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Viljoen H, Schoeman JP, Fosgate GT, Boucher C. Comparative antimicrobial efficacy of 4 surgical hand-preparation procedures prior to application of an alcohol-based hand rub in veterinary students. Vet Surg 2022; 51:447-454. [PMID: 35192206 DOI: 10.1111/vsu.13783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 01/23/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the influence of skin preparations before application of an alcohol-based hand rub (ABHR) on bacterial counts before and after elective surgery. STUDY DESIGN Clinical prospective study. SAMPLE POPULATION Veterinary students (n = 103) performing ovariohysterectomies on 140 dogs. METHODS Participants were randomly assigned to 1 initial surgical preparation on the day of surgery: A - hand preparation with medicated solution (4% w/v chlorhexidine bigluconate followed by an ABHR; B - application of a medication solution (benzalkonium chloride 0.1%-1% and polymeric biguanide hydrochloride 0.01%-0.1%) followed by an ABHR; C - nonmedicated pH-neutral soap hand wash followed by ABHR, and D - direct application of an ABHR. Samples were taken by pressing the distal finger tips to an agar plate before the hand preparation, after the hand preparation (n = 3), after ABHR application, and 120 minutes later. Colony-forming units (CFUs) for samples were determined. Total log CFU and CFU log10 reduction were calculated and used for comparison with P < .05. RESULTS Two hours after surgery commenced, the participants of groups that performed a hand preparation had lower total CFUs than those that did not perform a hand preparation (P = .001). In particular, the number of CFUs was lower when ABHR was performed after application of pHN compared to direct ABHR (P = .001). CONCLUSION In this population, performing a hand preparation with pHN prior to applying an ABHR had better antimicrobial effect for the duration of surgery than not performing a hand preparation. CLINICAL SIGNIFICANCE Surgeons should wash their hands prior to ABHR before starting their first surgery of the day, even when hands appear clean.
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Affiliation(s)
- Hermien Viljoen
- Department of Companion Animal, Clinical Studies, Faculty of Veterinary, Science, University of Pretoria, Pretoria, South Africa
| | - Johan P Schoeman
- Department of Companion Animal, Clinical Studies, Faculty of Veterinary, Science, University of Pretoria, Pretoria, South Africa
| | - Geoffrey T Fosgate
- Epidemiology Section, Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Charles Boucher
- Department of Companion Animal, Clinical Studies, Faculty of Veterinary, Science, University of Pretoria, Pretoria, South Africa
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Dörfel D, Maiwald M, Daeschlein G, Müller G, Hudek R, Assadian O, Kampf G, Kohlmann T, Harnoss JC, Kramer A. Comparison of the antimicrobial efficacy of povidone-iodine-alcohol versus chlorhexidine-alcohol for surgical skin preparation on the aerobic and anaerobic skin flora of the shoulder region. Antimicrob Resist Infect Control 2021; 10:17. [PMID: 33482910 PMCID: PMC7821636 DOI: 10.1186/s13756-020-00874-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background Cutibacterium acnes is part of the anaerobic skin microbiome and resides in deeper skin layers. The organism is an agent of surgical site infections (SSI) in shoulder surgery. We hypothesized that prolonged skin preparation with an agent that penetrates deeply into the skin would be beneficial. Thus, we compared two classes of antiseptics, each combined with alcohol, each applied with two different contact times. Methods Using a cross-over arrangement, shoulders of 16 healthy volunteers were treated for 2.5 min (standard) or 30 min (prolonged) with alcohol-based chlorhexidine (CHG-ALC) or alcohol-based povidone-iodine (PVP-I-ALC). Skin sites were sampled before, immediately after, and 3 h after treatment, using a standardized cup-scrub technique. Results Aerobic skin flora was reduced more effectively by PVP-I-ALC than by CHG-ALC after 2.5 min application and immediate sampling (reduction factor [RF] 2.55 ± 0.75 vs. 1.94 ± 0.91, p = 0.04), but not after prolonged contact times and 3-h sampling. Coagulase-negative staphylococci were completely eliminated after PVP-I-ALC application, but still recovered from 4 of 32 samples after CHG-ALC application. Anaerobic flora was reduced more effectively by PVP-I-ALC than CHG-ALC after standard (RF 3.96 ± 1.46 vs. 1.74 ± 1.24, p < 0.01) and prolonged (RF 3.14 ± 1.20 vs. 1.38 ± 1.16, p < 0.01) contact times and immediate sampling, but not after 3-h sampling. No adverse events were reported. Conclusions PVP-I-ALC showed marginal benefits concerning the aerobic flora, but more substantial benefits over CHG-ALC concerning the anaerobic flora of the shoulder. Standard and prolonged contact times showed superiority for PVP-I-ALC for anaerobic flora at all immediate sampling points, but missed significance at 3-h sampling. The results underscore the need for protection against C. acnes and coagulase-negative staphylococci in orthopaedic surgery. The clinical relevance of these findings, however, should be studied with SSI as an endpoint.
