Antimicrobial Resistance Following Prolonged Use of Hand Hygiene Products: A Systematic Review

Abstract

Background: This systematic review aimed to establish whether antimicrobial resistance (AMR) occurs following prolonged use of antimicrobial hand hygiene (HH) products, and, if so, in what magnitude. Methods: Key bibliographic databases were searched to locate items on HH use and AMR development from database inception to December 2020. Records were screened and full texts of all potentially eligible articles were retrieved and checked for inclusion. The following data from the included studies were abstracted: type of HH product used, including the name of antimicrobial agent, study setting, country, study year, duration of use and development of AMR including the organisms involved. Quality assessment was done using the Newcastle-Ottawa Scale (NOS). Results: Of 339 full-text articles assessed for eligibility, only four heterogeneous United States (US) studies conducted in the period between 1986 and 2015 were found eligible, and included. One hospital-based study showed evidence of AMR following long term use of HH products, two studies conducted in household settings showed no evidence of AMR, and another experimental study showed partial evidence of AMR. The overall certainty of the evidence was moderate. Conclusion: Prolonged use of HH products may cause AMR in health care settings, but perhaps not in other settings.

Prevalence of vancomycin-resistant Enterococci in India between 2000 and 2022: a systematic review and meta-analysis

“…Also, a survey study of hand hygiene practices among Indian medical undergraduates revealed that only 27.6% of students had good knowledge of hand hygiene practices [ 32 ]. Though it has been newly hypothesised that the prolonged use of hand hygiene products may cause AMR in healthcare settings [ 33 ], proper hand hygiene is regarded as one of the most important infection control measures [ 34 , 35 ]. Hand hygiene is specifically referenced as a principal practice for the prevention and control of the dissemination of antibiotic resistance with proven effectiveness in the case of VRE transmission [ 36 ].…”

Antibiotic-Resistant ESKAPE Pathogens and COVID-19: The Pandemic beyond the Pandemic

“…However, COVID-19 is a viral disease, and only a few patients might have bacterial co-infections; therefore, the use of antibiotics is not always necessary [ 25 ]. COVID-19 has increased the worldwide usage of antibiotics, personal protective equipment, and personal care products, such as soaps, handwashing liquids, and alcohol-based hand sanitizers, causing a knock-on effect in the existing global AMR problem [ 26 , 27 , 28 , 29 , 30 ]. Furthermore, the patients in intensive care, on prolonged mechanical ventilation, and with ventilator-associated pneumonia could have contributed to the colonization with nosocomial pathogens and led to an improved number of resistant isolates [ 31 ].…”

Alcohol-based Hand Rub as a Prophylactic Measure against SARS-COV-‎‎2 Infection: Can it Reduce the Infection with Vancomycin-Resistant ‎Enterococcus faecalis?‎ ‎

“…faecalis infection[17]. A systematic review of four studies suggested that the prolonged use of hand hygiene products may cause antimicrobial resistance (AMR) in health care settings[18].…”