A new alcohol solution (N-duopropenide) for hygienic (or routine) hand disinfection is more useful than classic handwashing: in vitro and in vivo studies in burn and other intensive care units

Introduction: Standard handwashing is a key measure for the prevention of crossed nosocomial infection, but this measure is not always observed. We study whether fast disinfection with an alcohol solution is better than handwashing and whether it can enhance observance. Materials and methods: The effects of several alcohol solutions on native and acquired microbiota are compared with classic handwashing in ‘in vitro’ and ‘in vivo’ (health volunteers) quantitative tests. A field assay was subsequently performed in severely ill patient intensive care units (ICUs) (Burn and other ICUs), using a semiquantitative method to compare the effects of disinfection with standard handwashing (n=102) with N-duopropenide alcohol application (n=264). Results and discussion: In both designs — health volunteers and hospital ward teams — we found significant differences between handwashing and N-duopropenide application. Handwashing barely modified the native or acquired microbiota (only 0.1 to <2 log10 reduction) and did not eliminate Staphylococcus aureus and Gram-negative bacteria (from 34 to 23%: P>0.05). However, N-duopropenide reduced the acquired microbiota by 5 log 10 and the native hand microbiota by more than 2 log10, as well as significantly reducing S. aureus and Gram-negative bacteria (33–1.3%; P<0.01).