Hand-washing Agents Research Articles

Quantifying the Viral Reduction Achieved Using Ash and Sand as Handwashing Agents.

The WHO recommends handwashing with soap and water for 20-40 seconds. In settings where soap is not available, ash or sand is used for handwashing, yet their efficacy as handwashing materials is underresearched. The purpose of this study was to quantify the removal of viruses using ash and sand as handwashing agents, and compare their efficacy to commonly recommended handwashing methods. We performed a volunteer study to estimate the log reduction value (LRV) of model viruses Phi6 and MS2 on hands after six handwashing conditions: two handwashing agents (ash and water, and sand and water) with two time points (5 and 20 seconds), and two handwashing agents (soap and water, and water only) with one time point (20 seconds). Plaque assays were used to measure infectious virus reduction. Handwashing with any of the handwashing agents for 20 seconds resulted in a greater LRV than the 2-log reduction U.S. Food and Drug Administration criteria for both viruses. Soap and water resulted in a significantly greater LRV (2.7-4.8) than washing with ash and water (2.0-2.8) or sand and water (1.8-2.7) for 5 seconds for both viruses, and water only resulted in a significantly higher LRV (2.8) than all ash (2.0-2.6) and sand (1.8-2.4) conditions for MS2 only. These results suggest that using ash or sand as handwashing agents can be efficacious in reducing viruses but may be less efficacious than soap, especially when used for shorter durations. Further research should investigate the use of ash and sand as handwashing agents in real-world settings.

Smart ring: a wearable device for hand hygiene compliance monitoring at the point-of-need

Hand hygiene compliance is one of the most effective means to prevent the spread of infections and diseases. The centers for disease control and prevention (CDC) recommends washing hands for at least 20 s. However, current hand hygiene compliance monitoring relies on either direct observation or complex electronic compliance monitoring systems. Here, we reported a simple, inexpensive, compact, wearable fluid sensing device, dubbed “smart ring”, for real-time monitoring hand hygiene compliance. The proposed smart ring was prototyped by 3D printing technology and includes an electrochemical fluid sensor, a LED indicator and an embedded electronic board. The ring is capable of detecting hand-washing events and monitoring hand-washing time without need for any expensive electronic monitoring instrument and well-trained personnel. It has been successfully demonstrated to detect a variety of hand-washing agents, such as tap water, soaps, sanitizers, and antimicrobial agents. Such a simple, compact, wearable device could open the door to improve hand hygiene compliance and reduce infection rates in our daily life, especially in hospitals, food businesses and schools.

A Study on the Economic Situation and Selection of Hand Washing Agents in Cambodian Rural Area

A Study on the Economic Situation and Selection of Hand Washing Agents in Cambodian Rural Area

Nonrandomized Trial of Feasibility and Acceptability of Strategies for Promotion of Soapy Water as a Handwashing Agent in Rural Bangladesh.

We conducted a nonrandomized trial of strategies to promote soapy water for handwashing in rural Bangladesh and measured uptake. We enrolled households with children < 3 years for three progressively intensive study arms: promotion of soapy water (N = 120), soapy water promotion plus handwashing stations (N = 103), and soapy water promotion, stations plus detergent refills (N = 90); we also enrolled control households (N = 72). Our handwashing stations included tap-fitted buckets and soapy water bottles. Community promoters visited households and held community meetings to demonstrate soapy water preparation and promote handwashing at key times. Field workers measured uptake 4 months later. In-depth interviews and focus group discussions assessed factors associated with uptake. More households had soapy water at the handwashing place in progressively intensive arms: 18% (promotion), 60% (promotion plus station), and 71% (promotion, station with refills). Compared with the promotion-only arm, more households that received stations had soapy water at the primary handwashing station (44%, P ≤ 0.001; 71%, P < 0.001 with station plus detergent refill). Qualitative findings highlighted several dimensions that affected use: contextual (shared courtyard), psychosocial (perceived value), and technology dimensions (ease of use, convenience). Soapy water may increase habitual handwashing by addressing barriers of cost and availability of handwashing agents near water sources. Further research should inform optimal strategies to scale-up soapy water as a handwashing agent to study health impact.

