Evaluation of a benzalkonium chloride hand sanitizer in reducing transient Staphylococcus aureus bacterial skin contamination in health care workers

Abstract

Background: This study was performed to evaluate the effectiveness of a new commercially available hand sanitizer using 0.12% benzalkonium chloride (BZK) as the active ingredient in reducing transient skin contamination with Staphylococcus aureus in health care workers (HCWs), as compared with the effectiveness of a 70% ethanol-based hand sanitizer. Methods: Fingertip touch culture plates were obtained from 40 HCWs in which all HCWs used antimicrobial soap containing 0.6% chloroxylenol for handwashing according to the Centers for Disease Control and Prevention guidelines for the entire study, while continuing to use the 70% ethanol-based hand sanitizer according to the Centers for Disease Control and Prevention guidelines for the first week. After the first week, the test subjects used the BZK hand sanitizer in place of the ethanol sanitizer. A paired sample t test was conducted to compare the mean bacterial colonies grown from HCWs fingertips during the use of the BZK and ethanol hand sanitizer. Results: The results showed a significant reduction in total bacterial colony counts of S aureus during the week of BZK use as compared with the week of 70% ethanol sanitizer use. Conclusions: There was a significant decrease in transient S aureus on the fingertips of HCWs in the BZK hand sanitizer use week as compared with the 70% ethanol hand sanitizer use week.

Alcohol-free hand sanitizer and other quaternary ammonium disinfectants quickly and effectively inactivate SARS-CoV-2

“…Since alcohol-based hand sanitizer is the only type recommended by the CDC and also the only type given expedited manufacturing approval by the U.S. Food and Drug administration, alcohol hand sanitizer has overwhelmingly been the dominant choice for SARS-CoV-2 control in the U.S., leading J o u r n a l P r e -p r o o f to acute supply shortages in the U.S. and elsewhere (3,9). However, benzalkonium chloride has several advantages over alcohol for hand disinfection: it is non-toxic, less irritating to skin, and non-flammable (10). In fact, switching from alcohol to benzalkonium chloride hand sanitizer can lead to better hand hygiene compliance from healthcare workers, possibly decreasing overall viral contamination of their hands (10).…”

Determining the efficacy of hand sanitizers against virulent nosocomial infections

“…The mechanism of action of BAC is related to its ability to penetrate the bacterial cell wall that leads to damage and loss of cell membrane integrity. This leads to leakage of molecular components, and eventual cell wall lysis [10]. Alcohol's antimicrobial effect stems from its ability to denature proteins.…”

“…Alcohol's antimicrobial effect stems from its ability to denature proteins. Concentrations between 60-95% are most effective with higher concentrations losing potency because of the necessity to have water with the alcohol to be most effective [10]. Alcohol is effective at killing microbes present on the skin but has no lasting effect.…”

“…Benzalkonium chloride (BAC) is the active ingredient contained in most alcohol-free hand sanitizer products available today. It has been theorized that BAC possesses an extended killing time of bacteria when the solution has dried compared to alcoholbased agents [7][8][9][10].…”

Greener options – a guide to hand sanitisers

“…One of the most common active ingredients in alcohol-free formulations is benzalkonium chloride 1. It has been shown to be an effective steriliser, and showed better results than an 70 per cent ethanol alternative in a study by Bondurant and others in 2019 2. Benzalkonium chloride is commonly used in pharmaceutical products and antibacterial soaps, as well as in the food industry 3.…”