Effectiveness of Alcohol-Based Hand Rubs for Removal of Clostridium difficile Spores from Hands

@article{Jabbar2010EffectivenessOA,
  title={Effectiveness of Alcohol-Based Hand Rubs for Removal of Clostridium difficile Spores from Hands},
  author={Umair Jabbar and Julie Leischner and Douglas J. Kasper and Robert Gerber and Susan P. Sambol and Jorge P. Parada and Stuart Johnson and Dale N. Gerding},
  journal={Infection Control \&\#x0026; Hospital Epidemiology},
  year={2010},
  volume={31},
  pages={565 - 570}
}
Background. Alcohol-based hand rubs (ABHRs) are an effective means of decreasing the transmission of bacterial pathogens. Alcohol is not effective against Clostridium difficile spores. We examined the retention of C. difficile spores on the hands of volunteers after ABHR use and the subsequent transfer of these spores through physical contact. Methods. Nontoxigenic C. difficile spores were spread on the bare palms of 10 volunteers. Use of 3 ABHRs and chlorhexidine soap-and-water washing were… 
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Effectiveness of Hand Hygiene for Removal of Clostridium difficile Spores from Hands
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References

SHOWING 1-10 OF 26 REFERENCES
Effectiveness of Liquid Soap vs. Chlorhexidine Gluconate for the Removal of Clostridium difficile from Bare Hands and Gloved Hands
TLDR
The two agents did not differ significantly in residual counts of C difficile on bare hands, but on gloved hands residual counts were lower following soap wash than following chlorhexidine wash, which support the use of either soap or chlor hexidine as a handwash for removal of C Difficile.
Hand Hygiene with Soap and Water Is Superior to Alcohol Rub and Antiseptic Wipes for Removal of Clostridium difficile
TLDR
Handwashing with soap and water showed the greatest efficacy in removing C. difficile and should be performed preferentially over the use of alcohol-based handrubs when contact with C. Difficile is suspected or likely.
Efficacy of selected hand hygiene agents used to remove Bacillus atrophaeus (a surrogate of Bacillus anthracis) from contaminated hands.
TLDR
In this evaluation of hand hygiene agents, handwashing with soap and water, 2% chlorhexidine gluconate, or chlorine-containing towels reduced the amount of B atrophaeus spore contamination, whereas use of a waterless rub containing ethyl alcohol was not effective in removing spores.
Temporal effects of antibiotic use and hand rub consumption on the incidence of MRSA and Clostridium difficile.
TLDR
An aggregate-level relation between the monthly MRSA incidence and the use of different antibiotic classes and increased consumption of ABHR after a successful hand hygiene campaign is observed, while no association with ABHR use was detected for C. difficile.
Reduction in Nosocomial Transmission of Drug-Resistant Bacteria After Introduction of an Alcohol-Based Handrub
TLDR
Reductions in the incidence of nosocomially acquired drug-resistant bacteria in this hospital in the 3 years following implementation of an ABHR provide clinical validation of the recent CDC recommendation that ABHRs be the primary choice for hand decontamination.
Measures to control and prevent Clostridium difficile infection.
  • D. Gerding, C. Muto, R. Owens
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2008
TLDR
Good antimicrobial stewardship complements infection control efforts and environmental interventions to provide a comprehensive strategy to prevent and control outbreaks of CDI.
Lack of Association Between the Increased Incidence of Clostridium difficile–Associated Disease and the Increasing Use of Alcohol-Based Hand Rubs
TLDR
There was no evidence that the incidence of CDAD increased despite a significant and progressive increase in the use of ABHRs in the authors' facility during a 3-year period, and these findings suggest that factors other than the increased use ofABHRs are responsible for the increasing incidence ofCDAD noted since 2000 in other facilities.
Use of sodium taurocholate to enhance spore recovery on a medium selective for Clostridium difficile
TLDR
TCCFA was simpler to prepare and, overall, was more sensitive than CCFA, and fluorescence of colonies of C. difficile was more intense on TCCFA than on CCFA.
Environmental contamination makes an important contribution to hospital infection.
  • J. Boyce
  • Medicine, Biology
    The Journal of hospital infection
  • 2007
Provision of alcohol hand rub at the hospital bedside: a case study.
  • S. King
  • Medicine
    The Journal of hospital infection
  • 2004
...
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