Comparative study of effectiveness of different germicidal hand washing agents in clinical and paraclinical health care personnel

Objective: This comparative, prospective study was conducted to estimate the effectiveness of five different germicidal hand washing agents and to obtain comparative data among clinical and paraclinical personnel.Methods: Five different hand washing agents were compared. Pre and post swabs were collected and cultured aerobically. Percentage reduction in colony counts was obtained and compared between different hand-washing agents and clinical and paraclinical personnelResults: Sixty nine (22 (31.88%) males; 47 (68.11%) females) health care personnel who fulfilled the intake criteria were included in study. Of these, 32 (4 (12.5%) males; 28 (87.5%) females) were clinical personnel and 37 (18 (48.64%) males; 19 (51.3%) females) were paraclinical personnel. The mean age of the participants was 30 years (SD: 11.3 years; range: 18-56 years). There was a significant difference (Z = ?2; p?0.05) in colony forming units (CFUs) after application of each agent on bare hands, in both groups. The reduction CFUs was significant (p=0.190196; <0.05) with use of Povidone iodine scrub.Conclusion: Povidone-iodine scrub is most effective agent amongst all tested. Bactericidal efficacy of all the agents was superior among paraclinical personnel.

Improving hand hygiene compliance among healthcare workers: an intervention study in a Hospital in Guizhou Province, China

ObjectiveHand hygiene (HH) is a critical component for controlling hospital-acquired infection (HAI). The present study was designed to develop an intervention approach to improve compliance with HH among healthcare workers in a hospital setting. MethodsThe HH intervention study was conducted in Guizhou Provincial People's Hospital, Guiyang, China and organized by its Department of HAI Management. It was an observational, prospective, quasiexperimental (before-after intervention) study. The study was divided into two phases: the baseline phase and the intervention phase. The investigative team included clinical monitoring staff and infection control practitioners who received a series of instructions on HH compliance, monitoring skills, and measurement of the use of HH products. ResultsBased on 27,852 observations in a 17-month period, the rate of compliance with HH improved from 37.78% at baseline to 75.90% after intervention. Significant improvement in compliance and an increase in consumption of HH products was observed after intervention. The per patient-day consumption of alcohol-based hand rub products and handwash agents increased by 4.75mL and 4.55mL, respectively. The consumption of paper towels increased 3.41 sheets per patient-day. During the same period, the prevalence rate of HAI decreased 0.83%. ConclusionsThis study demonstrates that a significant improvement in compliance with HH can be achieved through a systemic, multidimensional intervention approach involving all categories of healthcare workers in a hospital setting, which may result in a decrease of the HAI rate.

Cytomegalovirus Survival and Transferability and the Effectiveness of Common Hand-Washing Agents against Cytomegalovirus on Live Human Hands

Congenital cytomegalovirus (CMV) transmission can occur when women acquire CMV while pregnant. Infection control guidelines may reduce risk for transmission. We studied the duration of CMV survival after application of bacteria to the hands and after transfer from the hands to surfaces and the effectiveness of cleansing with water, regular and antibacterial soaps, sanitizer, and diaper wipes. Experiments used CMV AD169 in saliva at initial titers of 1 × 10(5) infectious particles/ml. Samples from hands or surfaces (points between 0 and 15 min) were placed in culture and observed for at least 2 weeks. Samples were also tested using CMV real-time PCR. After application of bacteria to the hands, viable CMV was recovered from 17/20 swabs at 0 min, 18/20 swabs at 1 min, 5/20 swabs at 5 min, and 4/20 swabs at 15 min. After transfer, duration of survival was at least 15 min on plastic (1/2 swabs), 5 min on crackers and glass (3/4 swabs), and 1 min or less on metal and cloth (3/4 swabs); no viable virus was collected from wood, rubber, or hands. After cleansing, no viable virus was recovered using water (0/22), plain soap (0/20), antibacterial soap (0/20), or sanitizer (0/22). Viable CMV was recovered from 4/20 hands 10 min after diaper wipe cleansing. CMV remains viable on hands for sufficient times to allow transmission. CMV may be transferred to surfaces with reduced viability. Hand-cleansing methods were effective at eliminating viable CMV from hands.

