Yuhua Yuan, Jin Zhao, Kunkun Leng, Yang Cao, Hui Jin
{"title":"Beyond Handrubs: QAC Wipes as a Water-Sparing Alternative for Protein-Contaminated Hand Hygiene with Persistent Dorsum Challenges.","authors":"Yuhua Yuan, Jin Zhao, Kunkun Leng, Yang Cao, Hui Jin","doi":"10.1016/j.jhin.2025.07.015","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study compared the effectiveness of quaternary ammonium compound (QAC) wipes, handwashing, and hydrogen peroxide-enhanced alcohol-based hand rubs (ABHRs) in removing microorganisms from hands contaminated with proteinaceous organic matter.</p><p><strong>Methods: </strong>A self-controlled crossover trial recruited 15 volunteers who received standardized hand hygiene training. Participants underwent three intervention methods: (1) handwashing with non-antimicrobial soap and running water for 60 seconds; (2) hand rubbing with 70% ethanol + 0.2% hydrogen peroxide for 30 seconds; and (3) hand wiping with QAC wipes for 60 seconds. Both hands were contaminated with Staphylococcus aureus (1.0-9.0 × 10<sup>6</sup> CFU/mL) and supplemented with 3% bovine serum albumin (BSA). The microbial reduction was quantified using log<sub>10</sub> CFU/hand for three regions (fingers, palm, and dorsum).</p><p><strong>Results: </strong>The efficacy of QAC wipes in bacterial removal from all three hand regions was non-inferior to soap, whereas its performance was significantly superior to that of handrub. Wipes and soap showed lower efficacy on the dorsum compared to the fingers (P < 0.001). The efficacy ranking across hand regions was: fingers > palm > dorsum, and the overall intervention efficacy ranking was: soap = wipes > handrub.</p><p><strong>Conclusion: </strong>When QAC wipes are used under conditions of organic contamination with a 60-second procedural wiping protocol, the efficacy is not inferior to handwashing with soap, offering a feasible alternative in water-scarce environments. Handrubs show significantly lower efficacy in protein-rich environments. The poor bacterial removal efficiency on the dorsum of the hand highlights an anatomical oversight in hygiene practices, necessitating technical improvements.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jhin.2025.07.015","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: This study compared the effectiveness of quaternary ammonium compound (QAC) wipes, handwashing, and hydrogen peroxide-enhanced alcohol-based hand rubs (ABHRs) in removing microorganisms from hands contaminated with proteinaceous organic matter.
Methods: A self-controlled crossover trial recruited 15 volunteers who received standardized hand hygiene training. Participants underwent three intervention methods: (1) handwashing with non-antimicrobial soap and running water for 60 seconds; (2) hand rubbing with 70% ethanol + 0.2% hydrogen peroxide for 30 seconds; and (3) hand wiping with QAC wipes for 60 seconds. Both hands were contaminated with Staphylococcus aureus (1.0-9.0 × 106 CFU/mL) and supplemented with 3% bovine serum albumin (BSA). The microbial reduction was quantified using log10 CFU/hand for three regions (fingers, palm, and dorsum).
Results: The efficacy of QAC wipes in bacterial removal from all three hand regions was non-inferior to soap, whereas its performance was significantly superior to that of handrub. Wipes and soap showed lower efficacy on the dorsum compared to the fingers (P < 0.001). The efficacy ranking across hand regions was: fingers > palm > dorsum, and the overall intervention efficacy ranking was: soap = wipes > handrub.
Conclusion: When QAC wipes are used under conditions of organic contamination with a 60-second procedural wiping protocol, the efficacy is not inferior to handwashing with soap, offering a feasible alternative in water-scarce environments. Handrubs show significantly lower efficacy in protein-rich environments. The poor bacterial removal efficiency on the dorsum of the hand highlights an anatomical oversight in hygiene practices, necessitating technical improvements.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
