Special Pathogens Laboratory Study First to Test 2002 CDC Recommendations that Alcohol-Based Rubs More Effective
Alcohol-based gels and hand rubs dominate the market for hand hygiene products, but that may start to change due to a new study conducted by Special Pathogens Laboratory (SPL) to determine which was more effective—wipes or rubs.
Revisiting the hand wipe versus gel debate: Is a higher-ethanol content hand wipe more effective than an ethanol rub? Published in the November issue of the American Journal of Infection Control, this study shows that wipes-towelettes saturated with alcohol are more effective than popular alcohol-based hand rubs in reducing some bacteria on hands.
"Our study gives infection control professionals more information so they can make evidence-based decisions when evaluating hand sanitizer products," says Janet E. Stout, PhD, director of SPL, and associate research professor at the University of Pittsburgh Swanson School of Engineering.
"With more effective hand hygiene products, we stand a better chance in reducing hospital-acquired infections that result in 90,000 patient deaths and $4.5 billion in medical expenses annually," says Dr. Stout.
Dr. Stout, who along with her colleagues at SPL and the University of Pittsburgh, Natalie N. D'Antonio, MS; John D Rihs, BS; and Victor L. Yu, MD, conducted and coauthored the study which measured the effectiveness of an ethanol wipe (PDI Sani-Hands® ALC) against an ethanol rub (Purell®) in eliminating bacteria.
In addition to the wipe’s effectiveness against bacteria, the study also demonstrated the wipe is equal to or more effective in physically removing spores from the surface of contaminated hands than the ethanol alcohol-based hand rub. According to the authors, the wipes’ “effectiveness in removing spores was due to the mechanical wiping action employed during product usage.” People using hand rubs cannot achieve this mechanical wiping action, which requires a cloth material. Spores, like bacteria, can cause infections. Clostridium difficile is one such spore-forming bacteria that causes life threatening inflammation of the colon and is transmitted to patients while hospitalized for other problems.
After inoculating subjects’ hands with bacteria, the researchers disinfected them with a wipe of 65.9% ethanol alcohol or rub containing 62% ethanol alcohol, and then tested for the presence of bacteria. The results showed the wipe “was significantly more effective” than the rub in reducing the number of viable bacteria and spores on the hands.
While the study’s main aim was to compare wipes and rubs, Dr. Stout and her team also compared the two products to antibacterial soap (Kindest Kare®). The soap proved more effective in reducing both bacteria and spores than either the wipe or rub. One important point: soap requires water-usually through a sink-but the wipe and rub does not require water.
Eight years after the Centers for Disease Control and Prevention issued guidelines stating that alcohol-based hand wipes weren’t as effective as alcohol-based hand rubs, this study shows that with the higher alcohol content, wipes were more effective than rubs.