Comparative efficacy of hand hygiene agents in the reduction of bacteria and viruses.
by
Sickbert-Bennett EE, Weber DJ, Gergen-Teague MF,
Sobsey MD, Samsa GP, Rutala WA.
Department of Hospital Epidemiology,
University of North Carolina Health Care System,
North Carolina, USA. Am J Infect Control. 2005 Mar;33(2):67-77.
ABSTRACT
BACKGROUND:
Health care-associated infections most commonly result from
person-to-person transmission via the hands of health care workers.
METHODS: We studied the efficacy of hand hygiene agents (n = 14)
following 10-second applications to reduce the level of challenge
organisms (Serratia marcescens and MS2 bacteriophage) from the hands of
healthy volunteers using the ASTM-E-1174-94 test method. RESULTS: The
highest log 10 reductions of S marcescens were achieved with agents
containing chlorhexidine gluconate (CHG), triclosan, benzethonium
chloride, and the controls, tap water alone and nonantimicrobial soap
and water (episode 1 of hand hygiene, 1.60-2.01; episode 10,
1.60-3.63). Handwipes but not alcohol-based handrubs were significantly
inferior from these agents after a single episode of hand hygiene, but
both groups were significantly inferior after 10 episodes. After a
single episode of hand hygiene, alcohol/silver iodide, CHG, triclosan,
and benzethonium chloride were similar to the controls in reduction of
MS2, but, in general, handwipes and alcohol-based handrubs showed
significantly lower efficacy. After 10 episodes, only benzethonium
chloride (1.33) performed as well as the controls (1.59-1.89) in the
reduction of MS2. CONCLUSIONS: Antimicrobial handwashing agents were
the most efficacious in bacterial removal, whereas waterless agents
showed variable efficacy. Alcohol-based handrubs compared with other
products demonstrated better efficacy after a single episode of hand
hygiene than after 10 episodes. Effective hand hygiene for high levels
of viral contamination with a nonenveloped virus was best achieved by
physical removal with a nonantimicrobial soap or tap water alone.