Lasting hand self-disinfection: A backup for hospital hand hygiene?

Background Hand disinfection should be performed on the occasion of 5 separate moments during patient care, but some occasions are skipped. Can using hand antiseptics with residual effect reduce the problem of infection spread? We evaluated a 30-minute residual effect by different antiseptic products on endogenous and acquired microbiota. Methods The products tested were 2% and 5% chlorhexidine, 1% and 10% iodine povidone, 60° n-propanol, 0.2% mecetronium + isopropanol, and 0.6% chlorhexidine + isopropanol + 0.1% benzalconium chloride. The microorganisms identified were 3 ATCC and 9 multiresistant strains isolated from intensive care unit patients (used as acquired microbiota). Logarithmic (log 10 ) reductions of the colony forming units obtained with each antiseptic product and for each microorganism were calculated via in vivo (6 volunteers) and in vitro tests. Results The better in vivo and in vitro products with a residual effect > 2 log 10 after 30 minutes on hands were 2%-5% chlorhexidine and 0.6% chlorhexidine + isopropanol + 0.1% benzalconium chloride. This reduction was significantly different ( P 2 log 10 ) can be considered a self-disinfecting hand status in daily practice. Conclusions Hand antiseptics used in hospitals must pass tests of residual efficacy (after 30 minutes on acquired microbiota) showing a reduction > 2 log 10 in vivo and in vitro. A good product can be the mixture of chlorhexidine + alcohol + benzalconium chloride.