title: A comparison of the antibacterial efficacy and cytotoxicity to cultured human skin cells of 7 commercial hand rubs and Xgel, a new copper-based biocidal hand rub.
abstract: BACKGROUND
  Hand cleanliness is important in hospital infection control, but skin irritation from frequent alcohol-based hand rub use reduces compliance. We have compared a new copper biocide/Aloe vera-based biocidal hand rub (Xgel) with 7 commercially available hand rubs.
  
  
  METHODS
  Hand rubs were cultured with human skin cells for 24 hours after which cytotoxicity was assessed using the sulforhodamine B assay. The EN 12054 bacterial suspension test protocol was used to assess biocidal activity of 2 of the least cytotoxic hand rubs (Xgel and Purell).
  
  
  RESULTS
  Hand rubs had 50% cytotoxic concentrations ranging from >10% to <0.1% vol/vol. In the EN12054 assay, Xgel reduced colony forming units (CFU) by >10(8) with methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter in 1 minute, whereas Purell only reduced CFU by 10(4) and 10(5), respectively. Purell was ineffective against C difficile spores, whereas Xgel produced a 3 x 10(3) reduction in CFU.
  
  
  CONCLUSIONS
  The hand rubs had a wide range of cytotoxicity values for human skin cells, with Xgel being the least cytotoxic to human skin cells. In the EN 12054 bacterial suspension test, Xgel was more effective than Purell against all organisms tested. It should be noted that these in vitro results may not translate into clinical differences.
authors.affiliation: Remedy Research Ltd., 8 Blenheim Road, London, UK. tonyjhall@hotmail.com
authors.forename: Tony J
authors.initials: TJ
authors.lastname: Hall
authors.forename: Michael W D
authors.initials: MW
authors.lastname: Wren
authors.forename: Annette
authors.initials: A
authors.lastname: Jeanes
authors.forename: Vanya A
authors.initials: VA
authors.lastname: Gant
mesh_terms: D000279:Administration, Cutaneous; D000438:Alcohols / Q000494:pharmacology*; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects*; D018929:Cell Culture Techniques; D002460:Cell Line / Q000187:drug effects; D015169:Colony Count, Microbial; D003300:Copper / Q000737:chemistry / Q000633:toxicity*; D004203:Disinfection / Q000379:methods; D004847:Epithelial Cells / Q000187:drug effects; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D012867:Skin / Q000166:cytology / Q000187:drug effects*; D023422:Skin Irritancy Tests
chemical_list: D000438:Alcohols; D000891:Anti-Infective Agents, Local; D003300:Copper