Barbut Frédéric, Maury Eric, Goldwirt Laurianne, Boëlle Piérre-Yves, Neyme Denis, Aman Rubina, Rossi Beatrice, Offenstadt Georges
Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Unité d'Hygiène et de Lutte contre les Infections Nosocomiales, 184 rue du faubourg Saint-Antoine, 75012 Paris 12, France.
J Hosp Infect. 2007 Jun;66(2):167-73. doi: 10.1016/j.jhin.2007.03.021. Epub 2007 May 21.
The aims of this study were to compare the antibacterial efficacy of handrubbing with an alcoholic rinse (AHRR) and two different alcoholic gels (AHRG) in reducing hand contamination under practical use conditions. We wanted to assess the acceptability of the three products and to determine the effect of each product on overall hand hygiene compliance. A prospective alternating time-series clinical trial was performed in a medical intensive care unit. The study was divided into three six-week periods (P1, P2, P3). Handrubbing was achieved with Sterillium rinse (AHRR) during P1, sterillium gel(AHRG-1) during P2 and Manugel Plus (AHRG-2) during P3. Pre- and post-rubbing hand contaminations were assessed immediately after a direct contact with a patient, using the glove juice technique. Health care workers (HCWs) evaluated the acceptability of the products through a self-administered anonymous questionnaire. Compliance of HCWs with hand hygiene was assessed during the three periods. We studied 242 handrubbing opportunities. The mean reduction factor (expressed as the Log(10) CFU/mL) of the AHRR, AHRG-1 and AHRG-2 were 1.28+/-0.95, 1.29+/-0.84 and 0.51+/-0.73, respectively (p<0.001). Assessment of the three products by HCWs indicated that AHRR and AHRG-1 were significantly better accepted than AHRG-2. The overall compliance of HCWs to hand hygiene was better when gel was available. Under practical use conditions, AHRG-1 and AHRR were more effective than AHRG-2, although all were claimed to pass the European standard EN1500. In vivo trials are essential to compare the antimicrobial efficacy of products for handrubbing.
本研究的目的是比较使用含酒精冲洗液（AHRR）和两种不同酒精凝胶（AHRG）进行手部揉搓在实际使用条件下减少手部污染的抗菌效果。我们希望评估这三种产品的可接受性，并确定每种产品对整体手部卫生依从性的影响。在一个医疗重症监护病房进行了一项前瞻性交替时间序列临床试验。该研究分为三个为期六周的阶段（P1、P2、P3）。在P1阶段使用施乐辉冲洗液（AHRR）进行手部揉搓，P2阶段使用施乐辉凝胶（AHRG - 1），P3阶段使用玛努洁尔加强型（AHRG - 2）。在与患者直接接触后，立即使用手套浸液技术评估揉搓前后的手部污染情况。医护人员通过自行填写的匿名问卷评估产品的可接受性。在这三个阶段评估医护人员手部卫生的依从性。我们研究了242次手部揉搓机会。AHRR、AHRG - 1和AHRG - 2的平均降低因子（以Log(10) CFU/mL表示）分别为1.28±0.95、1.29±0.84和0.51±0.73（p<0.001）。医护人员对这三种产品的评估表明，AHRR和AHRG - 1比AHRG - 2的接受度明显更高。当有凝胶可用时，医护人员对手部卫生的总体依从性更好。在实际使用条件下，尽管所有产品均声称通过了欧洲标准EN1500，但AHRG - 1和AHRR比AHRG - 2更有效。体内试验对于比较手部揉搓产品的抗菌效果至关重要。