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Affiliation(s)
- Dorothea Dörfel
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Duke-National University of Singapore Postgraduate School of Medicine, Singapore, Singapore
| | - Georg Daeschlein
- Department of Dermatology, University Medicine Greifswald, Greifswald, Germany.,Working Group Clinical Antisepsis, German Society of Hospital Hygiene, Berlin, Germany
| | - Gerald Müller
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Robert Hudek
- Shoulder and Elbow Surgery, Rhön-Klinikum AG, Bad Neustadt/Saale, Germany
| | - Ojan Assadian
- Regional Hospital Wiener Neustadt, Vienna, Austria.,Institute for Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK
| | - Günter Kampf
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - Thomas Kohlmann
- Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Julian Camill Harnoss
- Department of General, Visceral and Transplantation Surgery and Study Center, German Surgical Society, University Hospital Heidelberg, Heidelberg, Germany
| | - Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, 17475, Greifswald, Germany.
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Biermann NM, McClure JT, Doyle AJ. Letter to the Editor: Response to letter regarding: Prospective, randomised clinical trial of four different presurgical hand antiseptic techniques in equine surgery. Equine Vet J 2019; 52:158-159. [PMID: 31552679 DOI: 10.1111/evj.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 07/27/2019] [Indexed: 11/27/2022]
Affiliation(s)
- N M Biermann
- University of Veterinary Medicine Vienna, Vienna, Austria
| | - J T McClure
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - A J Doyle
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Kampf G, Verwilghen D. Letter to the Editor: Prospective, randomised clinical trial of four different presurgical hand antiseptic techniques in equine surgery. Equine Vet J 2019; 51:705. [PMID: 31373056 DOI: 10.1111/evj.13139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- G Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany
| | - D Verwilghen
- School of Veterinary Sciences, Faculty of Science, University of Sydney, Sydney, Australia
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5
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Kampf G. Aqueous chlorhexidine for surgical hand disinfection? J Hosp Infect 2018; 98:378-379. [DOI: 10.1016/j.jhin.2017.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022]
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Comparative Antimicrobial Efficacy of Two Hand Sanitizers in Intensive Care Units Common Areas: A Randomized, Controlled Trial. Infect Control Hosp Epidemiol 2018; 39:267-271. [DOI: 10.1017/ice.2017.293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVEContaminated hands of healthcare workers (HCWs) are an important source of transmission of healthcare-associated infections. Alcohol-based hand sanitizers, while effective, do not provide sustained antimicrobial activity. The objective of this study was to compare the immediate and persistent activity of 2 hand hygiene products (ethanol [61% w/v] plus chlorhexidine gluconate [CHG; 1.0% solution] and ethanol only [70% v/v]) when used in an intensive care unit (ICU).DESIGNProspective, randomized, double-blinded, crossover studySETTINGThree ICUs at a large teaching hospitalPARTICIPANTSIn total, 51 HCWs involved in direct patient care were enrolled in and completed the study.METHODSAll HCWs were randomized 1:1 to either product. Hand prints were obtained immediately after the product was applied and again after spending 4–7 minutes in the ICU common areas prior to entering a patient room or leaving the area. The numbers of aerobic colony-forming units (CFU) were compared for the 2 groups after log transformation. Each participant tested the alternative product after a 3-day washout period.RESULTSOn bare hands, use of ethanol plus CHG was associated with significantly lower recovery of aerobic CFU, both immediately after use (0.27 ± 0.05 and 0.88 ± 0.08 log10 CFU; P = .035) and after spending time in ICU common areas (1.81 ± 0.07 and 2.17 ± 0.05 log10 CFU; P<.0001). Both the antiseptics were well tolerated by HCWs.CONCLUSIONSIn comparison to the ethanol-only product, the ethanol plus CHG sanitizer was associated with significantly lower aerobic bacterial counts on hands of HCWs, both immediately after use and after spending time in ICU common areas.CLINICAL TRIAL IDENTIFIERClinicaltrials.gov identifier NCT02258412Infect Control Hosp Epidemiol 2018;39:267–271
