Effect of alcohol-based hand rub on hand microbiome and hand skin health in hospitalized adult stem cell transplant patients: A pilot study

Mukherjee, Pranab K.; Chandra, Jyotsna; Retuerto, Mauricio; Arters, Karen; Consolo, Mary C.; Patterson, A'ja; Bajaksouzian, Saralee; Arbogast, James W.; Cartner, Todd; Jacobs, Michael; Ghannoum, Mahmoud A.; Salata, Robert A.

doi:10.1016/j.jaad.2017.11.046

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Fungal and bacterial genomic DNA was isolated from the collected swabs using QiaAmp DNA Mini Kit (Qiagen) following the manufacturer's instructions, and their microbiome profile was determined using the Internally Transcribed Spacer 1 (ITS1) and 16S rDNA regions for fungi and bacteria, respectively, as described previously by our group (Mukherjee et al, 2014(Mukherjee et al, , 2017Chandra et al, 2016). The Greengenes V13_8 database was used for the taxonomic identification of the 16S RNA and the UNITE (7.2) database was used for the taxonomic identification of the ITS.…”

Section: Microbiome Analysesmentioning

confidence: 99%

Cutaneous dysbiosis may amplify barrier dysfunction in patients with atopic dermatitis

et al. 2022

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Atopic dermatitis (AD) is associated with cutaneous dysbiosis, barrier defects, and immune dysregulation, but the interplay between these factors needs further study. Early-onset barrier dysfunction may facilitate an innate immune response to commensal organisms and, consequently, the development of allergic sensitization. We aimed to compare the cutaneous microbiome in patients with active dermatitis with and without a history of childhood flexural dermatitis (atopic dermatitis). Next-gen Ion-Torrent deep-sequencing identified AD-associated changes in the skin bacterial microbiome (“bacteriome”) and fungal microbiome (“mycobiome”) of affected skin in swabs from areas of skin affected by dermatitis. Data were analyzed for diversity, abundance, and inter-kingdom correlations. Microbial interactions were assessed in biofilms using metabolic activity (XTT) assay and scanning electron microscopy (SEM), while host-pathogen interactions were determined in cultured primary keratinocytes exposed to biofilms. Increased richness and abundance of Staphylococcus, Lactococcus, and Alternaria were found in atopics. Staphylococcus and Alternaria formed robust mixed-species biofilms (based on XTT and SEM) that were resistant to antifungals/antimicrobials. Furthermore, their biofilm supernatant was capable of influencing keratinocytes biology (pro-inflammatory cytokines and structural proteins), suggesting an additive effect on AD-associated host response. In conclusion, microbial inter-kingdom and host-microbiome interactions may play a critical role in the modulation of atopic dermatitis to a greater extent than in non-atopic adults with allergic contact dermatitis.

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Section: Microbiome Analysesmentioning

confidence: 99%

Cutaneous dysbiosis may amplify barrier dysfunction in patients with atopic dermatitis

et al. 2022

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“…In addition, the overall trends in product efficacy largely stayed consistent for volunteers #2 and #3, however, for volunteer #1, results seemed to skew from the trends observed for the group as a whole. In other words, the products did not consistently perform better on one volunteer over another, suggesting that differences in skin properties such as skin hydration level, skin pH and/or skin microbiome ( Mukherjee et al, 2018 ) may influence the efficacy of different product formulations. Similar to data observed using in vivo fingerpad methods and bacteria, our results support the fact that subjects are a large source of variability when the same methods are applied to evaluating anti-hNoV activity in vivo ( Rotter, 1984 ; Suchomel et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

“…The U.S. Centers for Disease Control and Prevention (CDC) recommends the use of hand sanitizers, especially those containing at least 60% alcohol, as an acceptable method of hand hygiene when soap and water are not readily available ( U.S. Centers for Disease Control and Prevention, 2021 ). Hand sanitizers have several benefits relative to effective hand washing, including speed of use ( Hilburn et al, 2003 ), convenience, skin mildness ( Boyce, 2000 ; Boyce et al, 2000 ; Mukherjee et al, 2018 ) and broad-spectrum efficacy (for well-formulated products) ( Macinga et al, 2008 ; Edmonds et al, 2012 ). Commercial hand sanitizers contain active ingredients intended to destroy or otherwise inactivate pathogens.…”

