Alcohol gel and chlorhexidine in microbiota on hands

Excerpt:


J. Pharm. Pharmacogn. Res., vol. 12, no. 1, pp. 184-192, Jan-Feb 2024. DOI: https://doi.org/10.56499/jppres23.1733_12.1.184 Original Article Alcohol in gel is as effective as chlorhexidine in the reduction of microbiota on hands in hospital nurses [El alcohol en gel es tan eficaz como la clorhexidina en la reducción de la microbiota de las manos en enfermeras … Continue reading Alcohol gel and chlorhexidine in microbiota on hands

J. Pharm. Pharmacogn. Res., vol. 12, no. 1, pp. 184-192, Jan-Feb 2024.

DOI: https://doi.org/10.56499/jppres23.1733_12.1.184

Original Article

Alcohol in gel is as effective as chlorhexidine in the reduction of microbiota on hands in hospital nurses

[El alcohol en gel es tan eficaz como la clorhexidina en la reducción de la microbiota de las manos en enfermeras de hospital]

Diana R. Gil-Peña1, María S. Ayala-Ravelo1, Jorge E. Neciosup-Obando2, Julio V. Campos-Florián3*, Juan J. Huamán-Saavedra4

1Universidad Nacional de Trujillo. Postgraduate School of Medicine. Trujillo, Peru.

2Universidad San Pedro - Population and Development Research Institute. Chimbote, Peru.

3Universidad Nacional de Trujillo. School of Pharmacy and Biochemistry. Trujillo, Peru.

4Universidad Privada Antenor Orrego. Trujillo, Peru.

*E-mail: jcamposf@unitru.edu.pe

Abstract

Context: Alcohol gel (70% ethanol, AG) and 2% chlorhexidine foam (CF) are hand antiseptics recommended by the World Health Organization. Although both are effective, it is unclear if one is superior to the other in a hospital setting.

Aims: To evaluate the disinfectant ability comparing AG and CF by analyzing microbial reduction on the hands of nursing staff from two hospitals in Northern Peru.

Methods: The nursing staff was randomly assigned to the AG and CF treatment groups. Before and after antisepsis, samples were taken by inserting the hands into a sterile self-closing bag containing peptone water. A sample of the liquid medium was plated on agar and used to calculate the CFU/mL of the peptone water. Participant data was analyzed in aggregate or according to hospital, profession, or service.

Results: Both AG and CF were significantly effective in reducing CFU/mL. In aggregate, CFU/mL reduction was 80.9% for AG and 91.3% for CF, but the difference was not statistically significant. However, a small statistically significant difference in favor of CF was observed in the surgical center of both hospitals. These results are confirmed with multivariate analysis.

Conclusions: AG and CF are both effective in hand antisepsis, but other factors are important when deciding which agent is appropriate for a specific healthcare setting.

Keywords: local anti-infective agents; chlorhexidine; ethanol; hand disinfection; hygiene; microbiota.

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Resumen

Contexto: El alcohol en gel (etanol al 70%, AG) y la espuma de clorhexidina al 2% (CF) son antisépticos de manos recomendados por la Organización Mundial de la Salud. Aunque ambos son eficaces, no está claro si uno es superior al otro en un entorno hospitalario.

Objetivos: Evaluar la capacidad desinfectante comparando AG y CF mediante el análisis de la reducción microbiana en las manos del personal de enfermería de dos hospitales del norte de Perú.

Métodos: El personal de enfermería fue asignado aleatoriamente a los grupos de tratamiento AG y CF. Antes y después de la antisepsia, se tomaron muestras introduciendo las manos en una bolsa estéril de cierre automático que contenía agua de peptona. Una muestra del medio líquido se sembró en agar y se utilizó para calcular las UFC/mL del agua de peptona. Los datos de los participantes se analizaron en conjunto o según el hospital, la profesión o el servicio.

Resultados: Tanto AG como CF fueron significativamente eficaces en la reducción de UFC/mL. En conjunto, la reducción de UFC/mL fue del 80,9% para AG y del 91,3% para CF, pero la diferencia no fue estadísticamente significativa. Sin embargo, se observó una pequeña diferencia estadísticamente significativa a favor de la CF en el centro quirúrgico de ambos hospitales. Estos resultados se confirman con el análisis multivariante.

