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Despite the increase in popularity of hand sanitizers (HS) in Nigeria, there is a dearth of literature on the efficacies of these products. This study assessed the efficacies of four popular brands of HS in Nigeria against some clinically important bacterial pathogens. Using the well variant of the agar dilution method to determine antimicrobial susceptibility and the broth dilution method to determine minimum inhibitory concentration, the activities of the HS (HSF, HSM, HDT, and HSK) were evaluated against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumonia. Each of the products displayed varying activities against the test organisms. HSM had the highest inhibitory effect against all the test organisms, while HSF was the least effective. S. aureus was the most susceptible organism, with the highest susceptibility to HSM (12.0 mm). P. aeruginosa was the most resistant organism, with the highest resistance to HSM (9.0 mm). Each of the HS was bacteriostatic against all of the test bacteria and none displayed bactericidal activity. HSM and HDT reduced the mean colony-forming unit (cfu) counts of bacteria on the hands of subjects by 72% and 62%, respectively. A one-tailed t-test showed that HSM was more effective than HDT in this regard. None of the products could reduce bacterial counts by 99.9%, as the manufacturers claim. Such claims need to be verified to ensure that these products contain the correct quantities of active ingredients, and sellers need to store such products according to the manufacturers' instructions.
Keywords: Hand hygiene, Hand sanitizer, Nosocomial infection, Community-acquired infection, Antimicrobials
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Bischoff, W.E., Reynolds, T.M., Sessler, C.N., Edmond, M.B. and Wenzel, R.P. (2000). Handwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Archives of Internal Medicine , 160(7), 1017-1021.
Bloomfield, S.F., Aiello, A.E., Cookson, B., O'Boyle, C. and Larson, E.L. (2007). The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers. American Journal of Infection Control , 35(10), S27-S64.
Boyce, J.M. and Pittet, D. (2002). 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. Infection Control and Hospital Epidemiology , 23(S12), S3-S40.
Cheesbrough, M. (2006). District laboratory practice in tropical countries, part 2, second edition. Cambridge University Press, New York.
CLSI. (2006). Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standards, seventh edition. Clinical and Laboratory Standards Institute document M7-A7 [ISBN 156238-587-9]. Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087-1898 USA.
FDA. (2011). Hand sanitizers carry unproven claims to prevent MRSA infections. in: American FDA Consumer Health Information April 2011, U.S. Food and Drug Administration, pp. 1-2.
Gagne, D., Bedard, G. and Maziade, P. (2010). Systematic patients' hand disinfection: impact on meticillin-resistant Staphylococcus aureus infection rates in a community hospital. Journal of Hospital Infection, 75(4), 269-272.
Ghebremedhin, B., Olugbosi, M., Raji, A., Layer, F., Bakare, R., König, B. and König, W.(2009). Emergence of a community-associated methicillin-resistant Staphylococcus aureus strain with a unique resistance profile in Southwest Nigeria. Journal of Clinical Microbiology, 47(9), 2975-2980.
Hancock, R.E. and Speert, D.P. (2000). Antibiotic resistance in Pseudomonasa eruginosa : mechanisms and impact on treatment. Drug Resistance Updates, 3(4), 247-255.
Jumaa, P.A.( 2005). Hand hygiene: simple and complex. International Journal of Infectious Diseases , 9(1), 3-14.
Kampf, G. and Kramer, A. (2004). Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clinical Microbiology Reviews , 17(4), 863-93.
Kar, A. (2008). Pharmaceutical microbiology. New Age International (P) Limited, Publishers, New Delhi.
Knittle, M.A., Eitzman, D.V. and Baer, H. (1975). Role of hand contamination of personnel in the epidemiology of gram-negative nosocomial infections. The Journal of Pediatrics, 86(3), 433-437.
Kramer, A., Rudolph, P., Kampf, G. and Pittet, D.( 2002). Limited efficacy of alcohol-based hand gels. The Lancet , 359(9316), 14891490.
