cabrera, R, Vizcaino-Alcaide, MJ, Fdez-AciZero, MJ. Usefulness of an alcohol solution of N-duopropenide for the surgical antisepsis of the hands compared with handwashing with iodine-povidone and Chlorhexidine: clinical essay. J Surgical Research 2000;94:6–12.CrossRefGoogle ScholarPubMed
205.Hingst, VJuditzki, I, Heeg, P, Sonntag, HG. Evaluation of the efficacy of surgical hand disinfection following a reduced application time of 3 instead of 5 min. J Hosp Infect 1992;20:79–86.Google Scholar
206.Faoagali, J, Fong, J, George, N, Mahoney, P, O'Rourke, V. Comparison of the immediate, residual, and cumulative antibacterial effects of Novaderm R Novascrub R Betadine Surgical Scrub, Hibiclens, and liquid soap. Am J Infect Control 1995;23:337-43.Google Scholar
207.Pereira, LI, Lee, GM, Wade, KJ. The effect of surgical handwashing routines on the microbial counts of operating room nurses. Am J Infect Control 1990;18:354-64.Google Scholar
208.Peterson, AF, Rosenberg, A. Comparative evaluation of surgical scrub preparations. Surg Gynecol Obstet 1978;146:63-5.Google Scholar
209.Berkelman, RL, Holland, BW, Anderson, RL. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J Clin Microbiol 1982;15:635-9.Google Scholar
210.Merianos, JJ. Quaternary ammonium antimicrobial compounds [Chapter 13]. In: Block, SS, ed. Disinfection, Sterilization and Preservation. 4th ed. Philadelphia, PA. Lea and Febiger; 1991.Google Scholar
211.Dixon, RE, Kaslow, RA, Mackel, DC, Fulkerson, CC, Mallison, GF. Aqueous quaternary ammonium antiseptics and disinfectants: use and misuse. JAMA 1976;236:2415-7.Google Scholar
212.Sautter, RL, Mattman, LH, Legaspi, RC. Serratia marcescens meningitis associated with a contaminated benzalkonium chloride solution. Infect Control 1984;5:223-5.CrossRefGoogle ScholarPubMed
213.Oie S, Kamiya. Microbial contamination of antiseptics and disinfectants. Am J Infect Control 1996;24:389-95.Google Scholar
214.Hayes, RA, Trick, WE, Vernon, MO, et al. Comparison of three hand hygiene (HH) methods in a surgical intensive care unit (SICU) [Abstract K-1337]. Presented at the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago, IL: American Society for Microbiology, 2001.Google Scholar
215.Dyer, DL, Gerenraich, KB, Wadhams, PS. Testing a new alcohol-free hand sanitzer to combat infection. AORN J 1998;68:239-51.Google Scholar
216.Jones, RD, Jampani, HB, Newman, JL, Lee, AS. Triclosan: a review of effectiveness and safety in health care settings. Am J Infect Control 2000;28:184-96.Google Scholar
217.Ward, WH, Holdgate, GARowsell, S, et al. Kinetic and structural characteristics of the inhibition of enoyl (acyl carrier protein) reductase by triclosan. Biochemistry 1999;38:12514-25.Google Scholar
218.Heath, RJ, Ii, J, Roland, GE. Inhibition of the Staphylococcus aureus NADPH-dependent enoyl-acyl carrier protein reductase by triclosan and hexachlorophene. J Biol Chem 2000;275:4654-9.Google Scholar
219.Faoagali, JLGeorge, N, Fong, J, Davy, J, Dowser, M. Comparison of the antibacterial efficacy of 4% Chlorhexidine gluconate and 1% triclosan handwash products in an acute clinical ward. Am J Infect Control 1999;27:320-6.Google Scholar
220.Barry, MA, Craven, DE, Goularte, TA, Lichtenberg, DA. Serratia marcescens contamination of antiseptic soap containing triclosan: implications for nosocomial infection. Infect Control 1984;5:427-30.Google Scholar
221.Lowbury, EJLLilly, HA, Bull, JP. Disinfection of hands: removal of transient organisms. Br Med J 1964;2:230-3.Google Scholar
222.Rotter, MLSemmelweis' sesquicentennial: a little-noted anniversary of handwashing. Current Opinion in Infectious Diseases 1998;11:457-60.Google Scholar
223.Manivannan, G, Brady, MJ, Cahalan, PT, et al. Immediate, persistent and residual antimicrobial efficiency of Surfacine™ hand sanitizer [Abstract]. Infection Control Hosp Epidemiol 2000;21:105.Google Scholar
224.Gershenfeld, L. Povidone-iodine as a sporicide. Am J Pharm 1962;134:79–81.Google Scholar
225.Russell, AD. Chemical sporicidal and sporostatic agents [Chapter 22]. In: Block, SS, ed. Disinfection, Sterilization and Preservation. 4th ed. Philadelphia, PA: Lea and Febiger, 1991.Google Scholar
226.Johnson, S, Gerding, DN, Olson, MM, et al. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med 1990;88:137-40.Google Scholar
227.Russell, AD. Mechanisms of bacterial insusceptibility to biocides. Am J Infect Control 2001;29:259-61.Google Scholar
228.Cookson, BD, Bolton, MC, Platt, JH. Chlorhexidine resistance in methicillin-resistant Staphylococcus aureus or just an elevated MIC? An in vitro and in vivo assessment. Antimicrob Agents Chemother 1991;35:1997–2002.Google Scholar
229.McMurry, LM, Oethinger, M, Levy, SB. Overexpression of marA, soxS, or aar AB produces resistance to triclosan in laboratory and clinical strains of Escherichia coli. FEMS Microbiol Lett 1998;166:305-9.Google Scholar
