Revisiting the hand wipe versus gel rub debate: is a higher-ethanol content hand wipe more effective than an ethanol gel rub?

Am J Infect Control. 2010 Nov;38(9):678-82. doi: 10.1016/j.ajic.2010.07.002.

Abstract

Background: The Centers for Disease Control and Prevention's guidelines for hand hygiene state that the use of alcohol-based hand wipes is not an effective substitute for the use of an alcohol-based hand rub or handwashing with an antimicrobial soap and water. The objective of this study was to determine whether a hand wipe with higher ethanol content (65.9%) is as effective as an ethanol hand rub or antimicrobial soap in removing bacteria and spores from hands.

Methods: In two separate experiments, the hands of 7 subjects were inoculated with a suspension of Serratia marcescens or Geobacillus stearothermophilus. Subjects washed with each of 3 different products: 65.9% ethanol hand wipes (Sani-Hands ALC), 62% ethanol gel rub (Purell), and antimicrobial soap containing 0.75% triclosan (Kindest Kare).

Results: A total of 56 observations were analyzed for S marcescens removal and 70 observations were analyzed for G stearothermophilus removal. The rank order of product efficacy for both bacteria and spore removal was antibacterial soap > 65.9% ethanol hand wipes >62% ethanol hand rub. Mean S marcescens log reductions (±SD) for the 65.9% ethanol alcohol wipe, 62% ethanol alcohol rub, and antimicrobial foam soap were 3.44 ± 0.847, 2.32 ± 1.065, and 4.44 ± 1.018, respectively (P < .001). Mean G stearothermophilus log reductions for the 65.9% ethanol wipe, 62% ethanol rub, and antimicrobial foam soap were 0.51 ± 0.26, -0.8 ± 0.32 increase over baseline, and 1.72 ± 0.62, respectively (P < .001).

Conclusion: The alcohol-based hand wipe containing 65.9% ethanol was significantly more effective than the 62% ethanol rub in reducing the number of viable bacteria and spores on the hands.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Colony Count, Microbial
  • Disinfectants / administration & dosage*
  • Disinfectants / pharmacology
  • Ethanol / administration & dosage*
  • Ethanol / pharmacology
  • Geobacillus stearothermophilus / drug effects*
  • Hand Disinfection / methods*
  • Humans
  • Infection Control / methods*
  • Serratia marcescens / drug effects*
  • Spores, Bacterial / drug effects*

Substances

  • Disinfectants
  • Ethanol