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

Abstract

A patient contact model was devised for health care workers (HCWs) to define heavy hand contamination with aerobic gram-negative bacilli (AGNB) that requires alcohol for complete removal. In patients, AGNB quantitation was per ml cup scrub fluid; in HCWs per ml glove juice. Following 15-second contact, two Proteeae groin carriers yielding greater than or equal to 4 log10 AGNB (high burden) transmitted greater than or equal to 3 log10 in 67% of 24 tests of six HCWs, and less than or equal to 2 log10 in 29%. Two carriers yielding less than or equal to 3 log10 in 38%. At less than or equal to 2 log10 HCW acquisitions, soap eliminated all AGNB in three of 10; alcohol in eight of eight (p = 0.009). Contact with densely colonized patient skin may cause heavy AGNB contamination of HCWs' hands that generally necessitates alcohol for complete removal.

Epidemia de neumonía asociada a ventilación mecánica en Mérida, Yucatán

“…Ya se ha descrito previamente que en una unidad de cuidados intensivos la carga bacteriana en las manos del personal puede ser considerable, además de representar el mecanismo principal de contaminación cruzada dentro de la unidad. 6,7 La desinfección de cánulas endotraqueales y circuitos respiratorios con cloruro de benzalconio fue otro factor que probablemente contribuyó a la adquisición de NAV. Ha quedado claramente demostrado que el cloruro de benzalconio es un desinfectante de bajo nivel, inapropiado para procesar equipo de terapia respiratoria.…”