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Effectiveness of Liquid Soap vs. Chlorhexidine Gluconate for the Removal of Clostridium difficile from Bare Hands and Gloved Hands

Published online by Cambridge University Press:  02 January 2015

Kris Bettin ,
Connie Clabots ,
Pamela Mathie ,
Keith Willard  and
Dale N. Gerding
Kris Bettin
Affiliation:
Infectious Disease Section, Medical Service, Minneapolis VA Medical Center
Connie Clabots
Affiliation:
Microbiology Section, Laboratory Service, Minneapolis VA Medical Center
Pamela Mathie
Affiliation:
Infectious Disease Section, Medical Service, Minneapolis VA Medical Center
Keith Willard
Affiliation:
Microbiology Section, Laboratory Service, Minneapolis VA Medical Center
Dale N. Gerding*
Affiliation:
University of Minnesota Medical School, Minneapolis, Minnesota and Lakeside VA Medical Center and Northwestern University Medical School, Chicago, Illinois
*
Medical Service (111), Lakeside VA Medical Center, 333 E. Huron St., Chicago, IL 60611
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Abstract

Objective:

To compare liquid soap versus 4% chlorhexidine gluconate in 4% alcohol for the decontamination of bare or gloved hands inoculated with an epidemic strain of Clostridium difficile.

Design:

C difficile (6.7 log10 colony-forming units [CFU], 47% spores), was seeded onto bare or latex gloved hands of ten volunteers and allowed to dry. Half the volunteers initially washed with soap and half with chlorhexidine, followed by the other agent 1 week later. Cultures were done with Rodac plates at three sites on the hand: finger/thumbtips, the palmar surfaces of the fingers, and the palm. Statistical comparison was by paired Student’s t test.

Results:

On bare hands, soap and chlorhexidine did not differ in residual bacterial counts on the finger/thumbtips (log10 CFU, 2.0 and 2.1, P= NS) and fingers (log10 CFU, 2.4 and 2.5, P=NS). Counts were too high on bare palms to quantitate. On gloved hands, soap was more effective than chlorhexidine on fingers (log10 CFU 1.3 and 1.7, P<.01) and palms (log10 CFU 1.5 and 2.0, P<.01), but not finger/thumbtips (log10 CFU 1.6 with each, P=NS). Residual C difficile counts were lower on gloved hands than bare hands (P<0.01 to <0.0001).

Conclusions:

The two agents did not differ significantly in residual counts of C difficile on bare hands, but on gloved hands residual counts were lower following soap wash than following chlorhexidine wash. These observations support the use of either soap or chlorhexidine as a handwash for removal of C difficile, but efficacy in the prevention of C difficile transmission must be determined by prospective clinical trials.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 11 , November 1994 , pp. 697 - 702
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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