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Evaluation of the Effectiveness of Common Hospital Hand Disinfectants Against Methicillin-Resistant Staphylococcus aureus, Glycopeptide-Intermediate S. aureus, and Heterogeneous Glycopeptide-Intermediate S. aureus

Published online by Cambridge University Press:  02 January 2015

Mandy Wootton ,
Timothy R. Walsh ,
Eleri M. Davies  and
Robin A. Howe
Mandy Wootton*
Affiliation:
NPHS Microbiology Cardiff, University Hospital Wales, Heath Park, Cardiff, United Kingdom
Timothy R. Walsh
Affiliation:
Department of Medical Microbiology, Cardiff University, Heath Park, Cardiff, United Kingdom
Eleri M. Davies
Affiliation:
NPHS Microbiology Cardiff, University Hospital Wales, Heath Park, Cardiff, United Kingdom
Robin A. Howe
Affiliation:
NPHS Microbiology Cardiff, University Hospital Wales, Heath Park, Cardiff, United Kingdom
*
NPHS Microbiology Cardiff, University Hospital Wales, Heath Park, Cardiff CF14 4XW, UK([email protected])
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Abstract

Background.

The presence of methicillin-resistant Staphylococcus aureus (MRSA) and glycopeptide-intermediate S. aureus (GISA) in hospitals poses a significant challenge to hospital infection control teams. The use of disinfectants for both surface and hand cleaning is an essential part of the infection control measures.

Objective.

To evaluate the effectiveness of common hospital hand disinfectants against MRSA, GISA, and heterogeneous GISA (hGISA).

Methods.

For methicillin-susceptible S. aureus (MSSA), MRSA, GISA, and hGISA, the levels of susceptibility to hand disinfectants and their active ingredients were determined. Suspension tests were performed on commercial handwashing products.

Results.

Minimum inhibitory concentrations (MICs) of 2-propanol, Chlorhexidine, and hexachlorophene were similar for all phenotypes. The MICs of cetrimide and triclosan were higher for the MRSA, GISA, and hGISA strains than for the MSSA strain. The MICs for the chlorhexidine-containing agents Hibisol and Hibiscrub (AstraZeneca) and for the propanol-containing agent Sterillium (Medline) were 1-2-fold lower for the MSSA strains than for the MRSA, GISA, and hGISA strains. Suspension tests showed that the GISA and hGISA strains were less susceptible to the triclosan-containing agent Aquasept (SSL) than were the MRSA and MSSA strains, with resistance increasing with glycopeptide resistance. Products containing Betadine (Purdue) were more effective against the GISA and hGISA strains than against the MRSA and MSSA strains, especially after the strain was exposed to the product for 30 seconds.

Conclusions.

Using the EN 1040 standard criteria for the performance of disinfectants, we determined that all agents, except 50% Aquasept for hGISA and 0.33% hexachlorophene for GISA, performed effectively. However, the GISA and hGISA strains were less susceptible to triclosan-containing products, compared with the MRSA stains, but were more susceptible to products containing Betadine.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 3 , March 2009 , pp. 226 - 232
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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