An in-use comparison of chlorhexidine gluconate 4% [formula omitted], glycol-poly-siloxane plus methylcellulose and a liquid soap in a special care baby unit

Abstract

The effectiveness and harshness of three hand-wash agents, chlorhexidine gluconate 4%, glycol- poly-siloxane gel and a bland liquid soap were studied in-use in a Special Care Baby Unit (SCBU). Each product was used for consecutive 2-week periods by the same groups of 8 health care workers among the 56 in the SCBU. The first group had normal skin, the second had ‘sensitive skin’ and the third group were known MRSA nasal carriers. Blood agar and methicillin mannitol salt agar were inoculated before and after hand washing and differences in colony counts calculated. Nursing activities before washing were graded from clean to dirty on an eight-point scale and correlated with before-wash colony counts. Product acceptability was assessed with a self-reporting questionnaire. Chlorhexidine was the most effective product in reducing skin microflora but users preferred to wash with the gel preparation. The sensitive-skin group achieved the best effects from washing, irrespective of the product used. Nasal carriers of MRSA recorded the lowest reduction levels of methicillin-resistant organisms but achieved the same reduction levels as the normal-skin group for other microflora. No relationship could be established between the pre-wash activity and the prewash colony count. The weekly MRSA colonization rate in neonates on the SCBU remained unaffected by any of the products tested.