230.Chuanchuen, RBeinlich, K, Hoang, TT, et al. Cross-resistance between triclosan and antibiotics in Pseudomonas aeruginosa is mediated by multidrug efflux pumps: exposure of a susceptible mutant strain to triclosan selects nfxB mutants overexpressing MexCD-OprJ. Antimicrob Agents Chemother 2001;45:428-32.Google Scholar
231.Gröschel, DHM, Pruett, TL. Surgical antisepsis [Chapter 36]. In: Block, SS, ed. Disinfection, Sterilization and Preservation. 4th ed. Philadelphia, PA: Lea and Febiger, 1991.Google Scholar
232.Boyce, JM, Potter-Bynoe, G, Opal, SM, Dziobek, L, Medeiros, AA. A common-source outbreak of Staphylococcus epidermidis infections among patients undergoing cardiac surgery. J Infect Dis 1990;161:493-9.Google Scholar
233.Dewar, NE, Gravens, DL, Effectiveness of septisol antiseptic foam as a surgical scrub agent. Appi Microbiol 1973;26:544-9.Google Scholar
234.Grinbaum, RS, de Mendonça, JS, Cardo, DM. An outbreak of handscrub-bing-related surgical site infections in vascular surgical procedures. Infect Control Hosp Epidemiol 1995;16:198–202.Google Scholar
235.AORN Recommended Practices Committee. Recommended practices for surgical hand scrubs. In: Fogg, D, Parker, N, Shevlin, D, eds. Standards, Recommended Pradices, and Guidelines. Denver, CO: AORN, 2001.Google Scholar
236.Larson, E, Anderson, JK, Baxendale, L, Bobo, L. Effects of a protective foam on scrubbing and gloving. Am J Infect Control 1993;21:297–301.CrossRefGoogle ScholarPubMed
237.Mulberry, G, Snyder, AT, Heilman, J, Pyrek, J, Stahl, J. Evaluation of awater-less, scrubless Chlorhexidine gluconate/ethanol surgical scrub for antimicrobial efficacy. Am J Infect Control 2001;29:377-82.Google Scholar
238.Dineen, P. An evaluation of the duration of the surgical scrub. Surg Gynecol Obstet 1969;129:1181-4.Google Scholar
239.O'Farrell, DA, Kenny, G, O'Sullivan, M, Nicholson, P, Stephens, M, Hone, R. Evaluation of the optimal hand-scrub duration prior to total hip arthroplasty. J Hosp Infect 1994;26:93-8.Google Scholar
240.O'Shaughnessy, M, O'Malley, VP, Corbett, G, Given, HE. Optimum duration of surgical scrub-time [Short note]. Br J Surg 1991;78:685-6.Google Scholar
241.Wheelock, SM, Lookinland, S. Effect of surgical hand scrub time on subsequent bacterial growth. AORN J 1997;65:1087-98.Google Scholar
242.Deshmukh, N, Kjellberg, SI, Kramer, JW. A comparison of 5-minute povidone-iodine scrub and 1-minute povidone-iodine scrub followed by alcohol foam. Military Medicine 1998;163:145-7.Google Scholar
243.Kikuchi-Numagami, K, Saishu, T, Fukaya, M, Kanazawa, E, Tagami, H. Irritancy of scrubbing up for surgery with or without a brush. Acta Derm Venereal 1999;79:230-2.Google Scholar
244.Dineen, RThe use of a polyurethane sponge in surgical scrubbing. Surg Gynecol Obstet 1966;123:595-8.Google Scholar
245.Bornside, GH, Crowder, VH Jr, Cohn, I Jr. A bacteriological evaluation of surgical scrubbing with disposable iodophor-soap impregnated polyurethane scrub sponges. Surgery 1968;64:743-51.Google Scholar
246.McBride, ME, Duncan, WC, Knox, JM. An evaluation of surgical scrub brushes. Surg Gynecol Obstet 1973;137:934-6.Google Scholar
247.Berman, RE, Knight, RA. Evaluation of hand antisepsis. Arch Environ Health 1969;18:781-3.Google Scholar
248.Loeb, MB, Wilcox, L, Smaili, F, Walter, S, Duff, Z. A randomized trial of surgical scrubbing with a brush compared to antiseptic soap alone. Am J Infect Control 1997;25:11-5.CrossRefGoogle ScholarPubMed
249.Larson, E, Friedman, C, Cohran, J, Treston-Aurand, J, Green, S. Prevalence and correlates of skin damage on the hands of nurses. Heart Lung 1997;26:404-12.Google Scholar
250.Tupker, RA. Detergents and cleansers [Chapter 7]. In: van der Valk, PGM, Maibach, HI, eds. The Irritant Contad Dermatitis Syndrome. New York, NY: CRC Press, 1996.Google Scholar
251.Wilhelm, KP. Prevention of surfactant-induced irritant contact dermatitis. Curr Probi Dermatol 1996;25:78–85.Google Scholar
252.de Haan, P, Meester, HHM, Bruynzeel, DP. Irritancy of alcohols [Chapter 6]. In: van der Valk, PGM, Maibach, HI, eds. The Irritant Contad Dermatitis Syndrome. New York, NY: CRC Press, 1996.Google Scholar
253.Lübbe, J, Ruffieux, C, van Melle, G, Perrenoud, D. Irritancy of the skin disinfectant n-propanol. Contad Dermatitis 2001;45:226-31.Google Scholar
254.Ohlenschlaeger, J, Friberg, J, Ramsing, D, Agner, T. Temperature dependency of skin susceptibility to water and detergents. Acta Derm Venereol 1996;76:274-6.Google Scholar
255.Emilson, ALindberg, M, Forslind, B. The temperature effect of in vitro penetration of sodium lauryl sulfate and nickel chloride through human skin. Acta Derm Venereol 1993;73:203-7.Google Scholar
256.de Groot, AC. Contact allergy to cosmetics: causative ingredients. Contact Dermatitis 1987;17:26–34.Google Scholar
