Assessment of handwashing practices with chemical and microbiologic methods: Preliminary results from a prospective crossover study

Marena, Carlo; Lodola, Lorenzo; Zecca, Marco; Bulgheroni, A.; Carretto, Edoardo; Maserati, Renato; Zambianchi, Luigina

doi:10.1067/mic.2002.125809

Cited by 36 publications

(21 citation statements)

References 17 publications

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“…ATP concentrations correlated well to the concentrations of intact microbial cells (r 2 = 0.88) indicating that monitoring ATP is a meaningful tool. Marena et al (2002) used ATP measurement via bioluminescence with the rapid test HY-LiTE to assess hand washing of clinical staff. 74 health care workers were evaluated with regard to hand contamination over a four month period.…”

Section: Discussionmentioning

confidence: 99%

“…A significant correlation between ATP measurement and colony forming units (p < 0.001; r = 0.68) was documented. Marena et al (2002) concluded that ATP bioluminescence is a simple and easy-to-use method which provides reliable results. In addition, Amodio et al (2014) recently reported a significant correlation between ATP bioluminescence and amount of aerobic bacteria after analyzing 193 randomly selected surface samples in an Italian hospital.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Determination of ATP-activity as a useful tool for monitoring microbial load in aqueous humidifier samples

Liebers

Bachmann

Franke

et al. 2015

International Journal of Hygiene and Environmental Health

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Determination of ATP-activity as a useful tool for monitoring microbial load in aqueous humidifier samples

Liebers

Bachmann

Franke

et al. 2015

International Journal of Hygiene and Environmental Health

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“…In a cross-over study comparing plain soap with one containing 4% CHG, unexpectedly, the latter showed higher final CFU counts after use of CHG-soap compared with plain soap, but the comparative CFU log reduction was not provided to permit conclusions concerning relative efficacy. 455 In another clinical study in two neonatal intensive care units comparing an alcohol rub with 2% CHGsoap, no difference was found either in infection rates or in microbial counts from nurses' hands. 456 Of note, the ethanol concentration (61%) of the sanitizer was low and the chemicals to neutralize CHG washed from the hands into the sampling fluids might not have been appropriate.…”

Section: Relative Efficacy Of Plain Soap Antiseptic Soaps and Detergmentioning

confidence: 94%

Hand Hygiene

Longtin¹,

Sax²,

Allegranzi³

et al. 2011

N Engl J Med

107

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“…Three studies demonstrated a decrease in infection rates with the hand sanitizer. 21,24,25 Two other studies 22,23 reported no significant differences in HCAI rates between handwashing and the introduction of a hand sanitizer. Another study 26 reported a decrease in MRSA rates postintervention.…”

Section: Category 2 Hand Hygiene Productsmentioning

confidence: 97%

“…In 5 of these studies, one before and after design with no control group 21 and 4 cohort studies with control groups [22][23][24][25] compared handwashing with the introduction of an alcohol hand sanitizer. Another before and after study with control group 26 compared the 4% antiseptic solution with the introduction of a 1% antiseptic solution.…”

Section: Category 2 Hand Hygiene Productsmentioning

confidence: 99%

An integrative review of the current evidence on the relationship between hand hygiene interventions and the incidence of health care–associated infections

Backman

Zoutman

Marck

2008

American Journal of Infection Control

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Background: The objectives of this integrative review were to critically examine the overall state of the current evidence on the relationship between hand hygiene interventions and the incidence of health care-associated infections (HCAIs) in acute care and long-term care settings, and offer recommendations for future directions in the field based on our findings. Methods: We searched for original research and reviews of research published between January 1, 1996, and July 31, 2006. Studies were identified through the electronic databases Medline, CINAHL, EMBASE, PUBMED, the Cochrane Library, and through expert consultation. Our comprehensive search strategy included all English articles for which hand hygiene or handwashing-related terms were combined with HCAIs. All studies that investigated a relationship between hand hygiene practices and HCAIs in acute care facilities were considered. These hand hygiene practices included the initiation of multimodal hand hygiene initiatives, the introduction of alcohol sanitizers, the implementation or changes of the infection control practices or infection control policies, and other organizational interventions. Studies only examining hand hygiene compliance, efficacy of alcohol hand gels, plain soap, and antimicrobial soap in reducing bacteria count recovered from hands were excluded. Results: Of the 1120 articles retrieved, 35 publications, including 4 reviews of research discussed at the outset of this article, met our inclusion criteria. The remaining 31 eligible original studies included 18 (58.07%) before and after studies without control groups, 4 (12.90%) before and after studies with a control group, 3 (9.68%) cohort studies with no control group, 4 (12.90%) cohort studies with a control group, and 2 (6.45%) randomized trials. Over 50% (16 or 31) of the studies were conducted in the U.S. Two independent reviewers conducted independent evaluations of all eligible studies, critiquing and scoring each study using a rating scale for examining the fatal flaws of quasi-experimental and before and after studies. Conclusions: There is a lack of rigorous evidence linking specific hand hygiene interventions with the prevention of HCAIs. The varied nature of the interventions used and the diverse factors affecting the acquisition of HCAIs make it difficult to show the specific effect of hand hygiene alone. The most frequent methodologies currently used in this research area are before and after observational studies without a control comparison group. Based on these findings, we recommend that researchers used a modified version of Larson's 2005 criteria to guide the design and conduct of future before and after observational studies in this area. We also argue that as we accumulate stronger evidence of which interventions are most effective, we need to develop additional research approaches to study how organizations succeed and fail in fostering the uptake of evidence-based hand hygiene interventions. (Am J Infect Control 2008;36:333-48.)

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Assessment of handwashing practices with chemical and microbiologic methods: Preliminary results from a prospective crossover study

Cited by 36 publications

References 17 publications

Determination of ATP-activity as a useful tool for monitoring microbial load in aqueous humidifier samples

Determination of ATP-activity as a useful tool for monitoring microbial load in aqueous humidifier samples

Hand Hygiene

An integrative review of the current evidence on the relationship between hand hygiene interventions and the incidence of health care–associated infections

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