title: Impact of alcohol hand-rub use on meticillin-resistant Staphylococcus aureus: an analysis of the literature.
abstract: We aimed to evaluate the impact of alcohol hand disinfection with alcohol hand rub (AHR) as surrogate parameter of compliance or with compliance observations on the meticillin-resistant Staphylococcus aureus (MRSA) situation in hospital settings. Medline was searched for the keywords 'hand hygiene', 'compliance', 'disinfection', 'time series analysis' combined with 'meticillin-resistant Staphylococcus aureus/MRSA'. Data were included only from studies reporting exact numbers of AHR and/or compliance observations of MRSA situations over time. The literature search resulted in 272 hits, of which 12 studies met the inclusion criteria. The amount of AHR ranged between 3 and 78 mL/patient-day (pd) at the beginning and increased to 12 to 103 mL/pd at the end of the intervention studies. Compliance with hand disinfection ranged between 20% and 64% at the beginning and between 42% and 71% at the end. An increase in AHR correlated significantly with an improvement in the MRSA situation (r=0.78), whereas there was no such correlation between compliance and MRSA. An increased consumption of AHR was associated with a significant reduction of MRSA rates.
authors.affiliation: Institute of Hygiene and Environmental Medicine, Charité University Medicine Berlin, Hindenburgdamm 27, 12203 Berlin, Germany. susann.sroka@charite.de
authors.forename: S
authors.initials: S
authors.lastname: Sroka
authors.forename: P
authors.initials: P
authors.lastname: Gastmeier
authors.forename: E
authors.initials: E
authors.lastname: Meyer
mesh_terms: D000438:Alcohols / Q000008:administration & dosage*; D004202:Disinfectants / Q000008:administration & dosage*; D004363:Drug Utilization / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006225:Hand / Q000382:microbiology*; D006235:Hand Disinfection / Q000379:methods*; D006761:Hospitals; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: D000438:Alcohols; D004202:Disinfectants