257.Schnuch, AUter, W, Geier, J, Frosch, PJ, Rustemeyer, T. Contact allergies in healthcare workers—results from the IVDK. Acta Derm Venereol 1998;78:358-63.Google Scholar
258.Rastogi, SC, Heydorn, S, Johansen, JD, Basketter, DAFragrance chemicals in domestic and occupational products. Contad Dermatitis 2001;45:221-5.Google Scholar
259.Uter, WSchnuch, A. Geier, J, Pfahlberg, A. Gefeller, O. Association between occupation and contact allergy to the fragrance mix: a multifactorial analysis of national surveillance data. Occup Environ Med 2001;58:392-8.Google Scholar
260.Perrenoud, D, Bircher, A, Hunziker, T, et al. Frequency of sensitization to 13 common preservatives in Switzerland. Contact Dermatitis 1994;30:276-9.Google Scholar
261.Kiec-Swierczynska, M, Krecisz, B. Occupational skin diseases among the nurses in the region of Lodz. Int J Occup Med Environ Health 2000;13:179-84.Google Scholar
262.Garvey, LH, Roed-Petersen, J, Husum, B. Anaphylactic reactions in anaesthetised patients—four cases of Chlorhexidine allergy. Acta Anaesthesiol Scand 2001;45:1290-4.Google Scholar
263.Pham, NH, Weiner, JM, Reisner, GS, Baldo, BA. Anaphylaxis to Chlorhexidine. Case report Implication of immunoglobulin E antibodies and identification of an allergenic determinant. Clin Exp Allergy 2000;30:1001-7.Google Scholar
264.Nishioka, K, Seguchi, T, Yasuno, H, Yamamoto, T, Tominaga, K. The results of ingredient patch testing in contact dermatitis elicited by povidone-iodine preparations. Contact Dermatitis 2000;42:90-4.Google Scholar
265.Wong, CSM, Beck, MH. Allergic contact dermatitis from triclosan in antibacterial handwashes. Contact Dermatitis 2001;45:307.Google Scholar
266.Guin, JD, Goodman, J. Contact urticaria from benzyl alcohol presenting as intolerance to saline soaks. Contact Dermatitis 2001;45:182-3.Google Scholar
267.Podda, M, Zollner, T, Grundmann-Kollmann, M, Kaufmann, R, Boehncke, WF. Allergie contact dermatitis from benzyl alcohol during topical antimy-cotic treatment. Contact Dermatitis 1999;41:302-3.Google Scholar
268.Yesudian, PD, King, CM. Allergic contact dermatitis from stearyl alcohol in Efudix® cream. Contad Dermatitis 2001;45:313-4.Google Scholar
269.Aust, LB, Maibach, HI. Incidence of human skin sensitization to isostearyl alcohol in two separate groups of panelists. Contact Dermatitis 1980;6:269-71.Google Scholar
270.Funk, JO, Maibach, HI. Propylene glycol dermatitis: re-evaluation of an old problem. Contact Dermatitis 1994;31:236-41.Google Scholar
271.Hannuksela, M. Moisturizers in the prevention of contact dermatitis. Curr Probl Dermatol 1996;25:214-20.Google Scholar
272.Berndt, U, Wigger-Alberti, W, Gabard, B, Eisner, R. Efficacy of a barrier cream and its vehicle as protective measures against occupational irritant contact dermatitis. Contact Dermatitis 2000;42:77–80.Google Scholar
273.McCormick, RD, Buchman, TL, Maki, DG. Double-blind, randomized trial of scheduled use of a novel barrier cream and an oil-containing lotion for protecting the hands of health care workers. Am J Infect Control 2000;28:302-10.Google Scholar
274.Larson, E, Killien, M. Factors influencing handwashing behavior of patient care personnel. Am J Infect Control 1982;10:93-9.Google Scholar
275.Zimakoff, J, Kjelsberg, AB, Larsen, SO, Holstein, B. A multicenter questionnaire investigation of attitudes toward hand hygiene, assessed by the staff in fifteen hospitals in Denmark and Norway. Am J Infect Control 1992;20:58–64.Google Scholar
276.Mayer, JADubbert, PM, Miller, M, Burkett, PA, Chapman, SW. Increasing handwashing in an intensive care unit. Infect Control 1986;7:259-62.Google Scholar
277.Ojajärvi, J. The importance of soap selection for routine hand hygiene in hospital. J Hyg (Und) 1981;86:275-83.Google Scholar
278.Scott, D, Barnes, A, Lister, M, Arkell, P. An evaluation of the user acceptability of Chlorhexidine handwash formulations. J Hosp Infed 1991;18(suppl B):51–5.Google Scholar
279.Taylor, LJ. An evaluation of handwashing techniques—2. Nursing Times 1978,74:108–10.Google Scholar
280.Preston, GALarson, ELStamm, WE. The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit. Am J Med 1981;70:641-5.Google Scholar
281.Kaplan, LM, McGuckin, M. Increasing handwashing compliance with more accessible sinks. Infect Control 1986;7:408-10.Google Scholar
282.Freeman, J. Prevention of nosocomial infections by location of sinks for hand washing adjacent to the bedside [Abstract 60]. In: Program and abstracts of the 33rd Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology, 1993:130.Google Scholar
283.Bischoff, WE, Reynolds, TM, Sessler, CN, Edmond, MB, Wenzel, RP. Handwashing compliance by health care workers. The impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med 2000;160:1017-21.Google Scholar
