V S Sharma1, S Dutta, N Taneja, A Narang. 1. Departments of Pediatrics and *Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160 012, India. Correspondence to: Dr Sourabh Dutta, Additional Professor, Division of Neonatology, Department of Pediatrics, PGIMER, Chandigarh 160 012, India. sourabhdutta@yahoo.co.in.
Abstract
OBJECTIVE: To compare plain soap, alcohol hand rub and iodophors as hand hygiene measures in a neonatal intensive care unit (NICU). DESIGN: Randomized, crossover, three-armed, controlled trial with blinded outcome measurement. SETTING: Level III NICU. PARTICIPANTS: 35 NICU nurses. INTERVENTION: Participants were assigned to plain soap hand washing, alcohol hand rub and povidone-iodine hand scrub by a random cross-over design. Interventions were preceded by 14-day neutral periods. Cultures from hands were taken before and after each hand-hygiene use, prior to 5 patient-care activities. MAIN OUTCOME MEASURE: The primary outcome was mean post-hygiene colony forming unit count (CFU-C). RESULTS: There were differences between soap, alcohol and povidone groups vis a vis posthygiene CFUC [median: 60, 8 and 10.5, respectively (P<0.001)], absolute reduction in CFU-C [median: 15, 100 and 40, respectively (P<0.001)], percent reduction in CFUC [median: 33.3, 92 and 87, respectively (P<0.001)] and proportion with low CFU-C [47%, 71% and 72%, respectively (P<0.001)]. Alcohol [Adjusted OR 3.2 (95% CI 1.9, 5.3)], povidone-iodine [AOR 3.1 (95% CI 1.8, 5.3)] and high prehygiene CFU-C (>300) [AOR 0.18 (95% CI 0.1, 0.3)] were independently associated with low CFU-C. CONCLUSION: After a 2 minute hand wash at entry into NICU, alcohol hand rub and povidone-iodine scrub are superior to plain soap hand wash for subsequent decontamination of hands of nurses working in NICU.
RCT Entities:
OBJECTIVE: To compare plain soap, alcohol hand rub and iodophors as hand hygiene measures in a neonatal intensive care unit (NICU). DESIGN: Randomized, crossover, three-armed, controlled trial with blinded outcome measurement. SETTING: Level III NICU. PARTICIPANTS: 35 NICU nurses. INTERVENTION: Participants were assigned to plain soap hand washing, alcohol hand rub and povidone-iodine hand scrub by a random cross-over design. Interventions were preceded by 14-day neutral periods. Cultures from hands were taken before and after each hand-hygiene use, prior to 5 patient-care activities. MAIN OUTCOME MEASURE: The primary outcome was mean post-hygiene colony forming unit count (CFU-C). RESULTS: There were differences between soap, alcohol and povidone groups vis a vis posthygiene CFUC [median: 60, 8 and 10.5, respectively (P<0.001)], absolute reduction in CFU-C [median: 15, 100 and 40, respectively (P<0.001)], percent reduction in CFUC [median: 33.3, 92 and 87, respectively (P<0.001)] and proportion with low CFU-C [47%, 71% and 72%, respectively (P<0.001)]. Alcohol [Adjusted OR 3.2 (95% CI 1.9, 5.3)], povidone-iodine [AOR 3.1 (95% CI 1.8, 5.3)] and high prehygiene CFU-C (>300) [AOR 0.18 (95% CI 0.1, 0.3)] were independently associated with low CFU-C. CONCLUSION: After a 2 minute hand wash at entry into NICU, alcohol hand rub and povidone-iodine scrub are superior to plain soap hand wash for subsequent decontamination of hands of nurses working in NICU.
Authors: María B Martos-Cabrera; Emilio Mota-Romero; Raúl Martos-García; José L Gómez-Urquiza; Nora Suleiman-Martos; Luis Albendín-García; Guillermo A Cañadas-De la Fuente Journal: Int J Environ Res Public Health Date: 2019-08-22 Impact factor: 3.390
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