Section: Introductionmentioning

confidence: 99%

Comparative Assessment of the Efficacy of Commercial Hand Sanitizers Against Human Norovirus Evaluated by an in vivo Fingerpad Method

et al. 2022

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Human noroviruses (hNoV) are the leading cause of acute non-bacterial gastroenteritis worldwide and contaminated hands play a significant role in the spread of disease. Some hand sanitizers claim to interrupt hNoV transmission, but their antiviral efficacy on human hands is poorly characterized. The purpose of this work was to characterize the efficacy of representative commercial hand sanitizers against hNoV using an in vivo fingerpad method (ASTM E1838-17). Eight products [seven ethanol-based and one benzalkonium chloride (BAK)-based], and a benchmark 60% ethanol solution, were each evaluated on 10 human volunteers using the epidemic GII.4 hNoV strain. Virus titers before and after treatment were evaluated by RT-qPCR preceded by RNase treatment; product efficacy was characterized by log10 reduction (LR) in hNoV genome equivalent copies after treatment. The benchmark treatment produced a 1.7 ± 0.5 LR, compared with Product A (containing 85% ethanol) which produced a 3.3 ± 0.3 LR and was the most efficacious (p < 0.05). Product B (containing 70% ethanol), while less efficacious than Product A (p < 0.05), performed better than the benchmark with a LR of 2.4 ± 0.4. Five of the other ethanol-based products (labeled ethanol concentration ranges of 62–80%) showed similar efficacy to the 60% ethanol benchmark with LR ranging from 1.3 to 2.0 (p > 0.05). Product H (0.1% BAK) was less effective than the benchmark with a LR of 0.3 ± 0.2 (p < 0.05). None of the products screened were able to completely eliminate hNoV (maximum assay resolution 5.0 LR). Product performance was variable and appears driven by overall formulation. There remains a need for more hand sanitizer formulations having greater activity against hNoV, a virus that is comparatively recalcitrant relative to other pathogens of concern in community, healthcare, and food preparation environments.

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“…Outside of hand sanitizer effects on the skin, gut, and eyes, there has even been evidence of a connection between the oral cavity and hand microbiome, suggesting that excessive hand sanitizer use can create dysbiosis in the mouth as well [ 67 ]. While very few studies have been published to date examining the effect of hand sanitizer use on the oral microbiome, given the frequency with which people touch their hands to their mouth, it is possible that excessive hand sanitizer use could disrupt the abundancy or diversity of the oral microbiome.…”

Section: Reviewmentioning

confidence: 99%

Hand Sanitizer: Stopping the Spread of Infection at a Cost

Bhatt,

Patel,

Kesselman

et al. 2024

Cureus

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The recent rise in hand sanitizer use due to the COVID-19 pandemic has had a beneficial impact on stopping the spread of disease, but the potential negative implications of its overuse on the body and the microbiome have yet to be thoroughly reviewed. Epidermal layers absorb hand sanitizer from direct application to the skin, making them some of the most susceptible cells to the adverse effects of overuse. The increased usage of hand sanitizer can affect the variation, quantity, and diversity of the skin microflora, leading to conditions such as eczema, atopic dermatitis, and even systemic toxicity due to colonization of the skin with pathogenic bacteria. Due to the close-knit relationship between the skin and gut, the gastrointestinal system can also incur disruptions due to the negative effects on the skin as a result of excessive hand sanitizer use, leading to gut dysbiosis. Additionally, the accidental ingestion of hand sanitizer, and its abuse or misuse, can be toxic and lead to alcohol poisoning, which is an issue most commonly seen not only in the pediatric population but also in adolescents and adults due to aberrant recreational exposure. As a vulnerable body system, the eyes can also be negatively impacted by hand sanitizer misuse leading to chemical injury, visual impairment, and even blindness. In this review, we aim to highlight the variations in hand sanitizer formulation, the benefits, and how misuse or overuse may lead to adverse effects on the skin, gut, and eyes. In particular, we review the advantages and disadvantages of alcohol-based hand sanitizers (ABHSs) and non-alcohol-based hand sanitizers (NABHSs) and how the components and chemicals used in each can contribute to organ dysbiosis and systemic damage.

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Effect of alcohol-based hand rub on hand microbiome and hand skin health in hospitalized adult stem cell transplant patients: A pilot study

Cited by 6 publications

References 5 publications

Cutaneous dysbiosis may amplify barrier dysfunction in patients with atopic dermatitis

Cutaneous dysbiosis may amplify barrier dysfunction in patients with atopic dermatitis

Comparative Assessment of the Efficacy of Commercial Hand Sanitizers Against Human Norovirus Evaluated by an in vivo Fingerpad Method

Hand Sanitizer: Stopping the Spread of Infection at a Cost

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