284.Pittet, D. Compliance with hand disinfection and its impact on hospital-acquired infections. J Hosp Infect 2001;48(suppl A):S40–S46.Google Scholar
285.Wurtz, R, Moye, G, Jovanovic, B. Handwashing machines, handwashing compliance, and potential for cross-contamination. Am J Infect Control 1994;22:228-30.Google Scholar
286.Kohan, C, Ligi, C, Dumigan, DG, Boyce, JM. The importance of evaluating product dispensers when selecting alcohol-based handrubs. Am J Infect Control 2002 (in press).Google Scholar
287.Boyce, JM. Antiseptic techology: access, affordability, and acceptance. Emerg Infect Diseases 2001;7:231-3.Google Scholar
288.Taylor, LJ. An evaluation of handwashing techniques—1. Nursing Times 1978:54-5.Google Scholar
289.Albert, RK, Condie, E. Hand-washing patterns in medical intensive-care units. N Engl J Med 1981;304:1465-6.Google Scholar
290.Larson, E. Compliance with isolation technique. Am J Infect Control 1983;11:221-5.Google Scholar
291.Donowitz, LG. Handwashing technique in a pediatric intensive care unit. Am J Dis Child 1987;141:683-5.Google Scholar
292.Conly, JM, Hill, S, Ross, J, Lertzman, J, Louie, TJ. Handwashing practices in an intensive care unit: the effects of an educational program and its relationship to infection rates. Am J Infect Control 1989;17:330-9.Google Scholar
293.DeCarvalho, M, Lopes, JMA, Pellitteri, M. Frequency and duration of handwashing in a neonatal intensive care unit. Pediatr Infect Dis J 1989;8:179-80.Google Scholar
294.Graham, M. Frequency and duration of handwashing in an intensive care unit. Am J Infect Control 1990;18:77–80.Google Scholar
295.Dubbert, PM, Dolce, J, Richter, W, Miller, M, Chapman, SW. Increasing ICU staff handwashing: effects of education and group feedback. Infect Control Hosp Epidemiol 1990;11:191-3.Google Scholar
296.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;11:589-94.Google Scholar
297.Pettinger, ANetfleman, MD. Epidemiology of isolation precautions. Infect Control Hosp Epidemiol 1991;12:303-7.Google Scholar
298.Lohr, JAIngram, DL, Dudley, SM, Lawton, EL, Donowitz, LG. Hand washing in pediatric ambulatory settings: an inconsistent practice. Am J Dis Child 1991;145:1198-9.Google Scholar
299.Raju, TNK, Kobler, C. Improving handwashing habits in the newborn nurseries. Am J Med Sci 1991;302:355-8.Google Scholar
300.Larson, EL, McGinley, KJ, Foglia, A. et al. Handwashing practices and resistance and density of bacterial hand flora on two pediatric units in Lima, Peru. Am J Infect Control 1992;20:65–72.Google Scholar
301.Zimakoff, J, Stormark, M, Larsen, SO. Use of gloves and handwashing behaviour among health care workers in intensive care units. A multicentre investigation in four hospitals in Denmark and Norway. J Hosp Infed 1993;24:63-7.CrossRefGoogle ScholarPubMed
302.Pelke, S, Ching, D, Easa, D, Melish, ME. Gowning does not affect colonization or infection rates in a neonatal intensive care unit. Arch Pediatr Adolesc Med 1994;148:1016-20.Google Scholar
303.Gould, D. Nurses' hand decontamination practice: results of a local study. J Hosp Infect 1994;28:15–30.Google Scholar
304.Shay, DK, Maloney, SA. Montecalvo, M, et al. Epidemiology and mortality risk of vancomycin-resistant enterococcal bloodstream infections. J Infect Dis 1995;172:993–1000.Google Scholar
305.Berg, DE, Hershow, RC, Ramirez, CA. Control of nosocomial infections in an intensive care unit in Guatemala City. Clin Infect Dis 1995;21:588-93.Google Scholar
306.Tibballs, J. Teaching hospital medical staff to handwash. Med J Aust 1996;164:395-8.Google Scholar
307.Slaughter, S, Hayden, MK, Nathan, C, et al. A comparison of the effect of universal use of gloves and gowns with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit. Ann Intern Med 1996;125:448-56.CrossRefGoogle Scholar
308.Dorsey, ST, Cydulka, RK, Emerman, CL, Is handwashing teachable?: failure to improve handwashing behavior in an urban emergency department. Acad Emerg Med 1996;3:360-5.Google Scholar
309.Watanakunakorn, C, Wang, C, Hazy, J. An observational study of hand washing and infection control practices by healthcare workers. Infect Control Hosp Epidemiol 1998;19:858-60.Google Scholar
310.Avila-Agüero, MLUmaZa, MA, Jiménez, AL, Faingezicht, I, Paris, MM. Handwashing practices in a tertiary-care, pediatric hospital and the effect on an educational program. Clin Perform Qual Health Care 1998;6:70-2.Google Scholar
311.Kirkland, KB, Weinstein, JM. Adverse effects of contact isolation. Lancet 1999;354:1177-8.Google Scholar
312.Maury, E, Alzieu, M, Baudel, JLet al. Availability of an alcohol solution can improve hand disinfection compliance in an intensive care unit. Am J Respir Crit Care Med 2000;162:324-7.Google Scholar
