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PubMedDate not supplied

The efficacy of alcohol-based hand disinfectant products.

Over the last few years alcohol-based hand disinfectants have become widely available within health care, providing an alternative means of achieving good hand decontamination. In the hospital setting their advantage over soap and water is that they can be applied in transit to the next patient or task and therefore may help improve compliance with hand decontamination. Within the community setting they provide a suitable alternative to handwashing, particularly where there may be inadequate handwashing facilities. This article considers some issues around their use, namely indications for use, efficacy, and potential for skin damage.

Alcohols↗
PubMed2003

Comparison of two test methods for the determination of sufficient antimicrobial activity of three commonly used alcohol-based hand rubs for hygienic hand disinfection.

In Europe, the antimicrobial efficacy of alcohol-based hand rubs is determined with a quantitative suspension test (prEN 12054) and a test under practical conditions (EN 1500). Another test method has recently been published by the German Society for Hygiene and Microbiology (DGHM) with four differences to the European system in the in vitro tests: additional qualitative suspension tests with product dilutions to the ineffective range; a selection of the most resistant Gram-negative test strains in the qualitative suspension test, which should be used adjacent to Pseudomonas aeruginosa in the quantitative suspension test; a high organic load in the quantitative suspension tests (0.3% albumin and 0.3% sheep erythrocytes); and an aqueous control in the quantitative suspension test. According to DGHM, the in vitro tests should be followed by EN 1500. We have determined the antimicrobial efficacy of three commonly used alcohol-based hand rubs according to both methods. prEN 12054 was carried out without organic load. The qualitative suspension tests (DGHM) were carried out with P. aeruginosa, Escherichia coli, Proteus mirabilis, Staphylococcus aureus, Enterococcus hirae and Candida albicans. The quantitative suspension test (DGHM) was carried out with product dilutions of 75%, 50% and 25%, and a high organic load using the following test organisms: P. aeruginosa, P. mirabilis (one product only), S. aureus, E. hirae and C. albicans. All these suspension tests were carried out in quadruplicate with each product and exposure time. EN 1500 was carried out with 3 mL of each product and an application time of 30 s. All three products achieved the required bactericidal activity of prEN 12054 and the new DGHM method within 30 s, and were equally effective with the reference hand disinfection of EN 1500 within 30 s. In our study, the DGHM test method did not provide additional information for hand rubs which exhibit their bactericidal efficacy with 3 mL within 30 s (EN 1500).

Alcohols↗
PubMed1988

A laboratory model for testing agents for hygienic hand disinfection: handwashing and chlorhexidine for the removal of klebsiella.

A model for the laboratory assessment of hygienic hand disinfection is described which closely reproduces handwashing in a ward setting. The model uses a clinically relevant test organism and takes into account the natural antibacterial action of the skin. It also provides a means of measuring any residual antibacterial action after hand disinfection. Using an epidemic multiply-resistant strain of Klebsiella aerogenes K21, 0.5% chlorhexidine in iso-propyl alcohol yielded sterile post-disinfection finger washings more often than 4% chlorhexidine digluconate. Both preparations were more effective than soap and water, and with each residual action was demonstrable. The model is applicable to the laboratory evaluation of hygienic hand procedures and for agents of potential use in defined clinical settings.

1-Propanol↗
PubMed2006

Skin condition associated with intensive use of alcoholic gels for hand disinfection: a combination of biophysical and sensorial data.

Although hand hygiene is an important and inexpensive measure to prevent nosocomial infections in clinical settings, the compliance of healthcare workers remains low. In Europe, alcoholic hand disinfection is first choice, but there exists a limited user acceptability due to estimated adverse effects on skin condition. This study was designed to investigate skin tolerance to alcohol-based disinfecting gels and changes in skin condition depending on humectant concentration, alcohol grades, as well as type of alcohol used. A comparison of 6 alcohol-based gels was made based on a randomized double-blind study under in use conditions for 1 day. Skin condition was evaluated by measuring transepidermal water loss (TEWL), stratum corneum hydration, apparent skin pH, redness and degree of scaliness. With respect to user acceptability, all gels were sensorially evaluated using a questionnaire. We saw that none of the alcohol-based gels, applied under in use conditions, altered TEWL or caused irritation. All gels hydrated the skin, proportionally to their glycerine content, and decreased skin pH. Elevated ethanol concentrations resulted in increased scaliness. Sensorial assessment revealed less appreciation for isopropanol. From this study, it was concluded that gels containing an elevated glycerine concentration and 70% (v/v) ethanol are preferred.

