Comparative in vitro and in vivo study of nine alcohol-based handrubs

• Published in: American journal of infection control 2004-06, Vol.32 (4), p.200-204
• Main Authors: Rochon-Edouard, Stéphanie, Pons, Jean-Louis, Veber, Benoît, Larkin, Martine, Vassal, Serge, Lemeland, Jean-Franççois
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Infective Agents, Local - pharmacology; Bacterial Infections - prevention & control; Biological and medical sciences; Case-Control Studies; Ethanol - pharmacology; Fundamental and applied biological sciences. Psychology; Hand Disinfection - methods; Humans; In Vitro Techniques; Infectious diseases; Intensive Care Units; Medical sciences; Microbial Sensitivity Tests; Microbiology; Operating Rooms; Reference Values; Sensitivity and Specificity; Surgical Wound Infection - prevention & control
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2003.08.003

Hygienic hand disinfection using alcohol-based handrubs (AHRs) is an alternative method to conventional handwashing in hospital wards. Because a documented choice of such products would consider data from in-care evaluation, we designed a comparative study of 9 AHRs both in vitro and in vivo in actual care conditions. The bactericidal activity of AHRs was first measured in vitro against 4 hospital strains exhibiting multiple antibiotic resistance: Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacter aerogenes. In a second time, AHRs were tested in an intensive care unit for antibacterial activity against the cutaneous flora of personnel hands and for acceptance by the care personnel. The 9 AHRs could be classified in 3 groups on the basis of their in vitro activity: products of the first group showed a bactericidal activity higher than 4 log 10 against the 4 strains. Only 1 of these products presented simultaneously an effective antibacterial activity against the cutaneous flora of care personnel hands and a good acceptance by the care personnel. The in vitro study allowed the differentiation of the AHRs tested on the basis of bactericidal activity, but evaluation in an in-care situation allowed further discrimination through both antibacterial activity and acceptance. Thus, the combination of in vitro and in vivo evaluations should provide helpful arguments in the choice of AHRs.