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Hand Hygiene With Alcohol-Based Hand Rub: How Long Is Long Enough?

Published online by Cambridge University Press:  07 March 2017

Daniela Pires ,
Hervé Soule ,
Fernando Bellissimo-Rodrigues ,
Angèle Gayet-Ageron  and
Didier Pittet
Daniela Pires
Affiliation:
Infection Control Program and WHO Collaborating Center on Patient Safety, University of Geneva Hospitalsand Faculty of Medicine, Geneva, Switzerland Department of Infectious Diseases, Centro Hospitalar Lisboa Norte and Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
Hervé Soule
Affiliation:
Infection Control Program and WHO Collaborating Center on Patient Safety, University of Geneva Hospitalsand Faculty of Medicine, Geneva, Switzerland
Fernando Bellissimo-Rodrigues
Affiliation:
Infection Control Program and WHO Collaborating Center on Patient Safety, University of Geneva Hospitalsand Faculty of Medicine, Geneva, Switzerland Social Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
Angèle Gayet-Ageron
Affiliation:
Infection Control Program and WHO Collaborating Center on Patient Safety, University of Geneva Hospitalsand Faculty of Medicine, Geneva, Switzerland
Didier Pittet*
Affiliation:
Infection Control Program and WHO Collaborating Center on Patient Safety, University of Geneva Hospitalsand Faculty of Medicine, Geneva, Switzerland
*
Address correspondence to Prof. Didier Pittet, MD, MS, Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland ([email protected]).
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Abstract

BACKGROUND

Hand hygiene is the core element of infection prevention and control. The optimal hand-hygiene gesture, however, remains poorly defined.

OBJECTIVE

We aimed to evaluate the influence of hand-rubbing duration on the reduction of bacterial counts on the hands of healthcare personnel (HCP).

METHODS

We performed an experimental study based on the European Norm 1500. Hand rubbing was performed for 10, 15, 20, 30, 45, or 60 seconds, according to the WHO technique using 3 mL alcohol-based hand rub. Hand contamination with E. coli ATCC 10536 was followed by hand rubbing and sampling. A generalized linear mixed model with a random effect on the subject adjusted for hand size and gender was used to analyze the reduction in bacterial counts after each hand-rubbing action. In addition, hand-rubbing durations of 15 and 30 seconds were compared to assert non-inferiority (0.6 log10).

RESULTS

In total, 32 HCP performed 123 trials. All durations of hand rubbing led to significant reductions in bacterial counts (P<.001). Reductions achieved after 10, 15, or 20 seconds of hand rubbing were not significantly different from those obtained after 30 seconds. The mean bacterial reduction after 15 seconds of hand rubbing was 0.11 log10 lower (95% CI, −0.46 to 0.24) than after 30 seconds, demonstrating non-inferiority.

CONCLUSIONS

Hand rubbing for 15 seconds was not inferior to 30 seconds in reducing bacterial counts on hands under the described experimental conditions. There was no gain in reducing bacterial counts from hand rubbing longer than 30 seconds. Further studies are needed to assess the clinical significance of our findings.

Infect Control Hosp Epidemiol 2017;38:547–552

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 5 , May 2017 , pp. 547 - 552
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION: Some of these data were presented at the American Society of Microbiology (ASM) Microbe 2016 Congress in Boston, Massachusetts, on June 18, 2016 (Abstract 2016-A-4250).

References

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