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Author: Kampf G et al (2013) Source: Antimicrobial Resistance and Infection Control 2013, 2:19


Kampf G et al (2013)

Efficacy of hand rubs with a low alcohol concentration listed as effective by a national hospital hygiene society in Europe

Background: Three national hospital hygiene societies in Europe have positive lists of disinfectants: ÖGHMP, VAH and the SFHH. The positive lists are highly appreciated by the infection control practitioners because of the independent review of efficacy data. Few hand disinfectants with a rather low concentration of ethanol are listed by one society as effective for hygienic hand disinfection with 3 mL in 30 s including a virucidal activity in 30 s or 60 s, but published data allow having doubts. Therefore, the efficacy of three selected commercially available hand disinfectants with a low concentration of ethanol was evaluated according to EN 1500 and EN 14476.

Methods: Products 1 (Aniosgel 85 NPC) and 2 (Aniosrub 85 NPC) were based on 70% ethanol, product 3 (ClinoGel derma+) on 60% ethanol and 15% isopropanol (all w/w). They were tested in 3 laboratories according to EN 1500. Three mL were applied for 30 s as typically done in clinical practice and compared to the reference treatment of 2 x 3 mL applications of isopropanol 60% (v/v), on hands artificially contaminated with Escherichia coli. Each laboratory used a cross-over design against the reference alcohol with 15 or 20 volunteers. The virucidal activity of the products was evaluated (EN 14476) in one laboratory against adenovirus and poliovirus in different concentrations (80%, 90%, 97%), with different organic loads (none; clean conditions; phosphate-buffered saline) for up to 3 min.

Results: Products 1 and 2 were significantly less effective compared to the reference treatment in all three labs (EN 1500) and thereby failed to meet the efficacy requirement. Product 3 fulfilled the EN 1500 efficacy requirements in one laboratory but failed in the two other. None of the three products was able to reduce viral infectivity of both adenovirus and poliovirus by 4 log10 steps in 3 min according to EN 14476.

Conclusions: Efficacy data for very few selected hand rubs mentioned in a positive list should still be regarded with caution if they quite obviously contradict published data on the same or similar products. These products seem to have an alcohol concentration that does not reproducibly yield sufficient antimicrobial efficacy in contrast to formulations with a higher ethanol concentration (e.g. ≥ 80% w/w).

Antimicrobial Resistance and Infection Control 2013, 2:19

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Click here to read more about the article:  Hand disinfectants: better antimicrobial activity by sufficiently high ethanol contents