title: Antimicrobial activity of two techniques for arm skin disinfection of blood donors in Brazil.
abstract: OBJECTIVE
  Evaluation of the antimicrobial effect of skin disinfection techniques is essential to avoid the transmission of infectious agents during blood transfusion. The aim of this study was to examine the effectiveness of two methods of arm skin disinfection used in blood donors at a Hemotherapy Center in Brazil that represents an important centre for distributing haemocomponents to many cities in the country.
  
  
  METHODS
  Two skin disinfection techniques in 50 blood donors were evaluated. For the first arm, 10% povidone-iodine/two-stage technique was used. On the opposite arm, 0.5% chlorhexidine digluconate alcohol solution/one-stage technique was used. The swabs were seeded on three culture media: blood agar, mannitol salt agar and Mac Conkey agar. Automated bacterial classification based on biochemical tests/specific substrates was performed. Donor characteristics were collected using the computerised system of the Hemotherapy Center.
  
  
  RESULTS
  We found that microbial reduction was significantly higher for 10% povidone-iodine technique (98.57-98.87%) when compared with 0.5% chlorhexidine technique (94.38-95.06%). The species Leuconostoc mesenteroides and Staphylococcus hominis showed resistance to both disinfection techniques. We did not find statistically significant relationships between donor characteristics and microbial reduction.
  
  
  CONCLUSIONS
  Arm skin disinfection with 10% povidone-iodine produced better antimicrobial activity. We must acknowledge that 10% povidone-iodine technique has the limitation of being a two-stage method. However, prevention of adverse events due to bacterial contamination and transfusion reactions should be prioritised. Production of hypoallergenic and stronger antiseptics that allowed a safe one-stage disinfection technique should be encouraged in health systems, not only in Brazil but also around the world.
authors.affiliation: Regional Blood Center of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
authors.forename: M S
authors.initials: MS
authors.lastname: Celere
authors.forename: O
authors.initials: O
authors.lastname: Ferreira
authors.forename: E M A
authors.initials: EM
authors.lastname: Ubiali
authors.forename: F C
authors.initials: FC
authors.lastname: Julião
authors.forename: A F T
authors.initials: AF
authors.lastname: Fernandes
authors.forename: D
authors.initials: D
authors.lastname: de Andrade
authors.forename: S I
authors.initials: SI
authors.lastname: Segura-Muñoz
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001132:Arm; D001782:Blood Donors; D001938:Brazil; D004203:Disinfection / Q000379:methods*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D012867:Skin
chemical_list: D000891:Anti-Infective Agents, Local