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PubMedDate not supplied

Compliance and efficacy of hand rubbing during in-hospital practice.

OBJECTIVE: To compare alcohol-based hand rubbing with hand washing using antimicrobial soap regarding antimicrobial efficacy and compliance with routine practice in hospital and intensive care units. SUBJECTS AND METHODS: From February to June 2003, 35 nurses were randomly selected from a nursing staff of 141 and divided into two groups: hand rubbing and hand washing groups. Hand cultures were obtained before and after health care procedures. The nurses were observed on days 1, 7 and 14 of the study, in order to determine compliance and efficacy of the hand hygiene methods. RESULTS: A total of 368 routine patient care activities were observed during the study period. Hand rubbing with alcohol-based solutions significantly reduced the bacterial contamination of the hands of the nurses more than hand washing with an antimicrobial soap (54 and 27%, respectively; p < 0.01). Compliance was also better in the hand rubbing group than in the hand washing group (72.5 and 15.4%, respectively; p < 0.001). Compliance with hand rubbing was markedly lower among the nurses who had experience of more than 3 years in hospital practice. Both hand rubbing and hand washing compliance were poorer among nurses working in intensive care units than among nurses working in the other hospital wards. Generally, after taking off gloves, nurses preferred hand washing to hand rubbing. CONCLUSION: These data indicate that alcohol-based hand rubbing reduces mean bacterial counts on the hands of nurses more effectively than hand washing with antimicrobial soaps, and compliance rates with hand rubbing were also higher than with hand washing. Nevertheless, the compliance with hand rubbing was markedly lower in more experienced nurses.

Adult↗
PubMed2007

Amuchina 10% solution, safe antiseptic for preventing infections of exit-site of Tenckhoff catheters, in the pediatric population of a dialysis program.

Although, decreasing in incidence with the disconnection systems, the first complication is still peritonitis in patients with chronic renal failure and the second is infection of Tenckhoff catheter exit-site. All efforts made to diminish the frequency of exit-site infection lower the possibility of peritonitis. The pediatric population is well-known to have a major risk of infectious complications, and making easy and safe the care of the exit-site will prevent the peritonitis that follows. The aim of the study was to evaluate the efficacy of the Amuchina 10% solution vs. pH neutral soap in children with chronic renal failure, on preventing exit-site infection. There were 60 patients who were assigned randomly to one of two groups. One group used Amuchina 10% solution for the daily cleaning of the exit-site, and the other used pH neutral soap, with 14 months of follow-up. Before the study they have to be free of infection for at least 30 days. All were taught by the same nurse how to clean their exit-site. Groups were almost identical in years, sex, and time on dialysis. We had nine infections in the soap group and none in the Amuchina 10% solution group, with an OR: 17 (p = 0.004). From these nine infections, the bacteria isolated were: 4 (13%) were caused by Pseudomona aeruginosa, 1 (3.3%) by Staphylococcus aureus, coagulase-positive staphylococci in 2 (6.6%) and Serratia marcensens in 1 (3.3%). In conclusion, Amuchina 10% solution is effective in preventing infection on the exit-site, without any secondary topical reaction.

Adolescent↗
PubMed1995

The concept of the acid mantle of the skin: its relevance for the choice of skin cleansers.

Whereas soap has long been the only cleansing agent, a new generation of cleansers, the so-called synthetic detergents or syndets, has been developed during the last decades. They offer a wide variety of formulations and are therefore becoming more and more important for cleansing of diseased and healthy skin. Among the syndets, especially those with a pH of about 5.5 seem to be relevant. In contrast to alkaline soap, they do not interfere with the cutaneous microflora, whose composition is linked to the skin surface pH. As their irritancy potential might be even lower than that of soap, the benefit-to-risk ratio of syndets appears favorable.

Acids↗
PubMed2006

Increased retest reactivity by both patch and use test with methyldibromoglutaronitrile in sensitized individuals.