Adult↗
PubMed1975

[Test methods for surgical hand disinfection (author's transl)].

As exemplified by a test preparation, methods for assessing the effect of hand disinfection on the resident flora are put up for discussion. The test of a method for hand disinfection must make allowance for conditions prevailing in practice. Accordingly, the following steps should be taken into consideration: A. Single use 1. Immediate disinfecting effect 2. Duration of the disinfecting effect B. Repeated use 3. Course of the initial colony count 4. Immediate disinfecting effect 5. Behaviour of colony count after interruption of the disinfecting method applied. For the purpose of comparing the total count, as with all other disinfecting methods, the colony count must be determined by fractional collection methods; to this end, Traub's procedure may be modified, possibly using the plastic bag method described by Gaschen. A careful statistical evaluation with appropriate transformation of the results is indispensable.

Bacteria↗
PubMed2004

[Hand disinfection and cross-infection countermeasures].

Methicillin-resistant Staphylococcus aureus (MRSA) causes droplet infection and contact infection, and therefore when taking measures against cross-infection it is preferable to take even stricter action than for other bacteria. The basic policies for preventing cross-infection require measures that assume the presence of MRSA until the results of bacterial testing are reported if discharge from the patient is noted. To prevent cross-infection, it is not sufficient simply to enforce strict disinfecting of the hands. It is necessary to establish a manual of measures to deal with situations at different posts.

Cross Infection↗
PubMed2001

[Evaluation of efficacy of selected antiseptics for hands disinfection before surgical procedures].

The most important in surgical hands washing and disinfections is long-term and effective reduction of bacteria number. The aim of this study was to compare the efficiency of some antiseptic fluids used for surgical hands disinfection's (AHD 2000, Biotensid, Manopronto and Medi-Scrub PVP Iodine). 62 doctors and surgical nurses were examined. The material for the bacteriological examination was collected before and after hands disinfection's. The bacterial flora reduction have been presented as a percent and a logarithmic reduction ratio. All estimated antiseptic fluids were very potent and provided prolonged efficiency when the operation team complied with orders of hands washing.

Anti-Infective Agents, Local↗
PubMed1984

[Surgical hand disinfection using alcoholic rubbing disinfectants].

Since 1965, besides the use of scrubbing disinfectants, a number of alcoholic handrub methods are employed in the surgical skin disinfection of the hands. These contain, in addition to the alcohols, substances such as phenols and among others, cation-active substances. The efficacy of the substances is examined by means of in vitro-tests and through investigations conducted under conditions approximating those in the practice in accordance with the guidelines set down by the German Society of Hygiene and Microbiology. The comparison between the alcohol-containing handrub disinfectants and the scrubbing methods indicates clearly that the latter achieve only a low germ-reduction effect. The investigation on 4 alcoholic handrub disinfectants showed an initial potent germ-reducing and a good long-term effect. When mechanical scrubbing of the hands is carried out in a timely relationship to the application of the handrub -method, it is found to be able to produce extensive dermal damages. The reduction in the transient microbial flora by means of the mechanical hand scrubbing is minimal. The study on the germ-reduction after surgical disinfection of the hands using alcoholic handrub disinfectants in combination with and without initial soap-scrubbing demonstrated no differences, neither in the number of sterile hands nor in the averages of germ-reduction. The investigations conducted confirmed the excellent efficacy of the alcoholic handrub disinfectants and pointed out that it is unnecessary to combine mechanical hand scrubbing and the employment of alcoholic disinfectants in the same process.

Alcohols↗