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Hands
Hygienic Hand Disinfection
Kampf G; Löffler H; Gastmeier P.
Hand hygiene for the prevention of nosocomial infection
Dtsch Arztebl Int 2009; 106(49):649-55
In consideration of scientific literature as well as national and international recommendations the authors of the new overview study show that improved compliance and the targeted use of hand disinfectants can reduce the current rate of nosocomial infection by 40 percent. Recommendations on the targeted use of hand disinfectants, protective gloves and concrete suggestions on improving compliance make clear how the transmission of pathogens acquired in hospital can be prevented in consequence of evidence-based hand hygiene. In addition, the authors show how healthcare personnel can maintain their skin health through effective skin protection and skincare measures.
A reprint of this study can be requested from Anja Deecke.
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Kampf G, Reichel M, Feil Y, Eggerstedt S, Kaulfers PM.
Influence of the rub-in technique on required time and hand coverage in hygienic hand disinfection.
BMC Infect Dis. 2008, Oct 29; 8:149
Contents
Several data indicate that hand disinfectants available on the market can achieve the in-vitro bactericidal activity in the reference procedure according to EN 1500 within 15 seconds. The reference procedure according to EN 1500 samples the fingertips only. The present study verifies whether these data are clinically relevant. So, this study investigated the hand coverage of 15 test persons and 20 healthcare workers after applying the hand disinfectant with various rub-in techniques and different exposure times. Result: High-quality hand disinfection cannot be achieved within 15 seconds. It is recommended to maintain the 30-second exposure time for the clinical practice. In terms of the rub-in technique the independent application yielded the best results. However, the six steps according to EN 1500 – that were recommended so far – achieved the worst results in coverage.
A poster showing the independent rub-in technique
can be found here
Surgical Hand Disinfection
Suchomel M.; Gnant G.; Weinlich M.; Rotter M.:
Surgical hand disinfection using alcohol: the effects of alcohol type, mode and duration of application.
J Hosp Infect (2008), doi: 10.1016/j.jhin.2008.11.006.
The study's aim was to analyse the influence of alcohol type, rub-in method and exposure time on the efficacy of surgical hand disinfection in accordance to EN12791. Conclusion: The study confirms the results of previous studies that Sterillium® is effective in accordance with EN 12791 with a shortened exposure time of 1.5 minutes. Moreover, Sterillium® is even effective when in addition to the hands also forearms and elbows are wetted with the hand disinfectant within this 1.5-minute exposure time.
Kampf G, Ostermeyer C, Heeg P, Paulson D.
Evaluation
of two methods of determining the efficacies of two alcohol-based hand
rubs for surgical hand antisepsis.
Appl. Environ. Microbiol. 2006; 72: 3856-3861.
Content
For the first time, this study investigated, if the efficacy of surgical
hand disinfection with shortened exposure times still suffices, when,
in addition to the hands, two-thirds of the forearms are included in
the treatment. Both Sterillium (exposure time: 1.5 minutes) and Sterillium
Rub (exposure time: 2 minutes) proved to be effective enough.
Kampf G, Ostermeyer C, Heeg P.
Surgical hand disinfection with a propanol-based hand rub: equivalence
of shorter application times.
J. Hosp. Infect. 2005; 59: 304-310.
Content
The efficacy of Sterillium for surgical hand disinfection was investigated
with different exposure times (3, 2, 1.5 and 1 minute) in accordance with
EN 12791, and was compared to the 3 minutes reference procedure. For both
the immediate and long-term effect after 1.5 minutes Sterillium showed
a higher efficacy than the 3 minutes reference procedure.
A German translation of this article was published in:
Krh.-Hyg. + Inf.verh. 2005; 27: 51-56.
A reprint of this study can be requested from Anja Deecke
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Kampf G, Voss A, Widmer AF.
Die chirurgische Händedesinfektion
zwischen Tradition und Fortschritt
Hyg Med 2006; 31 [7+8]: 316–321
Content
This paper provides an overview of the changes in the practical execution
of surgical hand disinfection, which, over the decades, were the result
of scientific perceptions. Important innovations are pointed out, such
as the shortening of the washing time, and the reduction of the disinfection
exposure time to 1.5 minutes depending on the preparation. In terms of
efficacy of the preparations for surgical hand disinfection, the authors
examine the clinical relevance of EN 12791 and the fingertip test following
the American example. In addition, this paper evaluates compliance with
regard to the shortened exposure time in surgical hand disinfection.
