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

[Guest guest]

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_

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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,

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