Hyperreactivity on re-exposure of previous allergic contact dermatitis skin areas has been previously demonstrated. This study aimed to investigate in methyldibromoglutaronitrile (MDBGN) allergic patients whether skin with previous allergic dermatitis from MDBGN showed an augmented response on re-exposure by both a patch test challenge and a use test with a liquid soap preserved with MDBGN. MDBGN dermatitis was elicited on the back and arms of sensitized individuals. One month later the previously eczematous areas were challenged with MDBGN. On the back, the test sites were patch-tested with a serial dilution of MDBGN and a use test was performed on the arms with an MDBGN-containing soap. A statistically significant increased response was seen on the areas with previous dermatitis on the back. Eight of the nine patients who developed dermatitis on the arms from the MDBGN-containing soap had an augmented response on areas with prior allergic contact dermatitis. Even though the allergic dermatitis appeared to be healed, an increased reactivity to allergen re-exposure was demonstrated both by patch test and use test challenge.

Adult↗
PubMed1985

Influence of age, dietary cholic acid, and calcium levels on performance, utilization of free fatty acids, and bone mineralization in broilers.

The effects of age on the utilization of dietary palmitic or a 50/50 mixture of palmitic and oleic acid at the 8% inclusion level in the absence or presence of .2% cholic acid and also in the presence of low (.8%) or high (1.2%) calcium were investigated using broiler chicks from 1 to 56 days of age. Significant interactions (P less than .01) were observed between the type of fatty acid supplemented and the presence or absence of cholic acid on weight gain and feed efficiency. Supplementing diets with a mixture of equal weights of palmitic and oleic acid, reduced feed intake relative to control diets and diets supplemented with palmitic acid alone. There was an interaction between the age of the bird and the type of fatty acid supplemented on fat retention and metabolizable energy (ME) of diets (P less than .01). There was also a significant interaction between the type of fatty acid supplemented and the addition of cholic acid on fat retention and ME of diets. While cholic acid reduced soap formation during the process of digestion (P less than .05), increasing dietary calcium level increased the proportion of the digesta fat that was present as soap (P less than .01). The proportion of digesta and excreta fat, present as soap, depended on the type of fatty acid supplemented. The addition of free fatty acids to broiler diets resulted in a decrease in bone ash and bone calcium content relative to those birds fed the control diet. It is concluded that the ability of broilers to utilize dietary free fatty acids depends on the age at which they are fed, although in all cases supplemental cholic acid enhances fatty acid utilization.

Aging↗
PubMed2002

Control of Schistosoma mansoni by the soapberry Endod (Phytolacca dodecandra) in Wollo, northeastern Ethiopia: post-intervention prevalence.

OBJECTIVES: To record the effect of Endod soap and spraying of soaked Endod suspension on the prevalence of human schistosomiasis. DESIGN: A cross-sectional epidemiological study in which pre- and post-intervention parasitological results were compared. SETTING: Kemise, Bati and Harbu towns in northeastern Ethiopia. SUBJECTS: The study subjects included all members of the five per cent households systematically selected from the three towns. RESULTS: In Kemise town, where suspension of ground Endod was sprayed on the stream containing infected snails, the prevalence of the disease was reduced from 59% to 53% and the mean intensity of infection was reduced from 239 eggs per gram (EPG) of faeces to 99 EPG (p < 0.05). In Bati town where Endod soap approach was used, the respective reduction in the prevalence and intensity of infection was from 51% to 43% and from 195 EPG to 162 EPG (p < 0.05). There was also a significant reduction of the disease in the control town probably due to the effects of praziquantel treatment and other factors. CONCLUSION: The reduction achieved in the prevalence and intensity of schistosomiasis after an intervention period of four years was limited. This observation corroborates the fact that molluscicides must always be considered as supplementary to chemotherapy in the control of schistosomiasis. Although both approaches can be used, the spraying approach appears to be simpler and more feasible because two or three times yearly application of Endod suspension would suppress snail population and reduce transmission. Nevertheless, the choice as to what approach to use must be made on the basis of community preference, and for some soap-effect of Endod would be attractive

Adolescent↗
PubMedDate not supplied

Assessment of alternative hand hygiene regimens to improve skin health among neonatal intensive care unit nurses.

