Effectiveness of Alcohol-Based Hand Rubs for Removal of Clostridium difficile Spores from Hands
Effectiveness of Alcohol-Based Hand Rubs for Removal of Clostridium difficile Spores from Hands
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DOI：
10.1086/652772
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发表时间：
2010-06-01
影响因子：
4.5
通讯作者：
Gerding, Dale N.
中科院分区：
文献类型：
--
作者：
Jabbar, Umair;Leischner, Julie;Gerding, Dale N.
背景资料。酒精洗手是减少细菌病原体传播的有效手段。酒精对艰难梭菌的孢子不起作用。我们检测了使用ABHR后艰难梭菌孢子在志愿者手中的滞留情况，以及随后通过身体接触传播这些孢子的情况。比较了3种ABHR和洗必泰洗涤与单独用白水擦洗去除艰难梭菌孢子的效果。手部去污前后用平板冲压法进行掌侧培养。使用ABHR后，通过让每个志愿者与未接种的志愿者握手来测试艰难梭菌的可转移性。结果：白水摩擦使掌部培养物计数平均(+/-标准差[SD])减少1.57+/-0.11log(10)个菌落形成单位(CFU)/cm(2)，该值被设置为其他产品的零点。与水洗相比，洗必泰肥皂洗涤平均减少孢子数量(+/-SD)0.89+/-0.34log(10)cfu/cm2；在ABHR中，Isagel减少了0.11+/-0.20 log(10)cfu/cm(2)(P=.005)，耐受减少了0.37+/-0.42 log(10)cfu/cm(2)(P=.010)，普瑞尔减少了0.14+/-0.33 log(10)cfu/cm(2)(P=.005)。ABHR达到的减少量之间没有统计学上的显著差异；只有耐久的减少量与水控制摩擦的减少量有统计学差异(P=.040)。在使用ABHR后，握手平均将30%的艰难梭菌残留孢子转移到受试者手中。结论：用肥皂和水洗手明显比ABHR更有效地清除志愿者手中的艰难梭菌孢子。残留的孢子很容易在使用ABHR后通过握手转移。《感染控制与疫情》2010；31(6)：565-570
BACKGROUND. Alcohol-based hand rubs (ABHRs) are an effective means of decreasing the transmission of bacterial pathogens. Alcohol is not effective against Clostridium difficile spores. We examined the retention of C. difficile spores on the hands of volunteers after ABHR use and the subsequent transfer of these spores through physical contact.METHODS. Nontoxigenic C. difficile spores were spread on the bare palms of 10 volunteers. Use of 3 ABHRs and chlorhexidine soap-and-water washing were compared with plain water rubbing alone for removal of C. difficile spores. Palmar cultures were performed before and after hand decontamination by means of a plate stamping method. Transferability of C. difficile after application of ABHR was tested by having each volunteer shake hands with an uninoculated volunteer.RESULTS. Plain water rubbing reduced palmar culture counts by a mean (+/- standard deviation [SD]) of 1.57 +/- 0.11 log(10) colony-forming units (CFU) per cm(2), and this value was set as the zero point for the other products. Compared with water washing, chlorhexidine soap washing reduced spore counts by a mean (+/- SD) of 0.89 +/- 0.34 log(10) CFU per cm2; among the ABHRs, Isagel accounted for a reduction of 0.11 +/- 0.20 log(10) CFU per cm(2) (P = .005), Endure for a reduction of 0.37 +/- 0.42 log(10) CFU per cm(2) (P = .010), and Purell for a reduction of 0.14 +/- 0.33 log(10) CFU per cm(2) (P = .005). There were no statistically significant differences between the reductions achieved by the ABHRs; only Endure had a reduction statistically different from that for water control rubbing (P = .040). After ABHR use, handshaking transferred a mean of 30% of the residual C. difficile spores to the hands of recipients.CONCLUSIONS. Hand washing with soap and water is significantly more effective at removing C. difficile spores from the hands of volunteers than are ABHRs. Residual spores are readily transferred by a handshake after use of ABHR. Infect Control Hosp Epidemiol 2010; 31(6): 565-570