313.Muto, CASistrom, MG, Farr, BM. Hand hygiene rates unaffected by installation of dispensers of a rapidly acting hand antiseptic. Am J Infect Control 2000;28:273-6.Google Scholar
314.Jarvis, WRHandwashing—the Semmelweis lesson forgotten? Lancet 1994;344:1311-2.Google Scholar
315.Larson, E, Kretzer, EKCompliance with handwashing and barrier precautions. J Hosp Infect 1995;30 (suppl) :88–106.Google Scholar
316.Sproat, LJ, Inglis, TJJ. A multicentre survey of hand hygiene practice in intensive care units. J Hosp Infect 1994;26:137-48.Google Scholar
317.Kretzer, EK, Larson, EL. Behavioral interventions to improve infection control practices. Am J Infect Control 1998;26:245-53.Google Scholar
318.Voss, AWidmer, AF. No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance? Infect Control Hosp Epidemiol 1997;18:205-8.Google Scholar
319.Larson, E. Handwashing and skin physiologic and bactériologie aspects. Infect Control 1985;6:14–23.Google Scholar
320.Thompson, BL, Dwyer, DM, Ussery, XT, Denman, S, Vacek, P, Schwartz, B. Handwashing and glove use in a long-term care facility. Infect Control Hosp Epidemiol 1997;18:97–103.Google Scholar
321.Doebbeling, BN, Pfaller, MA, Houston, AK, Wenzel, RR. Removal of nosocomial pathogens from the contaminated glove. Ann Intern Med 1988;109:394-S.Google Scholar
322.McLane, C, Chenelly, S, Sylwestrak, ML, Kirchhoff, KT. A nursing practice problem: failure to observe aseptic technique. Am J Infect Control 1983;11:178-82.Google Scholar
323.Pittet, D. Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol 2000;21:381-6.Google Scholar
324.Teare, LHandwashing Liasion Group. Hand washing: a modest measure—with big effects. Br Med J 1999;318:686.Google Scholar
325.Teare, EL, Cookson, B, French, GLet al. UK handwashing initiative. J Hosp Infed 1999;43:1–3.Google Scholar
326.Larson, EL, Bryan, JL, Adler, LM, Blane, C. A multifaceted approach to changing handwashing behavior. Am J Infect Control 1997;25:3–10.Google Scholar
327.Weeks, AWhy I don't wash my hands between each patient contact [Letter]. Br Med J 1999;319:518.Google Scholar
328.Webster, J. Handwashing in a neonatal intensive care nursery: product acceptability and effectiveness of Chlorhexidine gluconate 4% and triclosan 1%. J Hosp Infect 1992;21:137-41.Google Scholar
329.Kelen, GD, Green, GB, Hexter, DAet al. Substantial improvement in compliance with universal precautions in an emergency department following institution of policy. Arch Intern Med 1991;151:2051-6.Google Scholar
330.Lundberg, GD. Changing physician behavior in ordering diagnostic tests [Editorial]. JAMA 1998;280:2036.Google Scholar
331.Phillips, DF. “New look” reflects changing style of patient safety enhancement. JAMA 1999;281:217-9.Google Scholar
332.Harbarth, S, Martin, Y, Rohner, R, Henry, N, Auckenthaler, R, Pittet, D. Effect of delayed infection control measures on a hospital outbreak of methicillin-resistant Staphylococcus aureus. J Hosp Infed 2000;46:43-9.Google Scholar
333.Early, E, Batde, K, Cantwell, E, English, J, Lavin, JE, Larson, E. Effect of several interventions on the frequency of handwashing among elementary public school children. Am J Infect Control 1998;26:263-9.Google Scholar
334.Butz, AM, Larson, E, Fosarelli, R, Yolken, R. Occurrence of infectious symptoms in children in day care homes. Am J Infect Control 1990;18:347-53.Google Scholar
335.Kimel, LS. Handwashing education can decrease illness absenteeism. J Sch Nurs 1996;12:14-6,18.Google Scholar
336.Master, D, Hess Longe, S, Dickson, H. Scheduled hand washing in an elementary school population. Farn Med 1997;29:336-9.Google Scholar
337.Roberts, L, Smith, W, Jorm, L, Patel, M, Douglas, RM, McGilchrist, C. Effect of infection control measures on the frequency of upper respiratory infection in child care: a randomized, controlled trial. Pediatrics 2000;105:738-42.Google Scholar
338.Roberts, LJorm, L, Patel, M, Smith, W, Douglas, RM, McGilchrist, C. Effect of infection control measures on the frequency of diarrheal episodes in child care: a randomized, controlled trial. Pediatrics 2000;105:743-6.Google Scholar
339.Khan, MU. Interruption of shigellosis by handwashing. Trans R Soc Trop Med Hyg 1982;76:164-8.Google Scholar
340.Shahid, NS, Greenough, WB, Samadi, AR, Huq, MI, Rahman, N. Hand washing with soap reduces diarrhoea and spread of bacterial pathogens in a Bangladesh village. J Diarrhoeal Dis Res 1996;14:85-9.Google Scholar
341.Stanton, BF, Clemens, JD. An educational intervention for altering water-sanitation behaviors to reduce childhood diarrhea in urban Bangladesh. Am J Epidemiol 1987;125:292–301.Google Scholar
342.McGinley, KJ, Larson, ELLeyden, JJ. Composition and density of microflora in the subungual space of the hand. J Clin Microbiol 1988;26:950-3.Google Scholar
343.Hedderwick, SA, McNeil, SALyons, MJ, Kauffman, CA. Pathogenic organisms associated with artificial fingernails worn by healthcare workers. Infect Control Hosp Epidemiol 2000;21:505-9.Google Scholar