OBJECTIVE: The frequent handwashing and gloving required in high-risk, high-volume patient care areas such as critical care units damages skin of the hands. The purpose of this exploratory study was to compare 2 hand care regimens (traditional antiseptic wash with chlorhexidine-containing detergent versus mild soap wash with subsequent alcohol-based rinse for degerming as necessary) in a neonatal intensive care unit (NICU). DESIGN: Prospective, quasi-experimental, random assignment. SETTING: One NICU (47 beds) in a New York City children's hospital. SUBJECTS: Sixteen full-time NICU nurses. OUTCOME MEASURES: Microbial flora and skin condition of hands. INTERVENTION: Nurses were randomly assigned to one of the 2 hand care regimens. RESULTS: No significant differences in microbial counts or types of organisms from hands of staff were found, but after 2 weeks nurses in the mild soap and alcohol group had significant improvements in their skin condition (P =.005). CONCLUSIONS: Use of a mild soap for cleaning and an alcohol-based product for degerming may offer an acceptable alternative to the traditional antiseptic handwash and may reduce skin damage to health care professionals' hands.

2-Propanol↗
PubMed1975

Investigations on the efficacy of surface disinfection and surface cleaning procedures. 2. Laboratory testing of the efficacy under conditions simulating those of real-life.

Using a standardised method (impression method by means of 'Rodac' plates and glass as well as ceramic surfaces as germ carriers) we tested for the efficacy of 3 surface disinfectants (aldehydes, aldehydes + detergent substances, phenol derivatives) and 3 disinfectant cleaning agents (aldehydes + detergent substances + wax) and 2 per cent soft soap solution on Staphylococcus aureus, Klebsiella pneumoniae and Sarcina lutea. The method enabled us to calculate the actual germ count reduction and also took account of the natural dying-rate of the test organisms. Their resistance to the different types of active substances varied greatly. Thus the 3 disinfectants had a better effect on Klebsiellae and Staphylococci than on Sarcinae. 2 of the 3 disinfectant cleaning agents, on the other hand, turned out to be less suitable for the elimination of Klebsiellae. It thus follows that Sarcina cannot be used as test organism for in-use tests (see Communication 1) unless the resistance of Staphylococci and Klebsiellae to the test preparation has first been established in laboratory experiments. The general question, namely whether in-use tests provide meaningful and accurate results remain to be elucidated. On the basis of our test results, the exclusive use of soap for cleaning floors, as a substitute of disinfection, should definitely be ruled out. Although soap reduces Gram-positive cocci well in actual practice, it is almost ineffective against problem germs such as Klebsiellae. What should be stipulated is the use of broad-spectrum disinfectants, i.e. they should, if possible, act equally well against different types of germs. From the commercially-available preparations that were tested, a phenol-base product gave the best results. On the basis of these results we venture to doubt that the use of aldehyde preparations which is customary at the moment, is the right approach to fight hospital infections.

Aldehydes↗
PubMed2000

[Skin reaction after St Lucia holiday celebration].

A 37-year-old man developed contact dermatitis on the front head after being exposed to dripping candles. The candles were placed in a crown on his head as he played St. Lucia in the traditional Lucia Day (13th December) pageant, trying to entertain the administrative staff of the University of Bergen where he was employed. Afterwards he washed his head with a soap he normally did not use. Probably the contact dermatitis is a skin reaction to the soap, but it is difficult to say whether the reaction was irritative or allergic. A similar case has not been reported earlier. It is of importance that noone stops celebrating the Lucia Day. However, proper precautions must be taken, with routines for avoiding exposure to stearine or unfamiliar soaps on the head of Lucia.

Adult↗
PubMed1975

Investigations on the efficacy of surface disinfection and surface cleaning procedures. 1. Tests under real-life conditions.

