Efficacy of waterless hand disinfection solutions following general examination of horses

(Winner of the Voorjaarsdagen Award for Clinical Research at the BEVA Congress 2017)

Reasons for performing study

According to the World Health Organization (WHO), proper handhygiene is the most cost-effective way to reduce healthcare associated infections. Based on “WHO Five moments of handhygiene”, hands should be sanitized with a disinfecting hand rubbing solution before and after each patient contact, before an aseptic task, after body fluid exposure risk, and after contact with the patient’s surroundings. When hands are visibly soiled a preceding hand-wash with water and soap (W&S) is mandatory. In equine healthcare situations water is not always available and therefore compliance with “handhygiene moments” can be difficult to obtain.

Objectives

Investigate the efficacy of hand sanitation products without preceding hand wash following general examination of horses.

Study design

In vivo trial.

Methods

An agar finger impression (neutraliser containing tryptophan soya agars) was taken from 20 participants before (BGE) and after general examination (AGE) of a horse and following one of 6 hand hygiene protocols: after W&S (BS1) / after W&S plus 30 seconds alcohol (BS2) / 30 (ST3) or 60 (ST6) seconds alcohol rub only / 30 (S73) or 60 (S76) seconds rub with a non-alcohol antiseptic only. Log10CFU and reduction factors were calculated from CFU identification 24h after plate incubation. Soiled hand surface area was evaluated using photography and computer image analysis. Protocols were statistically compared. Significance: p ≤ 0.05.

Results

Mean visual hand soiling level was 12.8 sd±8.1%. None of the protocols was as effective in reducing CFU counts as BS2. S73 revealed as effective as BS1, whereas ST3, ST6 and S76 were significantly more effective than BS1.

Conclusions

A rubbing hand sanitization with 30 seconds application of the alcoholic solution or 60 seconds of the non-alcoholic solution is more effective in removing bacteria compared to hand washing with water and soap only, thus showing great potential for easy hand hygiene of equine practitioners.

• Ethical animal research: not applicable
• Competing interests: none
• Sources of funding: Steri-7 Worldwide Ltd, UK donation for bacteriology testing. Products donated by Bode Chemie, Germany and Steri-7 Worldwide Ltd, UK
• Antimicrobial stewardship policy: not applicable  
• Informed Consent: all participants in trial signed informed consent.

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