Zaragoza M, Sallés M, Gomez J, Bayas J M, Trilla A
Hospital Hygiene and Central Sterilization Unit, Microbiology Laboratory, Preventive Medicine Department, Hospital Clinic-University of Barcelona, Spain.
Am J Infect Control. 1999 Jun;27(3):258-61. doi: 10.1053/ic.1999.v27.a97622.
The effectiveness of an alcoholic solution compared with the standard hygienic handwashing procedure during regular work in clinical wards and intensive care units of a large public university hospital in Barcelona was assessed.
A prospective, randomized clinical trial with crossover design, paired data, and blind evaluation was done. Eligible health care workers (HCWs) included permanent and temporary HCWs of wards and intensive care units. From each category, a random sample of persons was selected. HCWs were randomly assigned to regular handwashing (liquid soap and water) or handwashing with the alcoholic solution by using a crossover design. The number of colony-forming units on agar plates from hands printing in 3 different samples was counted.
A total of 47 HCWs were included. The average reduction in the number of colony-forming units from samples before handwashing to samples after handwashing was 49.6% for soap and water and 88.2% for the alcoholic solution. When both methods were compared, the average number of colony-forming units recovered after the procedure showed a statistically significant difference in favor of the alcoholic solution (P <.001). The alcoholic solution was well tolerated by HCWs. Overall acceptance rate was classified as "good" by 72% of HCWs after 2 weeks use. Of all HCWs included, 9.3% stated that the use of the alcoholic solution worsened minor pre-existing skin conditions.
Although the regular use of hygienic soap and water handwashing procedures is the gold standard, the use of alcoholic solutions is effective and safe and deserves more attention, especially in situations in which the handwashing compliance rate is hampered by architectural problems (lack of sinks) or nursing work overload.
在巴塞罗那一所大型公立大学医院的临床病房和重症监护病房日常工作期间，评估了酒精溶液与标准卫生洗手程序相比的有效性。
进行了一项采用交叉设计、配对数据和盲法评估的前瞻性随机临床试验。符合条件的医护人员包括病房和重症监护病房的长期和临时医护人员。从每个类别中随机抽取人员样本。医护人员通过交叉设计被随机分配到常规洗手（液体肥皂和水）或用酒精溶液洗手。对在3个不同样本中手上印模在琼脂平板上的菌落形成单位数量进行计数。
共纳入47名医护人员。从洗手前样本到洗手后样本，肥皂和水导致的菌落形成单位数量平均减少49.6%，酒精溶液导致的减少88.2%。当比较两种方法时，操作后回收的菌落形成单位平均数量显示酒精溶液具有统计学显著差异（P<.001）。酒精溶液被医护人员良好耐受。使用2周后，72%的医护人员将总体接受率归类为“良好”。在所有纳入的医护人员中，9.3%表示使用酒精溶液使先前存在的轻微皮肤状况恶化。
尽管经常使用卫生肥皂和水洗手程序是金标准，但酒精溶液的使用有效且安全，值得更多关注，尤其是在洗手依从率因建筑问题（水槽不足）或护理工作负荷过重而受到阻碍的情况下。