The suitability of disinfection preparations is assessed on the basis of laboratory tests, different methods being used in the various countries. Since such model tests are rather inadequate when it comes to judging surface disinfectants, additional in-use tests are desirable. They might, in any case, serve as a reference system for judging the evaluation criteria which still differ widely at the moment. The experiments described in this study were chiefly designed to establish the effect of cleaning and disinfection measures on bacteria normally present on surfaces and on the artificial contamination of surfaces with Sarcinae as model germs. The tests were carried out in the halls on 5 floors of a medical (lift landings). "Rodac" plates were used to identify the germs. 3 disinfectants (aldehydes, phenol derivative), 3 disinfectant cleaning agents and soft soap were used. The preparations reduced the normal germ count by approx. 80 per cent. The reduction was mainly due to the cleaning effect (soft soap was as effective as the preparations with disinfectant properties). The effect on the "normal germ count" cannot, therefore, be used as sole criterion of disinfectant action. When the various preparations were applied in twice the concentration recommended for Staphylococcus hospitalism, the Sarcina count was reduced by 99 to 99.9 per cent within 2 hours. The efficacy of disinfectants and disinfectant cleaning agents was practically the same. Additional laboratory tests are necessary before the effect of soft soap can be finally assessed. In actual practice the unit count of pathogenic germs- such as Staphylococci and Klebsiellae- is too low to enable an objective assessment of a disinfectant to be made. On the other hand, artificial contamination with such pathogens is not possible because of the risk involved. The use of Sarcina lutea as test germ is therefore subjects to certain limitations. One of the prerequisites for using it is, for example, prior reduction of the normal germ count to values of less than 500/100 cm2. The second communication will report on investigations into the chemoresistance of Sarcina and how this compares with that of Staphylococcus aureus and Klebsiella. The need for such studies arose from our present investigation.

Cell Count↗
PubMed1975

Acne detergicans.

Popular brands of soaps and shampoos were assayed for comedogenicity in the rabbit ear. Only a small number produced hyperkeratosis when applied at a 25% concentration. Bacteriostatic substances, especially hexachlorophene, were mildly comedogenic. Conventional soaps include salts of fatty acids; the latter are known comedogens. The obsessive use of soaps by patients with acne vulgaris may aggravate the disease and result in its extension to unusual locations.

Acne Vulgaris↗
PubMedDate not supplied

Foot soaks for callosities and fissures.

A study to assess the effect of soap soaks and plain water soaks on the dry anaesthetic sole of 15 leprosy patients bearing multiple fissures and callouses is reported. A callous scraper devised by us was found effective. It is recommended that a hypotonic keratolytic solution such as toilet soap or plain water be used for soaking which has the effect of softening the keratin. It may be better to use soap solution for this purpose.

Balneology↗
PubMedDate not supplied

[New possibilities of prevention of occupational Candida albicans infection].

The effects were studied in vitro of a score of various additives to toilet soaps on strains of Candida albicans isolated from patients. Their effect on the basic properties of toilet soaps was studied, determining foam production and the index of foam stability, and their resistance to high temperature was determined since in the process of production high temperature might reduce their effects on C. albicans. The strongest fungicidal effect was exerted in strongly alkaline soap solutions by Clotrimazole. Good effects were obtained also using Clioquinol, a derivative of 8-hydroxyquinoline. The results of these studies suggest that certain substances may be added for exerting a fungicidal effect in alkaline medium protecting thus against fungal infections.

Antifungal Agents↗
PubMed1986

[Effect of a synthetic detergent (Syndet) on the pH of the skin of infants].

The long- and short-term effects on the skin of infants of a synthetic detergent (syndet) with an acid pH were investigated and compared to ordinary soap. The short-term effect was determined by measuring the skin pH on different parts of the body before and 20 min after washing with syndet. The long-term effect was tested in a second group, in which the infants were washed either with ordinary soap or with syndet for 3 days. The skin pH was measured 4-5 h after washing. The results were evaluated statistically. The results show that for a short time syndet displaces the skin pH towards acid pH in younger infants; however, the skin pH is not influenced in older infants. Syndet keeps the skin pH in the physiological range for a longer time after washing than ordinary soap.

Acid-Base Equilibrium↗
PubMed1984

Quantitative distribution of locally applied lindane in human skin and subcutaneous fat in vitro. Dependence of penetration on the applied concentration, skin state, duration of action and nature and time of washing.

