Antimicrobial efficacy of alcohol-based hand gels with a 30-s application

Prado, Maria Fernanda do; Coelho, Ana Carolina; Brito, J.P.B. de; Ferreira, D.O.; Júnior, Ansaldi; Menecucci, Carolina da Silva; Queiroz, A.B. de; Garcia, Lourdes Botelho; Cardoso, Celso Luíz; Tognim, Maria Cristina Bronharo

doi:10.1111/j.1472-765x.2012.03240.x

Cited by 6 publications

(2 citation statements)

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“…In a nutshell, HCWs typically prefer one to the other based on their personal experience, and not following evidence-based research [ 20 – 24 ], nonetheless, such currently is almost non-existent. Our present-day knowledge concludes that the antibacterial efficiency of the gels and liquid ABHRs is equal, at least in an in vitro setting [ 25 , 26 ]. Due to their physical properties, liquids can spread faster, yet they are prone to spillage (causing material waste).…”

Section: Introductionmentioning

confidence: 99%

Evidence-based hand hygiene: Liquid or gel handrub, does it matter?

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Veres

et al. 2023

Antimicrob Resist Infect Control

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Background Recent studies put under scrutiny the prevailing hand hygiene guidelines, which incorporate quantitative parameters regarding handrub volume and hand size. Understanding the criticality of complete (i.e., efficient) hand hygiene in healthcare, objectivization of hand hygiene related parameters are paramount, including the formulation of the ABHR. Complete coverage can be achieved with optimal Alcohol-Based Hand Rub (ABHR) provided. The literature is limited regarding ABHR formulation variances to antimicrobial efficiency and healthcare workers’ preference, while public data on clinically relevant typical application differences is not available. This study was designed and performed to compare gel and liquid format ABHRs (the two most popular types in Europe) by measuring several parameters, including application time, spillage and coverage. Methodology Senior medical students were invited, and randomly assigned to receive pre-determined ABHR volumes (1.5 or 3 ml). All the 340 participants were given equal amounts of gel and liquid on two separate hand hygiene occasions, which occurred two weeks apart. During the hand hygiene events, by employing a digital, fully automated system paired with fluorescent-traced ABHRs, disinfectant hand coverage was objectively investigated. Furthermore, hand coverage in relation to the participants’ hand sizes was also calculated. Additional data collection was performed regarding volume differences and their effect on application time, participants’ volume awareness (consciousness) and disinfectant spillage during the hand hygiene events. Results The 1.5 ml ABHR volume (commonly applied in healthcare settings) is insufficient in either formulation, as the non-covered areas exceeded significant (5%+) of the total hand surface area. 3 ml, on the contrary, resulted in almost complete coverage (uncovered areas remained below 1.5%). Participants typically underestimated the volume which they needed to apply. While the liquid ABHR spreads better in the lower, 1.5 ml volume compared to the gel, the latter was easier handled at larger volume. Drying times were 30/32 s (gel and liquid formats, respectively) when 1.5 ml handrub was applied, and 40/42 s when 3 ml was used. As the evaporation rates of the ABHR used in the study are similar to those available on the market, one can presume that the results presented in the study apply for most WHO conform ABHRs. Conclusion The results show that applying 1.5 ml volume was insufficient, as large part of the hand surface remained uncovered (7.0 ± 0.7% and 5.8 ± 1.0% of the hand surface in the case of gel and liquid, respectively) When 3 ml handrub was applied drying times were 40 and 42 s (gel and liquid, respectively), which is a very long time in daily clinical practice. It looks like we cannot find a volume that fits for everyone. Personalized, hand size based ABHR volumes may be the solution to find an optimal balance between maximize coverage and minimise spillage and drying time. 3 ml can be a good volume for those who have medium size hands. Large handed people should use more handrub to reach appropriate coverage, while small-handed ones may apply less to avoid massive spillage and not to take unrealistically long to dry.

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Section: Introductionmentioning

confidence: 99%

Evidence-based hand hygiene: Liquid or gel handrub, does it matter?

Voniatis

Bánsághi

Veres

et al. 2023

Antimicrob Resist Infect Control

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“…The use of alcohol-based products (including those with reduced alcohol content [11]), for skin disinfection continue to attract clinical and commercial attention [12][13][14][15][16]. However, the generic use of 70% alcohol formulations for hard surface cleaning and microbial bioburden removal across several industries appears to be informed by tradition and not by robust research evidence.…”

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confidence: 97%

Use of 70% Alcohol for the Routine Removal of Microbial Hard Surface Bioburden in Life Science Cleanrooms

et al. 2014

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Alcohol-based disinfectants are used for the removal of microbial hard surface bioburden in Life science Cleanrooms. Evidence for using formulations containing 70% alcohol has been lost over time but probably originates from historical observations of the activity of 60-70% alcohol. Tradition is no longer adequate to inform contemporary cleaning practice. We evaluated the efficacy of ethanol, isopropanol and trade-specific denatured alcohol 7 against vegetative Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli and Enterococcus hirae using standardized European Suspension and Hard Surface tests. All three alcohols were effective at lower concentrations than the 70% standard. This constitutes the first evaluation of disinfectant formulations containing ≤70% alcohol using standard methodology. The utility of trade-specific denatured alcohol #7 and evidence-based cleanroom practice warrant further validation.

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