Re: Medscape C-Diff - Hand Sanitizers do not get rid of spores

[Guest guest]

Where have you been? Handwashing has been standard practice for C Diff for at

least 10 years!

Sent from my iPhone

> This is news to me. Hand sanitizers are NOT effective against CDiff. (And,

> c-diff kills 14,000 people annually in the US.)

>

> From Medscape - you have to have a subscription/password to get to the

> full article. Google the title plus medscape and you should probably get there

> for the full article.

>

> Refining Our Approach to Clostridium difficile Prevention

> A. Stokowski, RN, MS; L. Clifford Mc, MD

> _Authors and Disclosures_

> (javascript:newshowcontent('active','authordisclosures')

> Posted: 03/21/2012

>

> Medscape: Let's talk about each of these. What are the unique hand hygiene

> issues with CDI?

> Dr. Mc: We get a lot of questions about the hand hygiene issue with

> respect to CDI. We know that the alcohol-based (hand sanitizer) gels don't

> kill C difficile spores, nor do they reduce them. Essentially, hand gels

> don't do anything to these spores. So, some people have said that we should

> return to handwashing in healthcare facilities and eliminate hand gels. In

> one way, that makes sense. Handwashing, with soap, water, and friction, is

> better than alcohol-based hand sanitizers for C difficile, because of

> dilution and physical removal -- getting the spores off of the hands.

> However, alcohol-based hand sanitizers have probably saved thousands of

> lives through the prevention of countless infections. Not only are they, on

> the whole, more effective than handwashing for a huge range of usual

> pathogens that do not form spores (eg, methicillin-resistant Staphylococcus

aureus

> [MRSA], Escherichia coli), the ability to achieve higher levels of

> compliance in busy healthcare settings should not be overlooked. Thus, we need

to

> think carefully about overall patient safety and not think about only 1

> pathogen in devising our strategies.

> C difficile is probably transmitted primarily between patients on the

> hands of healthcare personnel who are transiently contaminated after contact

> with symptomatic patients or their surrounding environment. Once C difficile

> spores are on a healthcare provider's hands, they are hard to remove, even

> with handwashing. Our ability to kill common pathogens, such as MRSA or E

> coli, on hands using an alcohol gel is at least an order of magnitude

> greater than our ability to wash C difficile spores off our hands with soap

and

> water. It is much better to avoid getting them on your hands in the first

> place, and therefore gloves are the first and best line of defense. If you

> have a known patient with CDI, or even suspected CDI, wearing gloves is the

> most important thing to do to prevent hand contamination.

>

> Jan Patenaude, RD, CLT

> Director of Medical Nutrition

> Signet Diagnostic Corp.

> Telecommuting Nationwide

> (Mountain Time)

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> Certified LEAP Therapist and specialist in food sensitivity for IBS,

> migraine, fibromyalgia and multiple inflammatory conditions. Co-author of the

> Certified LEAP Therapist (CLT) Training Course.

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