344.Baumgardner, CA, Maragos, CS, Larson, EL. Effects of nail polish on microbial growth of fingernails: dispelling sacred cows. AORN J 1993;58:84-8.Google Scholar
345.Wynd, CASamstag, DE, Lapp, AM. Bacterial carriage on the fingernails of OR nurses. AORN J 1994;60:796–805.Google Scholar
346.Gross, ACutright, DE, D'Allessandro SM. Effect of surgical scrub on microbial population under the fingernails. Am J Surg 1979;138:463-7.Google Scholar
347.Pottinger, J, Burns, S, Manske, C. Bacterial carriage by artificial versus natural nails. Am J Infect Control 1989;17:340-4.Google Scholar
348.McNeil, SAFoster, CL, Hedderwick, SA, Kauffman, CA. Effect of hand cleansing with antimicrobial soap or alcohol-based gel on microbial colonization of artificial fingernails worn by health care workers. Clin Infect Dis 2001;32:367-72.Google Scholar
349.Rubin, DM. Prosthetic fingernails in the OR. AORN J 1988;47:944-5,948.Google Scholar
350.Moolenaar, RL, Crutcher, M, San Joaquin, VH, et al. A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hosp Epidemiol 2000;21:80-5.Google Scholar
351.Passaro, DJ, Waring, L, Amstrong, R, et al. Postoperative Serratia marcescens wound infections traced to an out-of-hospital source. J Infect Dis 1997;175:992-5.CrossRefGoogle Scholar
352.Foca, M, Jakob, K, Whittier, S, et al. Endemie Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 2000;343:695–700.Google Scholar
353.Parry, MF, Grant, B, Yukna, M, et al. Candida osteomyelitis and diskitis after spinal surgery: an outbreak that implicates artificial nail use. Clin Infect Dis 2001;32:352-7.Google Scholar
354.Garner, JS, Simmons, BE, Guideline for isolation precautions in hospitals. Infect Control 1983;4(suppl 4):245–325.Google Scholar
355.CDC. Recommendations for prevention of HIV transmission in healthcare settings: MMWR 1987;36(suppl 2S):3S–18S.Google Scholar
356.Occupational Safety and Health Administration. 29 CFR Part 1910.1030. Occupational exposure to bloodborne pathogens: final rule. Federal Register 1991;29 CFR Part 1910:1030.Google Scholar
357.Hartstein, AI, Denny, MAMorthland, VH, LeMonte, AM, Pfaller, MAControl of methicillin-resistant Staphylococcus aureus in a hospital and an intensive care unit. Infect Control Hosp Epidemiol 1995;16:405-11.Google Scholar
358.Maki, DG, McCormick, RD, Zilz, MAStolz, SM, Alvarado, CJ. An MRSA outbreak in a SICU during universal precautions: new epidemiology for nosocomial MRSA downside for universal precautions [Abstract 473]. In: Program and abstracts of the 30th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology, 1990.Google Scholar
359.Kotilainen, HRBrinker, JE, Avato, JL, Gantz, NM. Latex and vinyl examination gloves: quality control procedures and implications for health care workers. Arch Intern Med 1989;149:2749-53.Google Scholar
360.Reingold, ALKane, MA. Hightower, AW. Failure of gloves and other protective devices to prevent transmission of hepatitis B virus to oral surgeons. JAMA 1988;259:2558-60.Google Scholar
361.Korniewicz, DM, Laughon, BE, Butz, A, Larson, E. Integrity of vinyl and latex procedures gloves. Nurs Res 1989;38:144-6.Google Scholar
362.DeGroot-Kosolcharoen, J, Jones, JM. Fermeability of latex and vinyl gloves to water and blood. Am J Infect Control 1989;17:196–201.Google Scholar
363.Korniewicz, DM, Kirwin, M, Cresci, K, Markut, C, Larson, E. In-use comparison of latex gloves in two high-risk units: surgical intensive care and acquired immunodeficiency syndrome. Heart Lung 1992;21:81-4.Google Scholar
364.Korniewicz, DM, Kirwin, M, Cresci, K, et al. Barrier protection with examination gloves: double versus single. Am J Infect Control 1994;22:12-5.Google Scholar
365.Sistrom, MG, Muto, CA, Neal, J, Strain, BA, Farr, BM. Glove leakage rates as a function of latex content and brand: caveat emptor [Abstract 24]. In: Program and abstracts of the 10th Annual Meeting of Society of Healthcare Epidemiology of America. Orlando, Florida, 1998.Google Scholar
366.Flanagan, H, Farr, B. Continued evaluation of glove leakage rates at the University of Virginia. Presented at the 11th Annual Meeting of the Society for Healthcare Epidemiology of America. Toronto, Canada, April 1, 2001.Google Scholar
367.Korniewicz, DM, Laughon, BE, Cyr, WH, Lyde, CD, Larson, E. Leakage of virus through used vinyl and latex examination gloves. J Clin Microbiol 1990;28:787-8.Google Scholar
368.Rego, ARoley, L. In-use barrier integrity of gloves: latex and nitrile superior to vinyl. Am J Infect Control 1999;27:405-10.Google Scholar
369.Fisher, MD, Reddy, VR. Williams, FM, Un, KY, Thacker, JG, Edlich, RF. Biomechanical performance of powder-free examination gloves. J Emerg Med 1999;17:1011-8.Google Scholar