외식업소 종사자의 손 위생관리에 관한 연구

Objectives: This study was performed in order to investigate hand hygiene practices among food-service businesses employees based on the awareness of hand-washing and load of indicator bacteria on their hands. It focused on the comparison of full-time and part-time workers in food-service workplaces. Methods: A direct-interview questionnaire survey and microbiological analysis were carried out with sixty workers each. Samples for microbiological analysis were collected through a modified glove-juice method from the hands of the food-service workers and were analyzed for aerobic plate count, total coliform, fecal coliform, Escherichia coli, Staphylococcus aureus, and Salmonella spp. Microbiological analysis was done according to the Food Code of Korea. Results: Significant differences (p＜0.01) were found in the survey between the full-time and part-time workers in hand-washing frequency, use of hand-washing agents, and hand-drying methods. More full-time workers responded to washing their hands after preparing food, after visiting outside, after handling raw materials, and before putting on gloves/when changing gloves than did part-time workers (p＜0.05). No remarkable difference was found in bacterial load on the hands except in the aerobic plate count between the two groups. The detection of E. coli, S. aureus, and Salmonella spp. on the hands of some food-service workers in both groups revealed poor hand hygiene practices. Conclusions: The results of this study indicate that there is a need for training programs in order to improve hand hygiene practices and strict hand hygiene compliance by food-service workers.

Effects of hand wash agents: Prevent the laboratory associated infections

Background: The aim of this study was to find out the prevalence of bacteria and their antimicrobial susceptibility pattern in hands of the laboratory workers. Laboratory associated infections are an occupational hazard for laboratory workers in the microbiology laboratory. The workers can expose to infection if they do not properly wash their hands before taking food. Materials: Swabs from 35 laboratory workers was taken before and after applying the different disinfect ants. The swabs were directly inoculated onto blood agar, MacConkey agar and nutrient agar. Inoculated plates were incubated at 37oC for 24 hours. The antibiotic sensitivity testing was done by Kirby Bauer disc diffusion method according to CLSI guidelines. Results: This study detects the major pathogenic bacteria in hands i.e. Staphylococcus aureus (40.58%), CoNS (21.74%), Klebsiella oxytoca and Pseudomonas aeruginosa (8.70%) were isolated. Conclusion: This study helps to minimize the infections by proper hand washing and also minimizing the spread of infection from one person to others.

일반인과 식품취급자의 손 위생관리에 관한 비교

Objectives: This study was performed to investigate hygienic behavior of food handlers and general population focusing on awareness of hand-washing and the microbial load of their hands. Methods: A questionnaire survey and microbiological analysis were carried out for sixty-four people each. Samples for microbiological analysis were collected through the glove-juice method from the hands, and were analyzed for the presence of aerobic plate counts, total coliform, fecal coliform, Escherichia coli, Staphylococcus aureus, and Salmonella spp. according to the Food Code of Korea. Results: In the survey, significant differences between the food handlers and general population (p < 0.01) were found in hand-washing frequency, duration, use of hand-washing agents, washing parts of hands, hand-drying method, and method of turning off water. In eight different situations among the ten particular situations in their daily life, more food handlers responded to wash their hands than general population (p < 0.05). Bacterial load on hands with general population was consistently higher than with food handlers (p < 0.05), however, percentages of positive hands of S. aureus and Salmonella spp. were not. Conclusions: Poor hand hygiene practices were indicated by the positive results for E. coli, S. aureus, and Salmonella spp. on the hands of some respondents in both groups. This study reveals that there is the need for programs or campaigns to increase hand-washing practices of both groups.

