Comparative Antimicrobial Efficacy of Two Hand Sanitizers in Intensive Care Units Common Areas: A Randomized, Controlled Trial

• Published in: Infection control and hospital epidemiology 2018-03, Vol.39 (3), p.267-271
• Main Authors: Deshpande, Abhishek, Fox, Jacqueline, Wong, Ken Koon, Cadnum, Jennifer L, Sankar, Thriveen, Jencson, Annette, Schramm, Sarah, Fraser, Thomas G, Donskey, Curtis J, Gordon, Steven
• Format: Article
• Language: English
• Subjects: Alcohol; Anti-Infective Agents, Local - pharmacology; Antibiotics; Antimicrobial agents; Bacteria; Bacteria, Aerobic - drug effects; Bacteria, Aerobic - isolation & purification; Chlorhexidine - analogs & derivatives; Chlorhexidine - pharmacology; Cleaning compounds; Cross Infection - prevention & control; Cross-Over Studies; Double-Blind Method; Drug resistance; Ethanol; Ethanol - pharmacology; Gram-negative bacteria; Hand Sanitizers - pharmacology; Hands; Health care; Health Personnel; Hospitals; Hospitals, Teaching; Humans; Hygiene; Infection Control - methods; Intensive care; Intensive Care Units; Microbiota; Nosocomial infections; Nursing; Pathogens; Patients; Prospective Studies; Sanitizers; Skin; Staphylococcus infections
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/ice.2017.293

OBJECTIVE Contaminated hands of healthcare workers (HCWs) are an important source of transmission of healthcare-associated infections. Alcohol-based hand sanitizers, while effective, do not provide sustained antimicrobial activity. The objective of this study was to compare the immediate and persistent activity of 2 hand hygiene products (ethanol [61% w/v] plus chlorhexidine gluconate [CHG; 1.0% solution] and ethanol only [70% v/v]) when used in an intensive care unit (ICU). DESIGN Prospective, randomized, double-blinded, crossover study SETTING Three ICUs at a large teaching hospital PARTICIPANTS In total, 51 HCWs involved in direct patient care were enrolled in and completed the study. METHODS All HCWs were randomized 1:1 to either product. Hand prints were obtained immediately after the product was applied and again after spending 4-7 minutes in the ICU common areas prior to entering a patient room or leaving the area. The numbers of aerobic colony-forming units (CFU) were compared for the 2 groups after log transformation. Each participant tested the alternative product after a 3-day washout period. RESULTS On bare hands, use of ethanol plus CHG was associated with significantly lower recovery of aerobic CFU, both immediately after use (0.27 ± 0.05 and 0.88 ± 0.08 log10 CFU; P = .035) and after spending time in ICU common areas (1.81 ± 0.07 and 2.17 ± 0.05 log10 CFU; P