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Alcohol-Based Handrub: Evaluation of Technique and Microbiological Efficacy with International Infection Control Professionals

  • Andreas F. Widmer (a1) and Marc Dangel (a1)


Background And Objective:

The Centers for Disease Control and Prevention has published a new guideline on hand hygiene promoting the use of the alcohol-based handrub, but the technique was not addressed. The goal of this study was to evaluate the influence of technique on the efficacy of the alcohol-based handrub.


Healthcare workers (HCWs) attending a course in hospital epidemiology.


A fluorescent dye was added to a hand antiseptic, and hands were checked under ultraviolet light after antiseptic cleansing. Data regarding the numbers of predefined fluorescent areas on the skin were collected in addition to demographic data such as age, gender, job description, and job experience. Results of the visualization test were compared with the data from microbiological samples before and after the procedure by the hand plate technique.


Sixty HCWs were tested, 63% of whom had worked in infection control for more than 10 years. Sixty-six percent of all participants still had detectable bacteria after antisepsis. The mean log10 CFU reduction was 2.0 (range, 0–3.85). Twenty-five percent of all HCWs achieved less than 1.1 log10 CFU. Staphylococcus aureus was isolated from 13% (one of them being methicillin resistant) and gram-negative bacilli from 6.7%. After using the alcohol handrub, one subject still remained positive for S. aureus. Years of experience was the single most important factor predicting antimicrobial efficacy.


Technique is of crucial importance in hand antisepsis. Major deficiencies were detected among even highly trained HCWs. Training should be provided before switching from handwashing to the alcohol handrub.


Corresponding author

University of Basel Hospitals, 4031 Basel, Switzerland


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1.Pratt, RJ, Pellowe, C, Loveday, HP, et al. The epic project: developing national evidence-based guidelines for preventing healthcare associated infections. Phase I: Guidelines for preventing hospital-acquired infections. J Hosp Infect 2001;47(suppl 2):S3S82.
2.Girard, R, Amazian, K, Fabry, J. Better compliance and better tolerance in relation to a well-conducted introduction to rub-in hand disinfection. J Hosp Infect 2001;47:131137.
3.Widmer, AF. Infection control and prevention strategies in the ICU. Intensive Care Med 1994;20(suppl 4):S7S11.
4.Widmer, AF. Replace hand washing with use of a waterless alcohol hand rub? Clin Infect Dis 2000;31:136143.
5.Voss, A, Widmer, AF. No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance? Infect Control Hosp Epidemiol 1997;18:205208.
6.Boyce, JM, Pittet, D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol 2002;23(suppl):S3S40.
7.Pittet, D, Hugonnet, S, Harbarth, S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356:13071312.
8.Pittet, D, Dharan, S, Touveneau, S, Sauvan, V, Perneger, TV. Bacterial contamination of the hands of hospital staff during routine patient care. Arch Intern Med 1999;159:821826.
9.Cardoso, CL, Pereira, HH, Zequim, JC, Guilhermetti, M. Effectiveness of hand-cleansing agents for removing Acinetobacter baumannii strain from contaminated hands. Am J Infect Control 1999;27:327331.
10.Wade, JJ, Desai, N, Casewell, MW. Hygienic hand disinfection for the removal of epidemic vancomycin-resistant Enterococcus faecium and gentamicin-resistant Enterobacter cloacae. J Hosp Infect 1991;18:211218.
11.Girou, E, Loyeau, S, Legrand, P, Oppein, F, Brun-Buisson, C. Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial. BMJ 2002;325:362.
12.Girou, E, Oppein, F. Handwashing compliance in a French university hospital: new perspective with the introduction of hand-rubbing with a waterless alcohol-based solution. J Hosp Infect 2001;48(suppl A):S55S57.
13.Reagan, DR, Doebbeling, BN, Pfaller, MA, et al. Elimination of coincident Staphylococcus aureus nasal and hand carriage with intranasal application of mupirocin calcium ointment. Ann Intern Med 1991;114:101106.

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Alcohol-Based Handrub: Evaluation of Technique and Microbiological Efficacy with International Infection Control Professionals

  • Andreas F. Widmer (a1) and Marc Dangel (a1)


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