Antimicrobial activity of homemade WHO ethanol-based hand rub solution in pediatric department, Dr. Cipto Mangunkusumo National Referral Hospital

  • Nina Dwi Putri Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Hindra Irawan Satari Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Mulya Rahma Karyanti Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Ari Prayitno Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Pratama Wicaksana Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Anis Karuniawati Department of Microbiology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Delly Chipta Lestari Department of Microbiology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Nabila Maudy Salma Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Shindy Claudya Aprianti Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Amalia Almira Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
  • Andi Annisa Rusyda Khafiyani Infectious and Tropical Pediatric Division, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia
Keywords: Hand hygiene, ethanol-based, hand rub, homemade, WHO

Abstract

Background Hand hygiene is essential in reducing healthcare-associated infections. Alcohol-based hand rub solutions have been reported to have superior antimicrobial efficacy on both bacteria and lipophilic viruses compared to washing with hand soap. In low- and middle-income countries, the cost of infection control poses a challenge. Our hospital produced an ethanol-based hand rub based on a WHO formulation to reduce the infection prevention costs.

Objectives To identify the antimicrobial activity of a WHO ethanol-based hand rub solution against bacterial contamination on the hands of healthcare workers at the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital.

Methods This cross-sectional study was performed on the hands of healthcare workers (physicians and nurses) working in the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta. A total of 225 specimens from 75 subjects were obtained by collecting swabs on both hands before and after participants worked in the Department of Child Health, Dr. Cipto Mangunkusumo General Hospital. Bacterial culture tests were performed to identify gram-positive and gram-negative bacteria. Bacteria were grouped into no-growth/Bacillus sp, Enterobacteriaceae, cocci, and non-fermenter groups.

Results The use of our WHO ethanol-based hand rub solution, generally resulted in a statistically significant decrease in bacterial growth from 84 to 54.6%, before compared to after the hand rub was performed. In more detail, there was a 72.7% decrease in Enterobacteriaceae, a 71.4% decrease in non-fermenters, an 8.6% decrease in cocci and a 44.1% increase in the number of specimens showing no growth bacteria/Bacillus sp.

Conclusion Our WHO ethanol-based hand rub has significant antimicrobial activity for common nosocomial pathogens (e.g., Staphylococcus aureus, P. aeruginosa, and K. pneumoniae).

References

1. Widmer AF, Dangel M. Alcohol?based handrub: evaluation of technique and microbiological efficacy with international infection control professionals. Infect Control Hosp Epidemiol. 2004;25:207-9. DOI: 10.1086/502379.
2. Laustsen S, Lund E, Bibby BM, Kristensen B, Thulstrup AM, Kjolseth-Moller J. Effect of correctly using alcohol-based hand rub in a clinical setting. Infect Control Hosp Epidemiol. 2008;29:954-6. DOI: 10.1086/590393.
3. Brown SM, Lubimova AV, Khrustalyeva NM, Shulaeva SV, Tekhova I, Zueva LP, et al. Use of an alcohol-based handrub and quality improvement interventions to improve hand hygiene in a Russian neonatal intensive care unit. Infect Control Hosp Epidemiol. 2003;24:172-9. DOI: 10.1086/502186.
4. World Health Organization guidelines on hand hygiene in health care [Internet]. WHO Int. 2021 [cited 2021 September 8]. Available from: https://www.who.int/publications/i/item/9789241597906
5. Padsalg A, Jain D, Bidkar S, Harinarayana D, Jadhav V. Preparation and evaluation of handrub disinfectant. Asian J Pharm. 2008;2:18-21. DOI: 10.4103/0973-8398.41559.
6. Guide to local production: WHO-recommended handrub formulations. [Internet]. WHO.Int. 2021 [cited 2021 September 8]. Available from: https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf
7. Mathur P. Hand hygiene: back to the basics of infection control. Indian J Med Res. 2011;134:611-20. DOI: 10.4103/0971-5916.90985
8. Kampf G, Hollingsworth A. Comprehensive bactericidal activity of an ethanol-based hand gel in 15 seconds. Ann Clin Microbiol Antimicrob. 2008;7:2. DOI: 10.1186/1476-0711-7-2.
9. Oke MA, Bello AB, Odebisi MB, El-Imam AMA, Kazeem MO. Evaluation of antibacterial efficacy of some alcohol-based hand sanitizers sold in Ilorin (North-Central Nigeria). Ife J Sci. 2013;15:111-7.
10. Kumar D, Kaushal SK, Kumar G, Prakash V, Prakash P, Nath G. Evaluation of the antibacterial activity of commonly used alcohol-based hand sanitizers on common pathogenic bacteria. Indian J Appl Res. 2015;3:2249-555. DOI: 10.36106/ijar.
Published
2022-07-25
How to Cite
1.
Putri N, Satari H, Karyanti M, Prayitno A, Wicaksana P, Karuniawati A, Lestari D, Salma N, Aprianti S, Almira A, Khafiyani AA. Antimicrobial activity of homemade WHO ethanol-based hand rub solution in pediatric department, Dr. Cipto Mangunkusumo National Referral Hospital. PI [Internet]. 25Jul.2022 [cited 25Sep.2022];62(4):232-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2818
Section
Infection & Tropical Pediatrics
Received 2021-10-23
Accepted 2022-07-25
Published 2022-07-25