Hand Hygiene: The Efficacy of an Alcohol-based Hand Sanitizer vs. an Antimicrobial Soap and Water
Authors: Lee, Ann; Long, Corrie; Phillips, Rebecca
Source: Journal of Dental Hygiene, Number 4, Fall 1st October 2004 , pp. 17-17(1)
Publisher: American Dental Hygienists' Association
Abstract:Purpose. Because dental literature regarding the efficacy of alcohol-based gel is controversial, this study compared the effectiveness of an alcohol-based hand sanitizer versus an antiseptic hand soap for bacterial removal.
Methods and Materials. Product A (1.0% chloroxylenol) and Product B (62% ethyl alcohol hand sanitizer) were compared. Three subjects, the dental hygiene students completing this study, tested each product 25 times, totaling 75 trials. Staphylococcus epidermis was the indicator organism. Subjects marked a two-inch circle on a palm as an invariable testing zone. Each zone was inoculated with a swab dipped in a microbial solution of 1.6 x 10^7 colony forming units (CFU). After 15 seconds, for Product A, subjects followed Centers for Disease Control (CDC) handwashing guidelines, using a controlled amount of antimicrobial soap in wetted palms, rubbing them together for 15 seconds, rinsing the product off completely with warm water, and towel-drying their hands. For Product B, the subjects placed the same amount of product in their palm and rubbed them together for 15 seconds until dry. Five consecutive samples were collected before the palms were reinoculated by rubbing sterile swabs across the testing zone with even, firm pressure for 15 seconds. The swabs were then placed into 1 ml of broth and mixed. One hundred microliters of the resulting mix were placed on a TSA plate and spread with a glass rod. Plates were incubated for 24 hours at 37M-BM-0C and the bacterial colonies were counted.
Results. The Kruskal-Wallis Ranks Test demonstrated a highly significant decrease for both antimicrobial soap with water and alcohol-based gel (p< .0001). The Mann-Whitney U-Test showed that alcohol-gel significantly reduced bacterial counts compared to soap and water (p< .0001).
Conclusions. The alcohol-based gel was more effective in reducing bacterial counts than the antimicrobial soap after one application. It required four handwashings with the antimicrobial soap to be equally effective.
Clinical Significance. Because alcohol-based hand gels are highly effective, health care professionals should feel confident in replacing soap and water with an alcohol-based gel.
Document Type: Abstract
Publication date: Fall 2004
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