Commercial concentrations of radiolabelled lindane emulsion were applied to human skin specimens. Penetration of the substance into the different layers of the skin was examined quantitatively under the common conditions of therapy, but with variation of the period of action (3, 10 and 24 h), condition of skin specimens (intact, stripped), concentration of the emulsion applied (0.3 and 1%) and washing with water only or water and soap after different periods of action (3 and 10 h) and examination at different times after the washing procedure (7 and 14 h). The flux of lindane in the skin was found to be time-dependent. Generally, the concentration increased with the depth of the layer. An increased availability of lindane (in absence of the stratum corneum, and at long application period) resulted in a preferential accumulation in the epidermis and not in the subcutaneous fat. When the intact skin had been washed with soap and water 3 h after application, the concentration of lindane found in the layer below the stratum corneum 7 h later was higher than the one found when the skin had not been washed. When intact skin had been washed after a short penetration period (3 h), this resulted in an introduction of lindane by the washing process. This effect did not occur with stripped skin. Lindane could be more efficiently removed from the stratum corneum with soap and water than with water alone. A threefold increase of the lindane concentration applied resulted in a threefold increase of the concentration in all layers of intact skin specimens. In stripped skin specimens, an increase could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1982

A method for predicting effects of military rifles.

Comparative analysis of penetration of military bullets through soap blocks and an average 220 mm long trajectory through live muscle in pigs, at 50 m range, using Yugoslav M 48 cal. 7.9 mm and M 70 cal. 7.62 mm, Belgian FAL cal. 7.62 mm and American M 16 A 1 cal. 5.56 mm rifles were performed. The volume of residual cavity in soap (Z) and the mass of surgically excised dead tissue (G) were inter-related and a power curve G = a Zb was determined, yielding a coefficient of correlation 1.00. Another series of tests using two Soviet rifles - M 1891/30 cal 7.62 mm and Dragunov cal. 7.62 mm with average trajectory length in pigs 160 mm, was effected. Applying the same regression coefficients "a" and "b" from previous studies, a prediction of G from Z was found to be correct with less than 10% error, as compared to really excised tissue by a surgeon. In conclusion, a mathematical model derived from soap tests can be reliably applied for predicting injury made in vivo by standard military rifles.

Animals↗
PubMed1995

Newborn conjunctivitis associated with triclosan 0.5% antiseptic intrinsically contaminated with Serratia marcescens.

In February 1994, three cases of conjunctivitis with Serratia marcescens occurred in infants in the newborn nursery. An epidemiological investigation was conducted including environmental sampling. S marcescens was isolated from the bottle of triclosan 0.5% antiseptic soap that was in use in the nursery and from an unopened bottle on the pharmacy shelf. The manufacturer confirmed that this contaminant was dislodged from the air purification system during a filter change while the packaging was being completed in an adjoining room. The product was withdrawn from use in the nursery and replaced by individual bar soap. No further cases of infection with S marcescens have been identified following the withdrawal of the triclosan 0.5% soap.

Conjunctivitis, Bacterial↗
PubMed1996

A comparative study of eyelid cleaning regimens in chronic blepharitis.

PURPOSE: Blepharitis, an intrinsic eyelid inflammation with crusting and irritation, presents a great problem for patients wearing contact lenses. An important part of blepharitis therapy is eyelid hygiene, including the use of either soap, dilute baby shampoo, or commercial lid scrubs. In this study, a comparison was made between these three cleaning regimens in a group of 25 patients, 80% of whom (20/25) wore contact lenses. METHODS: Patients used commercial eyelid scrub on right eyelids and a hypo-allergenic bar soap on left eyelids. Patient symptoms, slit lamp findings, and overall preferences were determined at the end of 4 months. A subgroup of 10 patients using lid scrub on right eyelids and dilute baby shampoo on left eyelids was followed for an additional 3 months. RESULTS: At the end of 4 months, 24% (6/25) of the patients noted no difference between soap and lid scrub, but 89% (17/19) of the others preferred the lid scrub. In the group using baby shampoo, 50% (5/10) noted no difference in 3 months, but 80% (4/5) of the remaining patients preferred the lid scrub. CONCLUSIONS: All patients improved in slit lamp findings with all three regimens, and patient preference was overwhelmingly in favor of the lid scrub regimen for convenience and ease of use.

Adult↗