From the Guidelines
Bacterial spores, such as those from Clostridium spp. or Bacillus spp., are not reliably killed by alcohol-based hand rubs. This is because the spores have a protective coating that prevents the alcohol from penetrating and denaturing the proteins or disrupting the cell membrane 1. As a result, handwashing with soap and water is recommended for removing these spores from the surface of contaminated hands. Key points to consider include:
- The use of alcohol-based hand rubs with at least 60-95% alcohol concentration
- Applying enough product to cover all hand surfaces
- Rubbing until completely dry, which takes about 20-30 seconds
- Following facility-specific protocols in healthcare settings where resistant organisms are common
- Proper technique is crucial, as inadequate volume or insufficient contact time significantly reduces effectiveness. In the case of outbreaks of C. difficile-related infections, washing hands with soap and water after removing gloves is prudent 1. Additionally, healthcare workers with suspected or documented exposure to B. anthracis-contaminated items should wash their hands with soap and water.
From the Research
Bacteria Not Killed by Hand Rub
- Clostridium difficile spores are not effectively killed by alcohol-based hand rubs 2, 3, 4
- Studies have shown that hand washing with soap and water is more effective in removing C. difficile spores from hands than alcohol-based hand rubs 2, 3, 5, 4
- The use of alcohol-based hand rubs may not significantly reduce the transfer of C. difficile spores through physical contact 3
Effectiveness of Hand Hygiene Methods
- Hand washing with soap and water has been shown to be superior to alcohol-based hand rubs in removing C. difficile spores from hands 2, 3, 5, 4
- Chlorhexidine soap washing has also been shown to be effective in reducing C. difficile spore counts on hands 3
- Proper hand hygiene technique is crucial in reducing the transmission of C. difficile and other nosocomial infections 5, 6