Conclusiones: Tanto AG como CF son eficaces en la antisepsia de manos, pero otros factores son importantes a la hora de decidir qué agente es apropiado para un entorno sanitario específico.

Palabras Clave: agentes antiinfecciosos locales; clorhexidina; desinfección de manos; etanol; higiene; microbiota.

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Citation Format: Gil-Peña DR, Ayala-Ravelo MS, Neciosup-Obando JE, Campos-Florián JV, Huamán-Saavedra JJ (2024) Alcohol in gel is as effective as chlorhexidine in the reduction of microbiota on hands in hospital nurses. J Pharm Pharmacogn Res 12(1): 184–192. https://doi.org/10.56499/jppres23.1733_12.1.184
References

Arbogast J, Bowersock L, Parker A, Macinga D (2019) Randomized controlled trial evaluating the antimicrobial efficacy of chlorhexidine gluconate and para-chloro-meta-xylenol handwash formulations in real-world doses. Am J Infect Control 47: 726–728. https://doi.org/10.1016/j.ajic.2018.10.027

Cano-Gonzáles G, Reyes-Hernández K, López-Cruz G, Alonso-Pérez N, Soria-Saavedra F, Pacheco-Barete C, Reyes-Gómez U, Xochihua-Díaz L, Candelas-Delgado E, Alcántara-Salinas A, Escobar-Rojas V, Reyes-Hernández M (2020) Hand hygiene [Spanish]. Bol Clin Hosp Infant Edo Son. 37: 34–47. http://www.hies.gob.mx/img/boletin/BOLETIN201.pdf

D'Angelo I, Provenzano R, Florio E, Pagliuca C, Mantova G, Scaglione E, Vitiello M, Colicchio R, Salvatore P, Ungaro F, Quaglia F, Miro A (2022) Alcohol-based hand sanitizers: Does gelling agent really matter? Gels 8: 87. https://doi.org/10.3390/gels8020087

De la Cruz R, Villa M, Calderón J, Sánchez M (2013) Comparison of the germicidal activity and residual action of chlorhexidine, based disinfectants citrus and ethanol [Spanish]. Enf Inf Microbiol 33: 6–12. https://www.medigraphic.com/pdfs/micro/ei-2013/ei131b.pdf

Diomedi A, Chacón E, Delpiano L, Hervé B, Jemenao I, Medel M, Quintanilla M, Riedel G, Tinoco J, Cifuentes M (2017) Antisépticos y desinfectantes: apuntando al uso racional. Recomendaciones del Comité Consultivo de Infecciones Asociadas a la Atención de Salud, Sociedad Chilena de Infectología. Rev Chil Infectol 34: 156–174. http://dx.doi.org/10.4067/S0716-10182017000200010

Edwards RA, Riley CB, Howe L, Burrows EA, Riley KT, Frellstedt L (2017) Comparison of an alcohol-based hand sanitation product with a traditional chlorhexidine hand scrub technique for hand hygiene preparation in an equine hospital. N Z Vet J 65: 242–247. https://doi.org/10.1080/00480169.2017.1342175

Girou E, Loyeau S, Legrand P, Oppein F, Brun-Buisson C (2002) Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial. BMJ 325(7360): 362. https://doi.org/10.1136/bmj.325.7360.362

Gold N, Mirza T, Avva U (2022) Alcohol sanitizer. StatPearls [Internet]. Treasure Island (FL): Stat Pearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513254/

Ho J, Wang Y, Loh E, Tam K (2019) Antiseptic efficacies of waterless hand rub, chlorhexidine scrub, and povidone-iodine scrub in surgical settings: A meta-analysis of randomized controlled trials. J Hosp Infect 101(4): 370–379. https://doi.org/10.1016/j.jhin.2018.11.012

IREN - Regional Institute of Neoplastic Diseases - North [Instituto Regional de Enfermedades Neoplásicas - Norte (IREN)] (2012) Guía: Lavado de manos clínico y quirúrgico, 1st edn. Trujillo-Perú. http://www.irennorte.gob.pe/pdf/epidemiologia/GUIA-LAVADO-MANO-CLINICO-Y-QUIRURGICO-FINAL-ABV.pdf (Accessed 5 August 2022).

