背景:手部卫生在预防和控制感染方面至关重要。目前尚不清楚喷洒的基于酒精的手擦(ABHR)是否不劣于世界卫生组织(WHO)推荐的用倒ABHR进行手擦的方法。
目的:测试喷雾ABHR是否可以作为有效的手卫生的替代(非劣质)方法,有/没有手揉。
方法:根据欧洲标准1500用ABHR(异丙醇60%v/v)进行实验室实验。通过以下方式进行手部卫生:(1)用ABHR倒在手掌上的手摩擦;(2)用喷洒的ABHR进行手摩擦;和(3)将喷洒的ABHR施加到手上而不进行手摩擦。手被大肠杆菌ATCC10536污染,然后进行手部卫生和微生物采样。使用每个受试者具有随机截距的广义线性混合模型来分析手部卫生后细菌计数的减少。
结果:总计,19名医护人员参与了这项研究。与WHO推荐的用倒ABHR进行手擦的方法相比,用喷雾ABHR进行手擦的效果不差[边缘log100.6菌落形成单位(cfu)/mL];细菌计数减少为log103.66cfu/mL[95%置信区间(CI)1.68-5.64]和log103.46cfu/mL(95%CI1.27-5.65),分别。相反,不使用手擦的喷雾ABHR未发现非劣效性[细菌计数减少log102.76cfu/mL(95%CI1.65~3.87)].
结论:在实验条件下,喷洒ABHR的手擦不劣于将ABHR倒在手掌上的手擦,以减少手上的细菌计数。用喷洒的ABHR进行手擦可能是一种可接受的替代手部卫生方法,有待在其他环境中进行评估以及对其他病原体进行评估。
BACKGROUND: Hand hygiene is crucial in infection prevention and control. It is unclear whether sprayed alcohol-based hand rub (ABHR) is non-inferior to the World Health Organization (WHO)-recommended method of handrubbing with poured ABHR.
OBJECTIVE: To test whether sprayed ABHR can be an alternative (non-inferior) method for effective hand hygiene with/without handrubbing.
METHODS: A laboratory experiment was conducted with ABHR (isopropanol 60% v/v) according to European Norm 1500. Hand hygiene was performed by: (1) handrubbing with ABHR poured on to the palm of the hand; (2) handrubbing with sprayed ABHR; and (3) applying sprayed ABHR to hands without handrubbing. Hands were contaminated with Escherichia coli ATCC 10536, followed by hand hygiene and microbiological sampling. A generalized linear mixed model with a random intercept per subject was used to analyse the reduction in bacterial count following hand hygiene.
RESULTS: In total, 19 healthcare workers participated in the study. Handrubbing with sprayed ABHR was non-inferior [margin log10 0.6 colony-forming units (cfu)/mL] to the WHO-recommended method of handrubbing with poured ABHR; bacterial count reductions were log10 3.66 cfu/mL [95% confidence interval (CI) 1.68-5.64] and log10 3.46 cfu/mL (95% CI 1.27-5.65), respectively. Conversely, non-inferiority was not found for sprayed ABHR without handrubbing [bacterial count reduction log10 2.76 cfu/mL (95% CI 1.65-3.87)].
CONCLUSIONS: Handrubbing with sprayed ABHR was non-inferior to handrubbing with ABHR poured on to the palm of the hand to reduce bacterial counts on hands under experimental conditions. Handrubbing with sprayed ABHR may be an acceptable alternative hand hygiene method pending assessment in other settings and for other pathogens.