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Failure of Bland Soap Handwash to Prevent Hand Transfer of Patient Bacteria to Urethral Catheters

Published online by Cambridge University Press:  21 June 2016

N. Joel Ehrenkranz  and
Blanca C. Alfonso
N. Joel Ehrenkranz*
Affiliation:
Florida Consortium for Infection Control, South Miami, Florida
Blanca C. Alfonso
Affiliation:
Florida Consortium for Infection Control, South Miami, Florida
*
5901 SW 74th St., Suite 300, South Miami, FL 33143
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Abstract

Objective:

The study was designed to compare the efficacies of bland soap handwash and isopropyl alcohol hand rinse in preventing transfer of aerobic gram-negative bacilli to urinary catheters via transient hand colonization acquired from direct patient contact. Glove juice recovery of gram-negative bacteria was considered transient colonization; catheter recovery was considered transfer colonization.

Design:

The contact source for gram-negative bacteria was a single “high burden” groin skin carrier ( ≥ 104/ml cup scrub fluid). Using a two-period cross-over design, 6 healthcare workers had 2 15-second contacts for each hand followed by either soap handwash or alcohol hand rinse (12 experiments with each treatment). Between 4 to 5 minutes after contact, each hand manipulated a catheter; the catheter was then cultured and the hand was glove juice tested.

Results:

Soap handwash failed to prevent gram-negative bacteria transfer to the catheter in 11 of 12 (92%) experiments; alcohol hand rinse in 2 of 12 (17%) (p< .001). Soap handwash failed to prevent transient colonization in 12 of 12 (100%) experiments; alcohol in 5 of 12 (42%) (risk ratio 2.4,95% confidence interval 1.2-4.7). Single gram-negative bacteria species carried at source levels ≥ 5.5 × 103/ml (heavy contamination) established transient colonization in 23 of 30 (77%) exposures following soap handwash; single gram-negative bacteria species carried at levels ≤ 3.5 × 103/ml established colonization in 1 of 22 (5%) similar exposures (p<.001).

Conclusions:

Bland soap handwash was generally ineffective in preventing hand transfer of gram-negative bacteria to catheters following brief contact with a heavy-contamination patient source; alcohol hand rinse was generally effective.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 11 , November 1991 , pp. 654 - 662
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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