Kampf G, Ostermeyer C.
Efficacy of two distinct ethanol-based hand rubs for surgical hand disinfection
- a controlled trial according to prEN 12791.
BMC Infectious Diseases 2005, 5:17 doi:10.1186/1471-2334-5-17
Content
Aim of the study was to determine the efficacy of two distinct ethanol-based
hand rubs for surgical hand disinfection in a controlled cross-over trial
according to prEN 12791. Bacterial pre-values were between 4.38 ± 0.66
and 4.46 ± 0.71. Sterillium® Rub achieved the required immediate
(mean log10-reduction of 2.59 ± 1.19) and sustained effect (1.73 ± 1.08)
compared with the reference treatment (immediate effect: 2.58 ± 1.16;
sustained effect: 1.67 ± 0.96). Avagard, however, did not achieve
the required immediate (1.82 ± 1.40) and sustained effect (1.41 ± 1.08)
in comparison to the reference disinfection (immediate effect: 2.98 ± 0.90;
sustained effect: 2.56 ± 1.17; p < 0.01; Wilcoxon test).
Full version available online
Kampf G, Ostermeyer C.
Influence of Applied Volume on Efficacy of 3-Minute Surgical Reference
Disinfection Method prEN 12791.
Applied and Environmental Microbiology December 2004; 70 (12): 7066-7069.
Content
The European prEN 12791 test method prescribes – regardless of the
volume applied – that the hands have to be kept wet with the reference
alcohol during the 3 minutes application time. In 10 experiments with 200
reference disinfections, the study investigated whether the applied volume
of the reference alcohol n-propanol (60%, v/v) influences the preparation’s
effect on the resident skin flora. Result: if the hands are kept wet during
the whole application time of 3 minutes, the applied preparation volume
can vary without influencing the efficacy on the resident skin flora.
Full version available
Compliance
Kampf G.
The six golden rules to improve compliance in hand hygiene.
J Hosp Infect. 2005; 56 :3–5.
Content
Improving compliance with hand hygiene is probably the most effective step
to avoid nosocomial infections. The study names and evaluates the 6 most
important measures for improving compliance.
Kampf G, Kramer A.
Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important
Agents for Scrubs and Rubs.
Clinical Microbiology Reviews October 2004; 17 (4): 863-893.
Content
Comprehensive overview based on the current guideline on hand hygiene issued
by the Center for Disease Control and Prevention (CDC). The epidemiologic
importance of microbial and viral hand colonization, agents for reducing
pathogens, the respective products’ effect on nosocomial infections
and the compliance with hand hygiene measures are surveyed.
Full version available online
Efficacy
Kampf G, Steinmann J, Rabenau H.
Suitability of vaccinia virus and bovine viral diarrhea (BVDV) for determining
activities of three commonly-used alcohol based hand rubs against enveloped
viruses.
BMC Infectious Diseases 2007, 7:5 doi:10.11.86/1471-2334-7-5
Contents
The article assesses three alcohol-based hand rubs with a total alcohol
concentration of ≤ 75 % with regard to the activity against clinically
relevant enveloped viruses in accordance to prEN 14476. Vaccinia virus,
BVDV (surrogate for HCV), herpes simplex virus types 1 and 2, and human
and avian influenza A viruses were used as test viruses. Result: In the
quantitative suspension test with an exposure time of 15 seconds, all
alcohol-based hand disinfectants were active against all organic loads.
With this, the study is the first to provide evidence for the activity
against enveloped viruses.
Rabenau HF, Kampf G, Cinatl J, Doerr HW.
Efficacy of various antiseptics against SARS coronavirus.
J Hosp Infect. 2005 Oct; 61 (2) :107-111.
Content
Until the epidemic breakout, the pathogen of SARS had been an unknown coronavirus,
which in the meantime is referred to as SARS-associated coronavirus (SARS-CoV).
So far, only limited data on disinfectants’ efficacy against SARS-CoV
were available. In this study, eight disinfectants, which meet the RKI
and DVV recommendations for deployment against SARS-CoV, were tested
for their efficacy in accordance with prEN 14 476. All tested disinfectants
proved to be reproducibly effective against SARS-CoV with common concentration
and application time, even with additional organic exposure.