370.Edlich, RF, Suber, F, Neal, JG, Jackson, EM, Williams, FM. Integrity of powder-free examination gloves to bacteriophage penetration. J Biomed Mater Res 1999;48:755-8.Google Scholar
371.Murray, CABurke, FJT, McHugh, S. An assessment of the incidence of punctures in latex and non-latex dental examination gloves in routine clinical practice. Br Dental Journal 2001;190:377-80.Google Scholar
372.Jones, RD, Jampani, H, Mulberry, G, Rizer, RL. Moisturizing alcohol hand gels for surgical hand preparation. AORN J 2000;71:584-99.Google Scholar
373.Patterson, JE, Vecchio, J, Pantelick, EL, et al. Association of contaminated gloves with transmission oiAcinetobacter calcoaceticus var. antitratus in an intensive care unit. Am J Med 1991;91:479-83.CrossRefGoogle Scholar
374.Lowbury, EJL. Aseptic methods in the operating suite. Lancet 1968;1:705-9.Google Scholar
375.Hoffman, PN, Cooke, EM, McCarville, MR, Emmerson, AM. Microorganisms isolated from skin under wedding rings worn by hospital staff. Br Med J 1985;290:206-7.Google Scholar
376.Jacobson, G, Thiele, JE, McCune, JH, Farrell, LD. Handwashing: ringwear-ing and number of microorganisms. Nurs Res 1985;34:186-8.Google Scholar
377.Hayes, RATrick, WE, Vernon, MO, et al. Ring use as a risk factor (RF) for hand colonization in a surgical intensive care unit (SICU) [Abstract K-1333]. In: Program and abstracts of the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology, 2001.Google Scholar
378.Salisbury, DM, Huffilz, R, Treen, LM, Bollin, GE, Gautam, S. The effect of rings on microbial load of health care workers' hands. Am J Infect Control 1997;25:24-7.Google Scholar
379.Spire, B, Barré-Sinoussi, F, Montagnier, L, Chermann, JC. Inactivation of lymphadenopathy associated virus by chemical disinfectants. Lancet 1984;2:899–901.Google Scholar
380.Martin, LS, McDougal, JS, Loskoski, SL. Disinfection and inactivation of the human T lymphotropic virus type III/lymphadenopathy-associated virus. J Infect Dis 1985;152:400-3.Google Scholar
381.Resnick, L, Veren, K, Salahuddin, SZ, Tondreau, S, Markham, PD. Stability and inactivation of HTLV-III/LAV under clinical and laboratory environments. JAMA 1986;255:1887-91.Google Scholar
382.van Bueren, J, Larkin, DP, Simpson, RA. Inactivation of human immunodeficiency virus type 1 by alcohols. J Hosp Infect 1994;28:137-48.Google Scholar
383.Montefiori, DC, Robinson, WE Jr, Modliszewski, A, Mitchell, WM. Effective inactivation of human immunodeficiency virus with Chlorhexidine antiseptics containing detergents and alcohol. J Hosp Infect 1990;15:279-82.Google Scholar
384.Wood, APayne, D. The action of three antiseptics/disinfectants against enveloped and non-enveloped viruses. J Hosp Infect 1998;38:283-95.Google Scholar
385.Harbison, MAHammer, SM. Inactivation of human immunodeficiency virus by Betadine products and Chlorhexidine. J Acauir Immune Defic Syndr 1989;2:16–20.Google Scholar
386.Lavelle, GC, Gubbe, SL, Neveaux, JL, Bowden, BJ. Evaluation of an antimicrobial soap formula for virucidal efficacy in vitro against human immunodeficiency virus in a blood-virus mixture. Antimicrob Agents Chemother 1989;33:2034-6.Google Scholar
387.Bond, WW, Favero, MS, Petersen, NJ, Ebert, JW. Inactivation of hepatitis B virus by intermediate-to-high level disinfectant chemicals. J Clin Microbiol 1983;18:535-8.Google Scholar
388.Kobayashi, H, Tsuzuki, M, Koshimizu, K, et al. Susceptibility of hepatitis B virus to disinfectants or heat. J Clin Microbiol 1984;20:214-6.Google Scholar
389.Kurtz, JB. Virucidal effect of alcohols against echovirus 11 [Letter]. Lancet 1979;1:496-7.Google Scholar
390.Sattar, SARaphael, RA, Lochnan, H, Springthorpe, VS. Rotavirus inactivation by chemical disinfectants and antiseptics used in hospitals. Can J Microbiol 1983;29:1464-9.Google Scholar
391.Larson, E, Silberger, M, Jakob, K, et al. Assessment of alternative hand hygiene regimens to improve skin health among neonatal intensive care unit nurses. Heart Lung 2000;29:136-42.Google Scholar
392.Gould, D, Chamberlain, A. The use of a ward-based educational teaching package to enhance nurses' compliance with infection control procedures. J Clin Nursing 1997;6:55–67.Google Scholar
393.Aspöck, C, Koller, W. A simple hand hygiene exercise. Am J Infect Control 1999;27:370-2.Google Scholar
394.McGuckin, M, Waterman, R, Porten, L, et al. Patient education model for increasing handwashing compliance [Practice forum]. Am J Infect Control 1999;27:309-14.Google Scholar
395.Khatib, M, Jamaleddine, G, Abdallah, A, Ibrahim, Y. Hand washing and use of gloves while managing patients receiving mechanical ventilation in the ICU. Chest 1999;116:172-5.Google Scholar
396.Haley, RW, Bregman, DA. The role of understaffing and overcrowding in recurrent outbreaks of staphylococcal infection in a neonatal special-care unit. J Infect Dis 1982;145:875-85.Google Scholar
