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Alcohol-Based Hand Rub Systems Reduce In-Hospital Infection Rates of Resistant Organisms: Presented at ICAAC

By Ed Susman

SAN DIEGO, CA -- September 30, 2002 -- The placement of dispensers containing alcohol-based hand rub products is associated with a decrease in new cases of nosocomial infection with resistant organisms, researchers said.

After one year, infections with methicillin resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) were significantly decreased following the installation of 500 dispensers of an alcohol-based hand foam at the Washington DC Veterans Affairs Medical Center, an inner-city, tertiary-care teaching hospital with 167 acute and 120 long-term care beds.

"We placed the dispensers in every in-patient room, and in every outpatient room and in surgical and other rooms," said Maureen Schultz, an infection control program specialist at the VA Medical Center.

Dispensers were used at the rate of 200 to 300 per month (approximately 500 installed; 100 individual uses per dispenser). "The product costs us about $200 a month; the company placed the dispensers for free. So over the course of our study we spent about $2,400. Just preventing one infection could cover that cost."

In presentations September 28^th at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), sponsored by the American Society for Microbiology, Ms. Schultz explained that in-hospital infections caused by drug resistant bacteria impacts length of stay, hospital costs and possibly patient mortality.

"Hand hygiene is a cornerstone of the effort to limit the spread of these organisms," she said.

However, Elaine Larson, associate dean for research at Columbia University School of Nursing, in New York, United States, said that hand washing in hospitals no longer suffices in preventing spread of infection. She said new protocols from the Centers for Disease Control and Prevention, in Atlanta, Georgia, United States, will mandate that United States hospitals move to alcohol-based hand rubs that will be readily available for use as was demonstrated at the Washington VA Medical Center.

Ms. Schultz said that prior to the year 2000 when the new dispensers were put into place, the hospital averaged about 78 new cases of MRSA a year. Since the dispensers have been available, that number of new cases fell to 60 cases-a decrease of 23 percent. For VRE, the hospital saw about 40 cases a year before 2000; since the new program was initiated this decreased to 24 cases-a decrease of 40 percent.

"During that time frame the number of patients in the hospital was about the same. No new infection control programs were initiated,' she said. "The only change was the installation of the alcohol-based hand rub system."

Ms. Schultz said that any over-the-counter product that has at least 60 percent alcohol would be sufficient to control the microbe spread. She said the hospital tried several different product brands before settling on a foam substance. Various emollients are added to the gels or foams to protect hands.

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