Comparison of the germicidal efficacy between an alcohol-based hand rub, antimicrobial soap and plain soap in hand hygiene

Abstract

Health care associated infections (HCAI) affect millions of patients annually, can be difficult to treat and are potentially fatal. Hand hygiene (HH) is essential for the prevention of HCAI and is the most effective way to reduce the propagation of healthcare associated pathogens. The objective of this study was to determine which agent used in HH provided the most germicidal efficacy. A descriptive nonrandomized, prospective, experimental study was conducted on 105 medical students between 4th and 6th year. The samples were taken from the dominant hand of each student, before and after, through a sterile swab and later cultured on a blood agar (BA) plate. The alcohol-based hand rub and the two liquid soaps (antimicrobial, AS and plain,PS) were compared, utilizing the WHO guidelines of HH. Each BA plate was divided into 2 sections: 1) prior to, and 2) after HH. Germicidal efficacy was determined by the quantification of colony-forming units (CFU) in BA. The median values of the CFU were compared, before and after; by applying the nonparametric Wilcoxon test for related samples. Those students who used PS had a 21% reduction in CFU, those who used AS 84%, and those who used an alcohol-based hand rub (AB) 94%. There was no significant statistical difference between AS and AB (p = 0.233), but there was a difference between AS and PS (p <0.001), as well as between AB and PS (p <0.001). In conclusion, all three agents decreased CFU after HH. The median value of CFU with AB was lower in comparison to the other two agents. There was no significant difference between AB and AS; however, both agents proved to be superior to PS in their germicidal efficacy.