Antimicrobial persistence of two alcoholic preoperative skin preparation solutions

Abstract

Normal skin flora and suboptimal skin antisepsis are the primary drivers of healthcare-associated infections (HAIs). Antimicrobial persistence of preoperative skin preparation is necessary to limit microorganisms on the skin and help minimize their entry into an incision or device-insertion site after application. To assess the antimicrobial persistence of two preoperative skin preparation solutions. A randomized, single-centre, partially blinded, clinical study was conducted in 103 healthy volunteers to evaluate the persistent antimicrobial properties of BD ChloraPrep™ (2% w/v chlorhexidine gluconate [CHG]+ 70% v/v isopropyl alcohol [IPA]) and BD PurPrep™ (8.3% w/w povidone-iodine [PVPI]+ 72.5% w/w IPA) skin preparations out to 7 days and 96h, respectively, on abdomen and groin testing sites. An additional 32 healthy volunteers participated in a neutralization procedure to ensure that the study recovery solution was non-toxic to microorganisms, and a spore-recovery procedure to demonstrate that microorganisms could be successfully recovered from the PVP-I+IPA film-forming product. Both CHG+IPA and PVP-I+IPA produced a mean bacterial log10 reduction >2 and >3 on the abdomen and groin, respectively, 10min after application. CHG+IPA maintained antimicrobial persistence out to 7 days post application, whereas PVP-I+IPA maintained antimicrobial persistence out to 96h post application, the longest time-point selected for this product. CHG+IPA and PVP-I+IPA were both found to be effective, persistent antiseptic skin preparations. Overall, skin irritation was uncommon, and only one adverse event occurred following product application, which was not considered product-related but was considered procedure-related.