Effectiveness of hand-cleansing agents for removing methicillin-resistant Staphylococcus aureus from contaminated hands

OBJECTIVE: The effectiveness of hand-cleansing agents in removing a hospital strain of methicillin-resistant Staphylococcus aureus from artificially contaminated hands of five volunteers was studied. DESIGN: The products used were plain liquid soap, ethyl alcohol 70% (by weight), 10% povidone-iodine liquid soap PVP-I, and chlorhexidine gluconate (4%) detergent. The experiments were performed using a Latin square statistical design, with two 5x4 randomized blocks. The removal rates of S aureus cells from contaminated fingertips were estimated by analysis of variance, the response variable being the log(10) reduction factor (RF), ie, log(10) of the initial counts minus log(10) of the final counts. In the first and second blocks, the fingertips of the volunteers were contaminated in mean with 3.76 log(10) colony-forming units ([CFU] light-contamination hand) and 6.82 log(10) CFU (heavy-contamination hand), respectively. RESULTS: In the first block, there were significant differences between treatments (P<.05). The 10% PVP-I (RF, 3.76) and 70% ethyl alcohol (RF, 3.51) had significantly higher removal rates than plain liquid soap (RF, 1.96) and 4% chlorhexidine (RF, 1.91). In the second block, 10% PVP-I (RF, 4.39) and 70% ethyl alcohol (RF, 3.27) also were significantly more effective than plain liquid soap (RF, 1.77) and 4% chlorhexidine (RF, 1.37; P<.05). Plain liquid soap was significantly more effective than chlorhexidine (4%) detergent. CONCLUSIONS: The results suggest that 10% PVP-I and 70% ethyl alcohol may be the most effective hand-cleansing agents for removing methicillin-resistant S aureus strain from either lightly or heavily contaminated hands.