Hand Hygiene with Soap and Water Is Superior to Alcohol Rub and Antiseptic Wipes for Removal of<i>Clostridium difficile</i>

Oughton, Matthew; Loo, Vivian G.; Dendukuri, Nandini; Fenn, Susan; Libman, Michael

doi:10.1086/605322

Cited by 176 publications

(105 citation statements)

References 30 publications

(18 reference statements)

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“…However, there are no robust data in the literature to support this hypothesis. Oughton and colleagues (145) performed an in vitro study using 10 volunteers whose hands were inoculated with a standard culture of a nontoxigenic C. difficile strain (1.4 ϫ 10 5 CFU/ml, comprising 62% spore forms of the organism). Volunteers' hands were subsequently assigned randomly to one of five hand hygiene interventions, including an ABHR containing 70% (vol/vol) isopropanol, and C. difficile viable counts from hand washings were determined.…”

Section: Alcohol-based Hand Hygiene and Risk Of CDImentioning

confidence: 99%

The Changing Epidemiology of Clostridium difficile Infections

et al. 2010

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SUMMARY The epidemiology of Clostridium difficile infection (CDI) has changed dramatically during this millennium. Infection rates have increased markedly in most countries with detailed surveillance data. There have been clear changes in the clinical presentation, response to treatment, and outcome of CDI. These changes have been driven to a major degree by the emergence and epidemic spread of a novel strain, known as PCR ribotype 027 (sometimes referred to as BI/NAP1/027). We review the evidence for the changing epidemiology, clinical virulence and outcome of treatment of CDI, and the similarities and differences between data from various countries and continents. Community-acquired CDI has also emerged, although the evidence for this as a distinct new entity is less clear. There are new data on the etiology of and potential risk factors for CDI; controversial issues include specific antimicrobial agents, gastric acid suppressants, potential animal and food sources of C. difficile, and the effect of the use of alcohol-based hand hygiene agents.

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Section: Alcohol-based Hand Hygiene and Risk Of CDImentioning

confidence: 99%

The Changing Epidemiology of Clostridium difficile Infections

et al. 2010

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“…18,19 Alcohol-based hand sanitizers have limited efficacy against some enteric pathogens, such as the sporeforming bacteria Clostridium difficile and Norwalk virus. 20,21 However, because of its broad effectiveness, proven improved disinfection capabilities over plain soap, and ease of use, the World Health Organization (WHO) now recommends alcoholbased hand sanitizer as the preferred hand cleaning method for most clinical situations in healthcare facilities around the world. 22 There is evidence that alcohol-based sanitizers perform as well as handwashing with soap and water in settings where hands are highly contaminated with fecal bacteria and show visible dirt 23,24 ; however, limited research has been conducted on the behavioral and health impacts of hand sanitizer use in low-income settings.…”

Section: Introductionmentioning

confidence: 99%

Access to Waterless Hand Sanitizer Improves Student Hand Hygiene Behavior in Primary Schools in Nairobi, Kenya

Pickering¹,

Davis²,

Blum³

et al. 2013

The American Society of Tropical Medicine and Hygiene

111

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Abstract. Handwashing is difficult in settings with limited resources and water access. In primary schools within urban Kibera, Kenya, we investigated the impact of providing waterless hand sanitizer on student hand hygiene behavior. Two schools received a waterless hand sanitizer intervention, two schools received a handwashing with soap intervention, and two schools received no intervention. Hand cleaning behavior after toilet use was monitored for 2 months using structured observation. Hand cleaning after toileting was 82% at sanitizer schools (N = 2,507 toileting events), 38% at soap schools (N = 3,429), and 37% at control schools (N = 2,797). Students at sanitizer schools were 23% less likely to have observed rhinorrhea than control students (P = 0.02); reductions in student-reported gastrointestinal and respiratory illness symptoms were not statistically significant. Providing waterless hand sanitizer markedly increased student hand cleaning after toilet use, whereas the soap intervention did not. Waterless hand sanitizer may be a promising option to improve student hand cleansing behavior, particularly in schools with limited water access.

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“…82,[91][92][93] Hand rubs are less effective against bacterial spores, protozoal parasites, and some nonenveloped viruses. 82,94,95 In the field, when running water is not available and hands are visibly soiled, use of a moist wipe to remove organic material prior to application of an alcohol-based hand rub may increase the effectiveness of hand hygiene. Use of moist wipes alone is not recommended.…”

Section: Veterinary Standard Precautionsmentioning

confidence: 99%

Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel: National Association of State Public Health Veterinarians: Veterinary Infection Control Committee 2015

Williams¹,

Scheftel²,

Elchos³

et al. 2015

javma

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Hand Hygiene with Soap and Water Is Superior to Alcohol Rub and Antiseptic Wipes for Removal ofClostridium difficile

Abstract: Handwashing with soap and water showed the greatest efficacy in removing C. difficile and should be performed preferentially over the use of alcohol-based handrubs when contact with C. difficile is suspected or likely.

Cited by 176 publications

References 30 publications

The Changing Epidemiology of Clostridium difficile Infections

The Changing Epidemiology of Clostridium difficile Infections

Access to Waterless Hand Sanitizer Improves Student Hand Hygiene Behavior in Primary Schools in Nairobi, Kenya

Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel: National Association of State Public Health Veterinarians: Veterinary Infection Control Committee 2015

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