Summary
Background
The methods currently used in Europe and North America to evaluate the bactericidal
efficacy of hand hygiene products have some limitations, e.g., in the selection of
test organisms or the method of contamination, and none of the methods allows prediction
of actual clinical efficacy. WHO has therefore proposed to develop methods that better
reflect typical clinical reality.
Methods
In a first experiment, we investigated two contamination methods (immersion according
to EN 1500 and low-volume according to ASTM E2755) with the EN 1500 test organism
Escherichia coli and using 60% v/v iso-propanol. The second experiment was for comparison of the two
contamination methods with Enterococcus faecalis. Finally, the two test organisms were compared using the low-volume contamination
method. Data within each experiment was statistically compared using the Wilcoxon
test for paired samples and data from all experiments were combined and fit to linear
mixed effects models.
Results
Mixed-effects analysis confirmed that the test organism and contamination method both
impacted the pre-values and all three of these were factors that influenced log10 reductions. Higher pre-values resulted in significantly higher log10 reductions, immersion contributed to significantly higher log10 reductions, and E. coli affected significantly lower log10 reductions.
Conclusion
An efficacy evaluation against E. faecalis with a low-volume contamination method could be considered as an alternative to the
EN 1500 standard. This could help improve the clinical relevance of the test method
with including a Gram-positive organism and reducing soil load which allows a product
application closer to reality.
Keywords
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Article info
Publication history
Accepted:
May 4,
2023
Received in revised form:
May 2,
2023
Received:
March 24,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