Jing JLJ, Pei-Yi T, Bose RJC, McCarthy JR, Tharmalingam N, Madheswaran T (2020) Hand sanitizers: A review on formulation aspects, adverse effects, and regulations. Int J Environ Res Public Health. 17(9): 3326. https://doi.org/10.3390/ijerph17093326

Jolliffe IT, Cadima J (2016) Principal component analysis: A review and recent developments. Philos Trans A Math Phys Eng Sci 374(2065): 20150202. https://doi.org/10.1098/rsta.2015.0202

Leal A, Bocanegra R, Mojica L, Cely J, Guerrero C, Rodríguez I, Ávila M, Chalá M, Charry N, Vanegas S (2015) Manual de toma de muestras para análisis microbiológico. Secretaría Distrital de Salud, Colombia. http://www.saludcapital.gov.co/DSP/Resistencia%20Bacteriana/Manual%20Toma%20de%20Muestras/Manual_de_toma_de_muestras_para_an%C3%A1lisis_microbiol%C3%B3gico.pdf (Accessed 8 July 2022).

MINSA - Ministry of Health, Peru (2016) Guía técnica para la implementación del proceso de higiene de manos en los establecimientos de salud. RM N°255-2016/MINSA. http://bvs.minsa.gob.pe/local/MINSA/3554.pdf

Morejón DB, Notario R (2020) Comparison of the germicidal efficacy between an alcohol-based hand rub, antimicrobial soap and plain soap in hand hygiene [Spanish]. Rev Med Rosario 86: 67–76. http://revistamedicaderosario.org/index.php/rm/article/view/74

Norman G, Streiner D (1998) Bioestadística. Ed. Harcourt Brace. 1st edn. Spain, p. 61.

Patiño L, Morales C (2013) Skin microbiota: The cutaneous ecosystem. Rev Asoc Colomb Dermatol 21: 147–158. https://revistasocolderma.org/sites/default/files/microbiota_de_la_piel_el_ecosistema_cutaneo.pdf

Saha T, Khadka P, Das SC (2021) Alcohol-based hand sanitizer - composition, proper use and precautions. Germs 11(3): 408–417. https://doi.org/10.18683/germs.2021.1278

Sosa O (2019) La higiene de manos en el Hospital Juárez de México. Rev Hosp Jua Mex 86(2): 68–69. https://www.medigraphic.com/pdfs/juarez/ju-2019/ju192a.pdf

Tarka P, Gutkowska K, Nitsch-Osuch A (2019) Assessment of tolerability and acceptability of an alcohol-based hand rub according to a WHO protocol and using apparatus tests. Antimicrob Resist Infect Control 8: 191. https://doi.org/10.1186/s13756-019-0646-8

Tsai J, Lin Y, Huang Y, Loh E, Wen H, Wang C, Tsai Y, Hsieh W, Tam K (2017) Antiseptic effect of conventional povidone–iodine scrub, chlorhexidine scrub, and waterless hand rub in a surgical room: A randomized controlled trial. Infect Control Hosp Epidemiol 38: 417–422. https://doi.org/10.1017/ice.2016.296

Villa C, Russo E (2021) Hydrogels in hand sanitizers. Materials (Basel). 14(7): 1577. https://doi.org/10.3390/ma14071577

WHO (2009a) Guía de la OMS sobre Higiene de Manos en la Atención de la Salud: Resumen. WHO/IER/PSP/2009.07. Geneva, Switzerland. Pp. 9–11. http://cmas.siu.buap.mx/portal_pprd/work/sites/hup/resources/LocalContent/247/2/guia_lavado_de_manos.pdf

WHO (2009b) Manual técnico de referencia para la higiene de manos. WHO/IER/PSP/2009.02. pp. 8–20. https://apps.who.int/iris/bitstream/handle/10665/102537/WHO_IER_PSP_2009.02_spa.pdf

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