Hand Rubbing with Sprayed Alcohol-Based Hand Rub: An Alternative Method for Effective Hand Hygiene

Source avec lien : Journal of Hospital Infection, , 2/14/2020. 10.1016/j.jhin.2020.02.008

L’hygiène des mains est cruciale pour la prévention et le contrôle des infections. Il n’est pas certain que le lavage des mains à base d’alcool en aérosol (ABHR) ne soit pas inférieur à la méthode recommandée par l’OMS pour le lavage des mains avec de l’ABHR versé.

Background Hand hygiene is crucial in infection prevention and control. It is unclear whether sprayed alcohol-based handrub (ABHR) is non-inferior to the WHO recommended method of handrubbing with poured ABHR. Aim We tested whether sprayed ABHR can be an alternative (non-inferior) method for effective hand hygiene with/without handrubbing. Methods We conducted a laboratory experiment with ABHR (isopropanol 60% v/v) according to the European Norm 1500. Hand hygiene was performed by (1) handrubbing with ABHR poured onto a hand palm, (2) handrubbing with sprayed ABHR, and (3) applying sprayed ABHR on hands without rubbing. Hands were contaminated with Escherichia coli ATCC 10536, followed by hand hygiene and microbiological sampling. A generalized linear mixed model with a random intercept per subject was used to analyse the reduction in bacterial counts post-hand hygiene. Findings A total of 19 healthcare workers participated in the study. Handrubbing with sprayed ABHR was non-inferior (margin log10 0.6 colony forming units [CFU]/mL) to the WHO method of handrubbing with poured ABHR; bacterial count reduction was log10 3.66 CFU/mL (95% CI 1.68-5.64) and log10 3.46 CFU/mL (95% CI 1.27-5.65), respectively. Conversely, non-inferiority was not found for hand hygiene using sprayed ABHR without rubbing (bacterial count reduction: log10 2.76 CFU/mL, 95% CI 1.65-3.87). Conclusion Handrubbing with sprayed ABHR was non-inferior to rubbing with ABHR poured onto a hand palm to reduce bacterial counts on hands under experimental conditions. Rubbing with sprayed ABHR may be an acceptable alternative hand hygiene method pending assessment in other settings and for other pathogens.

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