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Hand gels not enough to block C. difficile.(News)
LOS ANGELES -- The use of alcohol-based hand-cleaning gels has burgeoned in hospitals, where physicians, nurses, and other medical staff members have enthusiastically embraced them as a quick and convenient alternative to soap and water hand washing.
But because such gels do not have activity against spores, reliance on their use faces further scrutiny in light of nationwide outbreaks of a new resistant strain of Clostridium difficile, according to John M. Boyce, M.D., chief of the infectious diseases section at the Hospital of St. Raphael in New Haven.
Dr. Boyce presented a study at the annual meeting of the Society for Healthcare Epidemiology of America that showed no increase in C. difficile-associated disease at his 500-bed community teaching hospital during the 3 years in which the use of alcohol-based hand rubs increased 10-fold.
Another study that was discussed during the meeting showed that rates of vancomycin-resistant Enterococcus (VRE) species and methicillin-resistant Staphylococcus aureus (MRSA) decreased in the 27 months following the introduction of alcohol-based hand gels and a hand-washing campaign at Loyola University Medical Center in Maywood, Ill. The reduction in VRE was statistically significant; however, the drop in MRSA was not.
Rates of C. difficile were unchanged in the Loyola study, presented by Julie Leischner, M.D., of the department of infectious disease at the university.
Both investigators concluded that the use of alcohol-based hand cleaners does not appear to influence rates of C. difficile infection. But recent hand-hygiene guidelines written by the Centers for Disease Control and Prevention and a multisociety task force suggest "prudent" precautions during C. ...
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