Comparative in vitro and in vivo study of nine alcohol-based handrubs.
BACKGROUND
Hygienic hand disinfection using alcohol-based handrubs (AHRs) is an alternative method to conventional handwashing in hospital wards. Because a documented choice of such products would consider data from in-care evaluation, we designed a comparative study of 9 AHRs both in vitro and in vivo in actual care conditions.


METHODS
The bactericidal activity of AHRs was first measured in vitro against 4 hospital strains exhibiting multiple antibiotic resistance: Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacter aerogenes. In a second time, AHRs were tested in an intensive care unit for antibacterial activity against the cutaneous flora of personnel hands and for acceptance by the care personnel.


RESULTS
The 9 AHRs could be classified in 3 groups on the basis of their in vitro activity: products of the first group showed a bactericidal activity higher than 4 log(10) against the 4 strains. Only 1 of these products presented simultaneously an effective antibacterial activity against the cutaneous flora of care personnel hands and a good acceptance by the care personnel.


CONCLUSIONS
The in vitro study allowed the differentiation of the AHRs tested on the basis of bactericidal activity, but evaluation in an in-care situation allowed further discrimination through both antibacterial activity and acceptance. Thus, the combination of in vitro and in vivo evaluations should provide helpful arguments in the choice of AHRs.
Rochon-Edouard
Stéphanie
S
Department of Microbiology, Centre Hospitalier Universitaire Charles Nicolle, Rouen, France.
Pons
Jean-Louis
JL
Veber
Benoît
B
Larkin
Martine
M
Vassal
Serge
S
Lemeland
Jean-François
JF
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001424:Bacterial Infections / Q000517:prevention & control*; D016022:Case-Control Studies; D000431:Ethanol / Q000494:pharmacology*; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D066298:In Vitro Techniques; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D009873:Operating Rooms; D012016:Reference Values; D012680:Sensitivity and Specificity; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D000431:Ethanol