Two reviews on “Bacterial Contamination of Antiseptics, Disinfectants, and Hand Hygiene Products Used in Healthcare Settings” on High and Low- and Middle-Income Countries
April 18, 2023
We conducted two reviews of healthcare-associated outbreaks and cross-sectional
surveys related to the contamination of antiseptics, disinfectants, and hand hygiene products in
healthcare settings: a scoping review on high-income countries and a systematic review on low- and middle-income countries.
Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping Review
Although numerous efforts have been done to reduce bacterial contamination of antiseptics, disinfectants and hand hygiene products used in healthcare facilities in high-income countries and its burden (healthcare-associated infections, outbreaks), some risk factors contributing to this contamination persist: resistance of Gram-negative bacteria to some products, intrinsic (manufacturing) contamination, containers reprocessing, biofilm control, and healthcare workers practices (topping-up and too long use)… Read more here: https://www.mdpi.com/2673-947X/3/2/12
Bacterial Contamination of Antiseptics, Disinfectants, and Hand Hygiene Products Used in Healthcare Settings in Low- and Middle-Income Countries—A Systematic Review
We conducted a systematic review of healthcare-associated outbreaks and cross-sectional surveys related to the contamination of antiseptics, disinfectants, and hand hygiene products in healthcare settings in low- and middle-income countries (PROSPERO CRD42021266271). Risk of bias was assessed by selected items of the ORION and MICRO checklists. From 1977 onwards, 13 outbreaks and 25 cross-sectional surveys were found: 20 from Asia and 13 from Africa. Products most associated with outbreaks were water-based chlorhexidine, chlorhexidine-quaternary
ammonium compound combinations (7/13), and liquid soap products (4/13). Enterobacterales (including multidrug-resistant Enterobacter cloacae, Klebsiella pneumoniae, and Serratia marcescens) and non-fermentative Gram-negative rods were found in 5 and 7 outbreaks and in 34.1% and 42.6% of 164 isolates , respectively, from cross-sectional surveys. Risk factors included preparation (place, utensils, or tap water high and incorrect dilutions), containers (reused, recycled, or inadequate reprocessing), and practices (topping-up or too long use). Potential biases were microbiological methods (neutralizers) and incomplete descriptions of products’ identity, selection, and denominators. External validity was compromised by low representativeness for remote rural settings and low-income countries in sub-Saharan Africa. Outstanding issues were water quality, biofilm control, field-adapted containers and reprocessing, in-country production, healthcare providers’ practices, and the role of bar soap. A list of “best practices” to mitigate product contamination was compiled.
Read more here: https://www.mdpi.com/2673-947X/3/2/10