背景:手部卫生指南建议使用含有湿润剂的含酒精的手部摩擦,以提高皮肤耐受性。然而,术前手部摩擦的杀菌效果受到世卫组织推荐的保湿剂甘油的负面影响,尤其是3小时的功效。这项研究的目的是调查是否替代甘油作为湿润剂增加基于异丙醇的手术手擦的杀菌功效(75%,wt/wt)。
方法:使用改良的WHOII配方(含有较低的甘油浓度)和含有新湿润剂(含有乙基己基甘油,右泛醇和脂肪醇)与欧洲标准12,791参考(正丙醇,60%,vol/vol)在施用后立即和3小时。
结果:两种基于异丙醇的手术磨擦在应用后立即接近参比的性能。发现改良的WHOII制剂的3小时效果不如EN12791有效,显示log10降低值降低30%。发现TPH5766手擦的3小时后施用效果与EN12791没有不同。
结论:根据我们的数据,如果在制剂中不使用甘油,则可以最好地获得基于异丙醇的手术手擦的杀菌功效。与甘油不同,由乙基己基甘油组成的湿润剂,发现右泛醇和脂肪醇不会降低手擦效果。对其他湿润剂的杀菌效力的进一步研究是必要的并且可能被证明是有用的。
BACKGROUND: Guidelines for hand hygiene recommend the use of alcohol-based hand rubs containing humectants in order to improve dermal tolerance. However, the bactericidal efficacy of pre-surgical hand rubs is negatively affected by the WHO-recommended humectant glycerol, especially the 3-h efficacy. The aim of this study was to investigate whether replacing glycerol as humectant increases the bactericidal efficacy of surgical hand rubs based on isopropanol (75%, wt/wt).
METHODS: The efficacy of 3 and 5 min applications of a modified WHO II-formulation (containing lower glycerol concentrations) and the TPH 5766 hand rub which contains a new humectant (containing ethylhexylglycerin, dexpanthenol and a fatty alcohol) were compared to the European Norm 12,791 reference (n-propanol, 60%, vol/vol) immediately following and 3 h after application.
RESULTS: Immediately after application both isopropanol-based surgical rubs approximated the performance of the reference. The 3-h effect of the modified WHO II-formulation was found to be less efficacious than the EN 12791, showing a 30% decrease in log10 reduction values. The 3-h post application effect for the TPH 5766 hand rub was found to not be different from EN 12791.
CONCLUSIONS: Based on our data, the bactericidal efficacy of isopropanol-based surgical hand rubs can best be obtained if glycerol is not used in the formulation. Unlike glycerol, a humectant comprised of ethylhexylglycerin, dexpanthenol and a fatty alcohol was found not to decrease hand rub effectiveness. Further investigation of the bactericidal efficacy of other humectants is necessary and may prove useful.