Indications for Alcohol or Bland Soap in Removal of Aerobic Gram-Negative Skin Bacteria: Assessment by a Novel Method

Eckert, Debra G.; Ehrenkranz, N. Joel; Alfonso, Blanca C.

doi:10.1086/646033

Cited by 19 publications

(8 citation statements)

References 16 publications

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“…Isopropanol at 60 to 70% was found to be necessary for removal of aerobic gram-negative bacteria from hands, whereas a simple hand wash with soap was inadequate (125). Transmission of gram-negative bacteria was also significantly better interrupted by propanol than by a social hand wash following brief contact with a heavily contaminated patient source (129).…”

Section: Ethanol Isopropanol and N-propanolmentioning

confidence: 96%

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

2004

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The etiology of nosocomial infections, the frequency of contaminated hands with the different nosocomial pathogens, and the role of health care workers' hands during outbreaks suggest that a hand hygiene preparation should at least have activity against bacteria, yeasts, and coated viruses. The importance of efficacy in choosing the right hand hygiene product is reflected in the new Centers for Disease Control and Prevention guideline on hand hygiene (J. M. Boyce and D. Pittet, Morb. Mortal. Wkly. Rep. 51:1-45, 2002). The best antimicrobial efficacy can be achieved with ethanol (60 to 85%), isopropanol (60 to 80%), and n-propanol (60 to 80%). The activity is broad and immediate. Ethanol at high concentrations (e.g., 95%) is the most effective treatment against naked viruses, whereas n-propanol seems to be more effective against the resident bacterial flora. The combination of alcohols may have a synergistic effect. The antimicrobial efficacy of chlorhexidine (2 to 4%) and triclosan (1 to 2%) is both lower and slower. Additionally, both agents have a risk of bacterial resistance, which is higher for chlorhexidine than triclosan. Their activity is often supported by the mechanical removal of pathogens during hand washing. Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all. In the new Centers for Disease Control and Prevention guideline, promotion of alcohol-based hand rubs containing various emollients instead of irritating soaps and detergents is one strategy to reduce skin damage, dryness, and irritation. Irritant contact dermatitis is highest with preparations containing 4% chlorhexidine gluconate, less frequent with nonantimicrobial soaps and preparations containing lower concentrations of chlorhexidine gluconate, and lowest with well-formulated alcohol-based hand rubs containing emollients and other skin conditioners. Too few published data from comparative trials are available to reliably rank triclosan. Personnel should be reminded that it is neither necessary nor recommended to routinely wash hands after each application of an alcohol-based hand rub. Long-lasting improvement of compliance with hand hygiene protocols can be successful if an effective and accessible alcohol-based hand rub with a proven dermal tolerance and an excellent user acceptability is supplied, accompanied by education of health care workers and promotion of the use of the product

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Section: Ethanol Isopropanol and N-propanolmentioning

confidence: 96%

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

2004

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“…6,7 From laboratory investigations, the antimicrobial effect of alcohol-based handhygiene products has been documented to be superior to hand washing. 8,9 This prompted the present study to assess the comparative microbiological efficiency of hand washing (HW) and hand washing and rubbing with an alcohol-based solution (HWR) by HCWs in intensive care units (ICUs) and non-ICU areas, with specific emphasis on transient flora. The study also aimed to determine the predisposing factors for hand contamination after patient care in daily hospital practice.…”

Section: Hand Hygiene During Hospital Patient Carementioning

confidence: 99%

Evaluation of Two Different Hand Hygiene Procedures during Routine Patient Care

et al. 2010

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In this study, the antimicrobial efficacy of hand washing (HW) and hand washing plus rubbing with an alcohol-based solution (HWR) on numbers of total and transient flora colonies on the hands of healthcare workers (HCWs) during routine patient care was assessed. Samples were collected, using a standard bag broth technique, from the hands of 154 HCWs, before and immediately after carrying out a hand hygiene procedure. The numbers of total and transient flora colonies per plate were counted and transient pathogens were identified. A significant statistical difference between ward speciality was detected with respect to the isolation rate of transient flora. Transient hand flora were recovered from 25.3% of HCWs before carrying out the hand hygiene procedure. With respect to the disappearance and prevention of regrowth of transient flora after hand hygiene, the HWR technique was significantly more effective than HW. In conclusion, a disinfectant should be added to the hand washing process to achieve optimum protection against nosocomial infections in routine hospital practice.

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“…16,[18][19][20] In the first set, hand hygiene was not standardized and paired hand samples of 60 employees were collected. In the second set, hand hygiene was standardized and paired hand samples from 20 randomly chosen employees were collected.…”

Section: Bacteriological Sampling From Hands Of Personnelmentioning

confidence: 99%

“…From laboratory investigations, the antimicrobial effect of alcoholbased hand-hygiene products is documented to be superior to handwashing. [14][15][16][17] If the effectiveness of the method is confirmed in a practical ICU setting, the simplicity of the method should encourage the widespread use of hand disinfection. The aim of this study was therefore to investigate the use of hand disinfection in an ICU and to evaluate the effectiveness of the method in a practical setting.…”

Section: Introductionmentioning

confidence: 99%

Alcohol-based hand disinfection: a more robust hand-hygiene method in an intensive care unit

Tvedt

Bukholm

2005

Journal of Hospital Infection

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Indications for Alcohol or Bland Soap in Removal of Aerobic Gram-Negative Skin Bacteria: Assessment by a Novel Method

Cited by 19 publications

References 16 publications

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

Evaluation of Two Different Hand Hygiene Procedures during Routine Patient Care

Alcohol-based hand disinfection: a more robust hand-hygiene method in an intensive care unit

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