Suchomel Miranda, Weinlich Martina, Kundi Michael
Institute of Hygiene and Applied Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
Antimicrob Resist Infect Control. 2017 Jun 27;6:72. doi: 10.1186/s13756-017-0229-5. eCollection 2017.
Guidelines for hand hygiene recommend the use of alcohol-based hand rubs containing humectants in order to improve dermal tolerance. However, the bactericidal efficacy of pre-surgical hand rubs is negatively affected by the WHO-recommended humectant glycerol, especially the 3-h efficacy. The aim of this study was to investigate whether replacing glycerol as humectant increases the bactericidal efficacy of surgical hand rubs based on isopropanol (75%, wt/wt).
The efficacy of 3 and 5 min applications of a modified WHO II-formulation (containing lower glycerol concentrations) and the TPH 5766 hand rub which contains a new humectant (containing ethylhexylglycerin, dexpanthenol and a fatty alcohol) were compared to the European Norm 12,791 reference (n-propanol, 60%, vol/vol) immediately following and 3 h after application.
Immediately after application both isopropanol-based surgical rubs approximated the performance of the reference. The 3-h effect of the modified WHO II-formulation was found to be less efficacious than the EN 12791, showing a 30% decrease in log reduction values. The 3-h post application effect for the TPH 5766 hand rub was found to not be different from EN 12791.
Based on our data, the bactericidal efficacy of isopropanol-based surgical hand rubs can best be obtained if glycerol is not used in the formulation. Unlike glycerol, a humectant comprised of ethylhexylglycerin, dexpanthenol and a fatty alcohol was found not to decrease hand rub effectiveness. Further investigation of the bactericidal efficacy of other humectants is necessary and may prove useful.
手部卫生指南建议使用含有保湿剂的酒精类洗手液，以提高皮肤耐受性。然而，世界卫生组织推荐的保湿剂甘油会对术前洗手液的杀菌效果产生负面影响，尤其是3小时的杀菌效果。本研究的目的是调查用其他保湿剂替代甘油是否能提高基于异丙醇（75%，重量/重量）的外科洗手液的杀菌效果。
将改良的世界卫生组织II型配方（甘油浓度较低）和含有新型保湿剂（含有乙基己基甘油、泛醇和一种脂肪醇）的TPH 5766洗手液分别作用3分钟和5分钟后的杀菌效果，与欧洲标准12791参考品（正丙醇，60%，体积/体积）在使用后立即及3小时后的杀菌效果进行比较。
使用后立即观察发现，两种基于异丙醇的外科洗手液的性能均接近参考品。改良的世界卫生组织II型配方在3小时后的效果不如EN 12791，对数减少值下降了30%。TPH 5766洗手液在使用3小时后的效果与EN 12791没有差异。
根据我们的数据，如果配方中不使用甘油，基于异丙醇的外科洗手液的杀菌效果最佳。与甘油不同，由乙基己基甘油、泛醇和一种脂肪醇组成的保湿剂不会降低洗手液的有效性。有必要对其他保湿剂的杀菌效果做进一步研究，这可能会被证明是有用的。