A survey of hand-washing facilities in the outpatient department of a tertiary care teaching hospital in India

Inadequate hand-washing facilities have been reported as a barrier to hand washing. This study aimed to evaluate the availability and accessibility of hand-washing facilities and supplies of hand-washing agents in the outpatient department (OPD) complex of a tertiary care teaching hospital. A checklist containing 13 variables was prepared and all rooms of direct patient care in the OPD were assessed on one occasion. Out of 211 rooms surveyed, a hand-washing facility was available in 209 (99.05%) rooms. Among these, 206 (98.56%) sinks were easily accessible and were placed close to users. Almost all sinks (99.5%) had hand-operated taps. Thirty-five (16.75%) sinks had no soap stand, and at 21 (10.5%) sinks, soap stands were found to be broken. At 14 (6.70%) sinks, soap bars were not available, while an antiseptic agent was available at 6 (2.87%) sinks. Four (1.91%) sinks had no towel stand, and at 8 (3.83%) sinks the towel stands were broken. At 43 (20.57%) sinks no towel was available, and at 23 (11%) sinks the towels provided were dirty. No sink drain was found to be blocked. No sink had hand-washing instructions displayed demonstrating the correct technique of hand washing. Physical facilities required for hand washing were adequate though not perfect. There is a need to shift from hand-operated taps to non-manual taps and from cloth towels to paper towels. Hospital managers in developing countries should continuously strive to provide the best possible hand-washing facilities within their financial resources.

Questions linked to Rotter M, Sattar, S Dharan, S Allegranzi B, Mathai E, Pittet D. Methods to evaluate the microbicidal activities of hand-rub and hand-wash agents. J Hosp Infect 2009; 73:1–9.

Questions linked to Rotter M, Sattar, S Dharan, S Allegranzi B, Mathai E, Pittet D. Methods to evaluate the microbicidal activities of hand-rub and hand-wash agents. J Hosp Infect 2009; 73:1–9.

Answers linked to Rotter M, Sattar S, Dharan S, Allegranzi B, Mathai E, Pittet D. Methods to evaluate the microbicidal activities of hand-rub and hand-wash agents. J Hosp Infect 2009; 73:1–9

Answers linked to Rotter M, Sattar S, Dharan S, Allegranzi B, Mathai E, Pittet D. Methods to evaluate the microbicidal activities of hand-rub and hand-wash agents. J Hosp Infect 2009; 73:1–9

Hand Hygiene

Hand Hygiene

Effect of Hand Wash Agents on Controlling the Transmission of Pathogenic Bacteria from Hands to Food

The goals of this study were to evaluate the effectiveness of two hand wash regimens in reducing transient bacteria on the skin following a single hand wash and the subsequent transfer of the bacteria to a ready-to-eat food item, freshly cut cantaloupe melon. The number of bacteria recovered from hands and the quantity transferred to the melon were significantly less following the use of an antibacterial soap compared with plain soap. The antimicrobial soap achieved >3-log reductions versus Escherichia coli and 3.31- and 2.83-log reductions versus Shigella flexneri. The plain soap failed to achieve a 2-log reduction against either organism. The bacteria recovered from the melon handled by hands treated with antimicrobial hand soap averaged 2 log. Melon handled following hand washing with plain soap had >3 log bacteria in the experiments. Based on previously published feeding studies, an infection rate in the range of approximately 15 to 25% would be expected after ingesting melon containing 2 log CFU compared with ingesting greater than the 3 log transferred from hands washed with plain soap, which would result in a higher infection attack rate of 50 to 80%. The data thus demonstrate there is a greater potential to reduce the transmission and acquisition of disease through the use of an antimicrobial hand wash than through the use of plain soap.

