Hand Hygiene with Soap and Water Is Superior to Alcohol Rub and Antiseptic Wipes for Removal ofClostridium difficile

Author:

Oughton Matthew T.,Loo Vivian G.,Dendukuri Nandini,Fenn Susan,Libman Michael D.

Abstract

Objective.To evaluate common hand hygiene methods for efficacy in removingClostridium difficik.Design.Randomized crossover comparison among 10 volunteers with hands experimentally contaminated by nontoxigenic C.difficile.Methods.Interventions included warm water with plain soap, cold water with plain soap, warm water with antibacterial soap, antiseptic hand wipes, alcohol-based handrub, and a control involving no Intervention. All interventions were evaluated for mean reduction in colony-forming units (CFUs) under 2 contamination protocols: “whole hand” and “palmar surface.” Results were analyzed according to a Bayesian approach, by using hierarchical models adjusted for multiple observations.Results.Under the whole-hand protocol, the greatest adjusted mean reductions were achieved by warm water with plain soap (2.14 log10CFU/mL [95% credible interval (Cri), 1.74-2.54 log10CFU/mL]), cold water with plain soap (1.88 log10CFU/mL [95% Cri, 1.48-2.28 log10CFU/mL), and warm water with antibacterial soap (1.51 log10CFU/mL [95% Cri, 1.12-1.91 logu, CFU/mL]), followed by antiseptic hand wipes (0.57 log10CFU/mL [95% Cri, 0.17-0.96 log10CFU/mL]). Alcohol-based handrub (0.06 log10CFU/mL [95% CrI, -0.34 to 0.45 log10CFU/mL]) was equivalent to no Intervention. Under the palmar surface protocol, warm water with plain soap, cold water with plain soap, and warm water with antibacterial soap again yielded the greatest mean reductions, followed by antiseptic hand wipes (26.6, 26.6, 26.6, and 21.9 CFUs per plate, respectively), when compared with alcohol-based handrub. Hypothenar (odds ratio, 10.98 [95% Cri, 1.96-37.65]) and thenar (odds ratio, 6.99 [95% Cri, 1.25-23.41]) surfaces were more likely than fingertips to remain heavily contaminated after handwashing.Conclusions.Handwashing with soap and water showed the greatest efficacy in removingC. difficileand should be performed preferentially over the use of alcohol-based handrubs when contact withC. difficileis suspected or likely.

Publisher

Cambridge University Press (CUP)

Subject

Infectious Diseases,Microbiology (medical),Epidemiology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3