Diss_Schamberger_Joachim.pdf - Ernst-Moritz-Arndt-Universität ...

5 Summary
The prevention of nosocomial diseases plays an important role in daily clinical
routine in german hospitals. Infections with spore-forming bacteria, especially
Clostridium difficile associated diseases (CDAD), increase as a result of
antibiotic therapy. Expanding virulence, careless use of antibiotics and growing
co-morbidity amongst older patients are responsible for an increased
susceptibility to spore-forming bacteria. The consequences of increasing
infection rates are felt not only in terms of increased patient mortality and
morbidity but also in the growing demand that infection control measures places
on hospital resources and staff time.
Data regarding the susceptibility of spore forming bacteria to disinfectants is
unfortunately fairly weak at present. This study attempts to redress this by
comparing the efficacy of peracetic acid, hydrogen peroxide, the combination of
peracetic acid and hydrogen peroxide, poly alcohol hand wash and potassium
soap against spore-forming bacteria. The testing organism was Bacillus subtilis
(atropheus), a non-pathogenic, aerobic gram-positive spore-forming rod.
The basis for this trial is a modified design of DIN EN 1500. The main difference
was the use of sterile test bags which take the whole hand instead of just the
fingertip to determine the values before and after contact with the testing
organism. The hand hygiene agents were left on for 30 s. After the use of
potassium soap (also 30s) the hands had to be cleaned under running water.
The testing of the compound took place with 15 volunteers arranged with latin
quadrat.
As a result of the experiment we were able to show that no agent tested could
produce a reduction of 3 log in organism numbers, however peracetic acid,
peracetic acid and hydrogen peroxide and potassium soap did produce the
greatest reduction.
As such, we conclude that no disinfectant agent tested is sufficient to prevent
the spreading of spores by hand. It is therefore necessary to undertake further
experiments for the elimination of spore-forming bacteria from bare hands.
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