The fingerpad protocol to assess hygienic hand antiseptics against viruses

Many types of viruses can be spread by the hands of caregivers and food handlers, and regular and proper decontamination of hands is crucial in interrupting such spread. Standardized methods to assess the virus-eliminating potential of handwash and handrub agents have not been available and this test method addresses this gap. Each fingerpad of an adult subject receives 10 μl of the test virus suspension and the inoculum allowed to dry. The contaminated area is then exposed to 1 ml of a control or test agent for the desired contact time and virus remaining on the fingerpad is eluted, and the eluates are titrated for infectious virus along with the required controls. The method can also allow the determination of further virus removal due to post-treatment rinsing of the fingerpads with water and/or their subsequent towel- or air-drying. Percent reductions in the amounts of infectious virus after treatment with the control and test agents are then determined. The method gives results that are comparable to those obtained using the whole-hand. The activities of all major classes of germicidal chemicals used in hygienic hand antiseptics have been tested against several enveloped and non-enveloped viruses of human origin.

Effect of testing method on apparent activities of antiviral disinfectants and antiseptics

This study was designed to evaluate the independent effects of various test methods on the activities of antiviral chemical germicides. The activities of germicides against MS2 and phi 6 bacteriophages in a new porcine tissue carrier model were compared to those obtained by four other methods (suspension, glass carrier, tile carrier, and fingerpad tissue carrier tests). After a 1-min contact followed by neutralization (and elution off the carriers), the residual virus in the treated samples was quantified and the amount was compared with that in the saline controls. Antiviral activity was highly dependent on the test method for both viruses and was always greatest in suspension tests and lowest in tissue carrier tests. Results obtained for hydrophilic MS2 with the porcine tissue carrier were comparable to those from fingerpads, but lipophilic phi 6 was subject to spontaneous inactivation on human skin and proved unsuitable for fingerpad testing. These data indicate that the activities of germicides in tests with nonbiological substrates may overestimate antiviral antiseptic activity on skin surfaces. Products intended for use as antiviral antiseptics or hand-washing agents should be evaluated in a tissue carrier system. The porcine tissue carrier model provides a safe, inexpensive, accurate, and reproducible method for testing the activities of antiseptics.

3 メチシリン耐性ブドウ球菌に対する消毒剤の効果 : 第1報 手指用消毒剤について (第434回 大阪歯科学会例会)

3 メチシリン耐性ブドウ球菌に対する消毒剤の効果 : 第1報 手指用消毒剤について (第434回 大阪歯科学会例会)

Comparative in vivo efficiencies of hand-washing agents against hepatitis A virus (HM-175) and poliovirus type 1 (Sabin)

The abilities of 10 hygienic hand-washing agents and tap water (containing approximately 0.5 ppm of free chlorine) to eliminate strain HM-175 of hepatitis A virus (HAV) and poliovirus (PV) type 1 (Sabin) were compared by using finger pad and whole-hand protocols with three adult volunteers. A mixture of the two viruses was prepared in a 10% suspension of feces, and 10 microliters of the mixture was placed on each finger pad. The inoculum was allowed to dry for 20 min, and the contaminated area was exposed to a hand-washing agent for 10 s, rinsed in tap water, and dried with a paper towel. In the whole-hand protocol, the hands were contaminated with 0.5 ml of the virus mixture, exposed for 10 s to a hand-washing agent, washed, and dried as described above. Tryptose phosphate broth was used to elute any virus remaining on the finger pads or hands. One part of the eluate was assayed directly for PV with FRhK-4 cells, while the other part was first treated with a PV-neutralizing serum and then assayed for HAV with the same cell line. The results are reported as mean percentages of reduction in PFU compared with the amount of infectious virus detectable after initial drying.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units: Doebbeling BN, Stanley GL, Sheetz CT, et al. N Engl J Med 1992;327:88–93. Reprint requests: Dr. R, P. Wenzel, Dept. of Internal Medicine, C41, GH, The University of Iowa College of Medicine, Iowa City, IA 52242

Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units: Doebbeling BN, Stanley GL, Sheetz CT, et al. N Engl J Med 1992;327:88–93. Reprint requests: Dr. R, P. Wenzel, Dept. of Internal Medicine, C41, GH, The University of Iowa College of Medicine, Iowa City, IA 52242