Levison, M.E. (2004). Pharmacodynamics of antimicrobial drugs. Infectious Disease Clinics of North America, 18(3), 451-465.
Liu, P., Yuen, Y., Hsiao, H.-M., Jaykus, L.-A. and Moe, C. (2010). Effectiveness of liquid soap and hand sanitizer against Norwalk Sakamoto, F., Yamada, H., virus on contaminated hands. Applied and Environmental Microbiology, 76(2), 394399.
Marchetti, M.G., Kampf, G., Finzi, G. and Salvatorelli, G. (2003). Evaluation of the bactericidal effect of five products for surgical hand disinfection according to prEN 12054 and prEN 12791. Journal of Hospital Infection, 54(1), 63-67.
Michaels, B., Gangar, V., Lin, C.M. and Doyle, M. (2003). Use limitations of alcoholic instant hand sanitizer as part of a food service hand hygiene program. Food Service Technology, 3(2), 71-80.
Montravers, P., Lepape, A., Dubreuil, L., Gauzit, R., Pean, Y., Benchimol, D. and Dupont, H. (2009). Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study. Journal of Antimicrobial Chemotherapy, 63(4), 785794.
Mortimer Jr, E.A., Lipsitz, P.J., Wolinsky, E., Gonzaga, A.J. and Rammelkamp Jr, C.H. (1962). Transmission of staphylococci between newborns: importance of the hands of personnel. Archives of Pediatrics and Adolescent Medicine, 104(3), 289.
Oke, M.A., Bello, A.B., Odebisi, M.B., Ahmed ElImam, A.M. and Kazeem, M.O. (2013). Evaluation of antibacterial efficacy of some alcohol-based hand sanitizers sold in Ilorin (North-Central Nigeria). Ife Journal of Science, 15(1), 111-117.
Reynolds, S.A., Levy, F. and Walker, E.S. (2006). Hand sanitizer alert. Emerging Infectious Diseases , 12(3), 527-529.
Rosenthal, V.D., Maki, D.G., Mehta, A., ÃlvarezMoreno, C., Leblebicioglu, H., Higuera, F., Cuellar, L.E., Madani, N., Mitrev, Z. and DueÃas, L. (2008). International nosocomial infection control consortium report, data summary for 2002-2007, issued January 2008. American Journal of Infection Control, 36(9), 627-637.
Sakamoto, F., Yamada, H., Suzuki, C., Sugiura, H. and Tokuda, Y. (2010). Increased use of alcohol-based hand sanitizers and successful eradication of methicillin-resistant Staphylococcus aureus from a neonatal intensive care unit: A multivariate time series analysis. American Journal of Infection Control, 38(7), 529-534.
Sheehan, J.J., Mott, P.J., Sisk, B.W., Arbogast, J.W., Ferrazzano-Yaussy, C. and Bondi, C.A. (2007). Alcohol-based instant hand sanitizer use in military settings-a prospective cohort study of army basic trainees. Military Medicine, 172(11), 11701176.
Shittu, A., Okon, K., Adesida, S., Oyedara, O., Witte, W., Strommenger, B., Layer, F. and Nübel, U. (2011). Antibiotic resistance and molecular epidemiology of Staphylococcus aureus in Nigeria. BMC Microbiology , 11(1), 92
Talaat, M., Afifi, S., Dueger, E., El-Ashry, N., Marfin, A., Kandeel, A., Mohareb, E. and El-Sayed, N. (2011). Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt. Emerging Infectious Diseases, 17(4), 619.
Valgas, C., Souza, S.M.d., Smânia, E.F. and Smânia Jr, A.(2007). Screening methods to determine antibacterial activity of natural products. Brazilian Journal of Microbiology, 38(2), 369-380.
WHO. (2006). WHO guidelines on hand hygiene in health care (advanced draft): global safety challenge 2005-2006: clean care is safer care. World Health Organization, Geneva