397.Pittet, D, Boyce, JM. Hand hygiene and patient care: pursuing the Semmelweis legacy. Lancet Infectious Diseases 2001 April:9-20.Google Scholar
398.Boyce, JM. Scientific basis for handwashing with alcohol and other waterless antiseptic agents. In: Rutala, WA, ed. Disinfection, Sterilization and Antisepsis: Principles and Practices in Healthcare Facilities. Washington, DC: Association for Professionals in Infection Control and Epidemiology, Inc., 2001.Google Scholar
399.O'Boyle, CA, Henly, SJ, Duckett, LJ. Nurses' motivation to wash their hands: a standardized measurement approach. Applied Nursing Research 2001;14:136-45.Google Scholar
400.Semmelweis, IEDie adiologie, der begriff und die prophylaxis des kindbettfiebers. Pest, Wien und Leipzig: CA Hartleben's Verlags-Expedition 1861.Google Scholar
401.Eggimann, EHarbarth, S, Constantin, MN, Touveneau, S, Chevrolet, JC, Pittet, D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 2000;355:1864-8.Google Scholar
402.Bull, DANeumayer, LA, Hunter, GC, et al. Improved sterile technique diminishes the incidence of positive line cultures in cardiovascular patients. J Surgical Research 1992;52:106-10.Google Scholar
403.Hirschmann, H, Fux, L, Podusel, J, et al. The influence of hand hygiene prior to insertion of peripheral venous catheters on the frequency of complications. J Hosp Infect 2001;49:199–203.Google Scholar
404.Drusin, LM, Sohmer, M, Groshen, SL, Spiritos, MD, Senterfit, LB, Christenson, WN. Nosocomial hepatitis A infection in a paediatric intensive care unit. Arch Dis Child 1987;62:690-5.Google Scholar
405.Doebbeling, BN, Li, N, Wenzel, RP. An outbreak of hepatitis A among health care workers: risk factors for transmission. Am J Public Health 1993;83:1679-84.Google Scholar
406.Standaert, SM, Hutcheson, RH, Schaffher, W. Nosocomial transmission of Salmonella gastroenteritis to laundry workers in a nursing home. Infect Control Hosp Epidemiol 1994;15:22-6.Google Scholar
407.Rodriguez, EM, Parrott, C, Rolka, H, Monroe, SS, Dwyer, DM. An outbreak of viral gastroenteritis in a nursing home: importance of excluding ill employees. Infect Control Hosp Epidemiol 1996;17:587-92.Google Scholar
408.Schaffner, W, Lefkowitz, LB Jr, Goodman, JS, Koenig, MG. Hospital outbreak of infections with group a streptococci traced to an asymptomatic anal carrier. N Engl J Med 1969;280:1224-5.Google Scholar
409.Viglionese, ANottebart, VF, Bodman, HAPlatt, R. Recurrent group A streptococcal carriage in a health care worker associated with widely separated nosocomial outbreaks. Am J Med 1991;91(suppl 3B):329S–33S.Google Scholar
410.Ojajärvi, J. An evaluation of antiseptics used for hand disinfection in wards. J Hyg (Land) 1976;76:75–82.Google Scholar
411.Mermel, LAJosephson, SL, Dempsey, J, Parenteau, S, Perry, C Magill. Outbreak of Shigella sonnei in a clinical microbiology laboratory. J Clin Microbiol 1997;35:3163-5.Google Scholar
412.McBride, ME. Microbial flora of in-use soap products. Appl Environ Microbiol 1984;48:338-41.Google Scholar
413.Kabara, JJ, Brady, MB. Contamination of bar soaps under “in use” condition. J Environ Pathol Toxicol Oncol 1984;5:1–14.Google Scholar
414.Heinze, JE, Yackovich, E. Washing with contaminated bar soap is unlikely to transfer bacteria. Epidem Inf 1988;101:135–42.Google Scholar
415.Bannan, FAJudge, LE. Bacteriological studies relating to handwashing: 1. the inability of soap bars to transmit bacteria. Am J Public Health 1965;55:915-21.Google Scholar
416.Field, EAMcGowan, P, Pearce, PK, Martin, MV. Rings and watches: should they be removed prior to operative dental procedures? J Dent 1996;24:65-9.Google Scholar
417.Lowbury, EJL, Lilly, HAGloved hand as applicator of antiseptic to operation sites. Lancet 1975;2:153-6.Google Scholar
418.AORN Recommended Practices Committee. Recommended practices for surgical hand scrubs. AORN J 1999;69:842-50.Google Scholar
419.Grohskopf, LARoth, VR, Feikin, DR, et al. Serratia liquefaciens bloodstream infections from contamination of epoetin alfa at a hemodialysis center. N Engl J Med 2001;344:1491-7.Google Scholar
420.Dharan, S, Hugonnet, S, Sax, H, Pittet, D. Evaluation of interference of a hand care cream with alcohol-based hand disinfection. Occup Environ Dermatol 2001;49:81-4.Google Scholar
421.Heeg, EDoes hand care ruin hand disinfection? J Hosp Infect 2001;48(suppl A) :S37–S39.Google Scholar
422.McGuckin, M, Waterman, R. Starr, J, et al. Evaluation of a patient-empowering hand hygiene programme in the U.K. J Hosp Infed 2001;48:222-7.Google Scholar
423.Girou, E, Oppein, F. Handwashing compliance in a French university hospital: new perspective with the introduction of hand-rubbing with a waterless alcohol-based solution. J Hosp Infect 2001;48(suppl A):S55–S57.Google Scholar