Wade J J, Casewell M W
Department of Medical Microbiology, King's College School of Medicine & Dentistry, London, UK.
J Hosp Infect. 1991 Jun;18 Suppl B:23-8. doi: 10.1016/0195-6701(91)90259-b.
A model for evaluation of the residual activity of agents used for hygienic hand disinfection, which relates closely to the "in-use" setting, is described. We looked for residual activity following hand disinfection by a standard method with soap and water and four skin disinfectants in common use. Two test organisms known to have caused cross-infection and having clinically-significant antibiotic resistance were used: a strain of vancomycin-resistant Enterococcus faecium and one of gentamicin-multiply-resistant Enterobacter cloacae. Both organisms survived well on artificially inoculated hands. Residual activity on previously disinfected hands against both test organisms was most marked for alcoholic chlorhexidine ('Hibisol') which showed a 4 log10 reduction within 1 min of inoculation. Chlorhexidine digluconate skin cleanser ('Hibiscrub') and povidone-iodine surgical scrub ('Betadine') also had marked residual activity, but less than alcoholic chlorhexidine. 60% Isopropanol showed no residual activity and, except for marginal activity against E. cloacae, soap and water showed little residual activity. The residual activity of alcoholic chlorhexidine may be useful to control cross-infection with those multiply-resistant strains which survive well on fingers previously washed with soap and water.
本文描述了一种用于评估卫生手消毒所用制剂残留活性的模型，该模型与“实际使用”情况密切相关。我们通过标准方法，用肥皂和水以及四种常用皮肤消毒剂对手进行消毒后，检测其残留活性。使用了两种已知会引起交叉感染且具有临床显著抗生素耐药性的测试微生物：一株耐万古霉素的粪肠球菌和一株对庆大霉素多重耐药的阴沟肠杆菌。两种微生物在人工接种的手上均存活良好。对于酒精洗必泰（“希比索”），在先前消毒过的手上对两种测试微生物的残留活性最为显著，接种后1分钟内显示出4个对数级的减少。葡萄糖酸洗必泰皮肤清洁剂（“希比 scrub”）和聚维酮碘手术擦洗剂（“碘伏”）也有显著的残留活性，但低于酒精洗必泰。60%异丙醇未显示出残留活性，除了对阴沟肠杆菌有微弱活性外，肥皂和水几乎没有残留活性。酒精洗必泰的残留活性可能有助于控制与那些在先前用肥皂和水清洗过的手指上存活良好的多重耐药菌株的交叉感染。
