Rinse, gel, and foam - is there any evidence for a difference in their effectiveness in preventing infections?

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES
John M Boyce, Didier Pittet
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引用次数: 0

Abstract

Background: Following publication of the 2009 World Health Organizations Guidelines for Hand Hygiene in Health Care, a debate has emerged regarding the relative antimicrobial efficacy of the different formats (rinse, gel, foam) of ABHRs and their ability to contribute to reduction of healthcare-associated infections (HAIs).

Methods: Data regarding the in-vivo antimicrobial efficacy of ABHRs and other factors that likely affect their effectiveness in reducing HAIs were reviewed, and a comprehensive review of studies that reported the effectiveness of each of the three ABHR formats to improve hand hygiene compliance and reduce HAIs was conducted.

Results: The amount of rubbing time it takes for hands to feel dry (dry time) is the major driver of ABHR antimicrobial efficacy. ABHR format is not a major factor, and several studies found that rinse, gel, and foam ABHRs have comparable in-vivo antimicrobial efficacy. Other factors that likely impact the ability of ABHRs to reduce transmission of healthcare-associated pathogens and HAIs include ABHR formulation, the volume applied to hands, aesthetic characteristics, skin tolerance, acceptance by healthcare personnel, and hand hygiene compliance rates. When accompanied by complementary strategies, promoting the use of each of the three ABHR formats has been associated with improvements in hand hygiene compliance rates. A review of 67 studies failed to identify an ABHR format that was significantly more effective in yielding statistically significant reductions in transmission of healthcare-associated pathogens or HAIs.

Conclusions: Current evidence is insufficient to definitively determine if one ABHR format is more effective in reducing transmission of healthcare-associated pathogens and HAIs. More rigorous studies such as multicenter randomized controlled trials comparing the different formats are needed to establish if one format is significantly more effective in reducing HAIs.

冲洗、凝胶和泡沫--有证据表明它们在预防感染的效果上有区别吗?
背景:2009 年世界卫生组织发布《医疗保健手部卫生指南》之后,关于不同形式(冲洗、凝胶、泡沫)的 ABHRs 的相对抗菌效果及其减少医疗保健相关感染(HAIs)的能力出现了争论:方法:对 ABHR 的体内抗菌效果数据以及可能影响其减少 HAIs 效果的其他因素进行了回顾,并对报告了三种 ABHR 形式在提高手部卫生依从性和减少 HAIs 方面效果的研究进行了全面回顾:结果:双手感觉干燥所需的摩擦时间(干燥时间)是 ABHR 抗菌功效的主要驱动因素。ABHR 的形式并非主要因素,多项研究发现,冲洗型、凝胶型和泡沫型 ABHR 的体内抗菌功效相当。其他可能影响 ABHR 减少医护相关病原体和 HAIs 传播能力的因素包括 ABHR 配方、涂抹在手上的剂量、美观特性、皮肤耐受性、医护人员的接受程度以及手部卫生依从率。如果辅以补充策略,推广使用三种 ABHR 形式中的每一种都与手部卫生依从率的提高有关。在对 67 项研究进行回顾后,未能发现哪种 ABHR 形式能更有效地减少医护人员相关病原体或 HAIs 的传播:目前的证据不足以明确确定 ABHR 形式在减少医疗相关病原体传播和 HAIs 方面是否更有效。需要进行更严格的研究,如比较不同形式的多中心随机对照试验,以确定是否有一种形式能更有效地减少 HAIs。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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