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Contaminated hands of healthcare workers (HCWs) are an important source of transmission of healthcare-associated infections. Alcohol-based hand sanitizers, while effective, do not provide sustained antimicrobial activity. The objective of this study was to compare the immediate and persistent activity of 2 hand hygiene products (ethanol [61% w/v] plus chlorhexidine gluconate [CHG; 1.0% solution] and ethanol only [70% v/v]) when used in an intensive care unit (ICU).
Prospective, randomized, double-blinded, crossover study
Three ICUs at a large teaching hospital
In total, 51 HCWs involved in direct patient care were enrolled in and completed the study.
All HCWs were randomized 1:1 to either product. Hand prints were obtained immediately after the product was applied and again after spending 4–7 minutes in the ICU common areas prior to entering a patient room or leaving the area. The numbers of aerobic colony-forming units (CFU) were compared for the 2 groups after log transformation. Each participant tested the alternative product after a 3-day washout period.
On bare hands, use of ethanol plus CHG was associated with significantly lower recovery of aerobic CFU, both immediately after use (0.27 ± 0.05 and 0.88 ± 0.08 log10 CFU; P = .035) and after spending time in ICU common areas (1.81 ± 0.07 and 2.17 ± 0.05 log10 CFU; P<.0001). Both the antiseptics were well tolerated by HCWs.
In comparison to the ethanol-only product, the ethanol plus CHG sanitizer was associated with significantly lower aerobic bacterial counts on hands of HCWs, both immediately after use and after spending time in ICU common areas.
Antimicrobial stewardship programs (ASPs) became an accreditation requirement for Canadian hospitals in 2013. Pediatric programs are in various stages of program development and implementation, with 93% of surveyed Canadian academic pediatric hospitals having established ASPs. The programs varied in their team composition, implementation of stewardship strategies, and measured metrics.
Significant uncertainty surrounds the processes involved in the formation of basalt-hosted corundum, particularly the role that the mantle plays in corundum generation. Some previous studies have suggested that trace-element ratios (namely, Cr/Ga and Ga/Mg) are useful for distinguishing two types of corundum: ‘magmatic’ and ‘metamorphic’, designations that include mantle and crustal processes. However, recent studies, including this one, have discovered transitional groups between these end-members that are difficult to classify.We used laser ablation inductively coupled plasma mass spectrometry (LA–ICP–MS) to measure trace-element concentrations in sapphire and ruby crystals from eight alluvial deposits that span a significant length of the eastern Australian gemstone belt. Additionally, we collected LA–ICP–MS U–Pb and traceelement data from zircon megacrysts atWeldborough, Tasmania, which is also within the gemstone belt. Our sapphire and ruby results reveal a continuum in trace-element compositions, an observation that raises questions regarding previous classifications that ascribe corundum from basalt-hosted gemfields to either ‘magmatic’ or ‘metamorphic’ sources. The spatial association of basalt-related gemfields in eastern Australia with a long-lived convergent margin suggests a link between corundum formation and Al-enrichment of the mantle wedge during periods of subduction.