A novel rapid and effective donor arm disinfection method.
BACKGROUND
The aim of the study was to derive a donor arm disinfection technique that was rapid, but with a disinfection efficacy equivalent to a previous "best-practice" technique. This method consisted of a two-stage procedure with an initial application of 70% isopropyl alcohol and then 2% tincture of iodine (IATI). The total time for the IATI method was 2 minutes in duration. A rapid technique (1 min in duration) was needed to obviate potential problems due to increased donor waiting time, had the IATI method been implemented at blood donation sessions.


METHODS
A direct swabbing and plating technique was used to enumerate bacteria present before and after disinfection. In total, seven methods were evaluated.


RESULTS
The chlorhexidine/alcohol applicator (CAA) disinfection device containing 1.5 mL of 2% chlorhexidine gluconate and 70% isopropyl alcohol (99.91% reduction; confidence limits, 99.55%, 99.98%) was shown to have equivalent disinfection efficacy as the IATI method (99.89% reduction; confidence limits, 99.36%, 99.98%; p = 0.86). Procedural time for the 1.5-mL CAA method was 1 minute thereby avoiding potential problems of increased donor waiting time, inherent in the IATI 2-minute procedure at blood donation sessions.


CONCLUSIONS
The 1.5-mL CAA disinfection method offers blood services a rapid and effective donor arm disinfection procedure. In 2006, the 1.5-mL CAA procedure was implemented throughout the entire English blood service for all donations.
McDonald
Carl
C
National Bacteriology Laboratory, NHS Blood and Transplant, London, UK. carl.mcdonald@nhsbt.nhs.uk
McGuane
Siobhan
S
Thomas
Julia
J
Hartley
Stephen
S
Robbins
Steve
S
Roy
Anjana
A
Verlander
Neville
N
Barbara
John
J
D019840:2-Propanol / Q000008:administration & dosage; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D016470:Bacteremia / Q000517:prevention & control* / Q000635:transmission; D001419:Bacteria / Q000187:drug effects; D019985:Benchmarking; D001771:Blood Banks / Q000592:standards; D001782:Blood Donors; D002710:Chlorhexidine / Q000008:administration & dosage; D004203:Disinfection / Q000379:methods* / Q000592:standards; D006801:Humans; D007455:Iodine / Q000008:administration & dosage; D018962:Phlebotomy / Q000379:methods* / Q000592:standards; D012867:Skin / Q000382:microbiology; D013997:Time Factors; D000094902:Blood Banking / Q000379:methods*
D000891:Anti-Infective Agents, Local; D007455:Iodine; D019840:2-Propanol; D002710:Chlorhexidine