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Hennig TJ, Werner S, Naujox K, Arndt A. Chlorhexidine is not an essential component in alcohol-based surgical hand preparation: a comparative study of two handrubs based on a modified EN 12791 test protocol. Antimicrob Resist Infect Control 2017; 6:96. [PMID: 28924473 PMCID: PMC5598061 DOI: 10.1186/s13756-017-0258-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 09/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Surgical hand preparation is an essential part of modern surgery. Both alcohol-based and antiseptic detergent-based hand preparation are recommended practices, with a trend towards use of alcohol based handrubs. However, discussion has arisen whether chlorhexidine is a required ingredient in highly efficacious alcohol-based formulations, in view of providing sustained antimicrobial efficacy. METHODS One alcohol-only formulation (product A), containing ethanol and n-propanol, and one formulation containing a chlorhexidine-ethanol combination (product B) were directly compared with each other using a modified test protocol based on European standard EN 12791 (2016) with 25 volunteers. The alcohol-only formulation (product A) was applied for only 90 s, the chlorhexidine-alcohol formulation (product B) for 180 s. Microbial log reduction factors were determined and statistically compared immediately after application and at 6 h under surgical gloves. RESULTS The alcohol-only formulation (product A) achieved mean log reduction factors of 1.96 ± 1.06 immediately after application and 1.67 ± 0.71 after 6 h. The chlorhexidine-alcohol combination (product B) achieved mean log reduction factors of 1.42 ± 0.79 and 1.24 ± 0.90 immediately and after 6 h, respectively. The values for product A were significantly greater than those for product B at both measured time points (p ≤ 0.025 immediately after application and p ≤ 0.01 after 6 h). CONCLUSIONS An optimized alcohol-only formulation tested according to a modified EN 12791 protocol in 25 healthy volunteers outperformed a chlorhexidine-alcohol formulation both immediately after application and at 6 h under surgical gloves, despite a much shorter application time. Thus, optimized alcohol-only formulations do not require chlorhexidine to achieve potent immediate and sustained efficacy. In conclusion, chlorhexidine is not an essential component for alcohol-based surgical hand preparation.
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Affiliation(s)
- Thomas-Jörg Hennig
- B. Braun Medical AG, Centre of Excellence Infection Control, Seesatz 17, 6204 Sempach, Switzerland
| | - Sebastian Werner
- HygCen Germany GmbH, Bornhövedstrasse 78, 19055 Schwerin, Germany
| | - Kathrin Naujox
- HygCen Germany GmbH, Bornhövedstrasse 78, 19055 Schwerin, Germany
| | - Andreas Arndt
- B. Braun Medical AG, Centre of Excellence Infection Control, Seesatz 17, 6204 Sempach, Switzerland
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Hardy JM, Owen TJ, Martinez SA, Jones LP, Davis MA. The effect of nail characteristics on surface bacterial counts of surgical personnel before and after scrubbing. Vet Surg 2017; 46:952-961. [DOI: 10.1111/vsu.12685] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 01/25/2017] [Accepted: 02/14/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Jade M. Hardy
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine, Washington State University; Pullman Washington
| | - Tina J. Owen
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine, Washington State University; Pullman Washington
| | - Steven A. Martinez
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine, Washington State University; Pullman Washington
| | - Lisa P. Jones
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine, Washington State University; Pullman Washington
| | - Margaret A. Davis
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine, Washington State University; Pullman Washington
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Edwards RA, Riley CB, Howe L, Burrows EA, Riley KT, Frellstedt L. Comparison of an alcohol-based hand sanitation product with a traditional chlorhexidine hand scrub technique for hand hygiene preparation in an equine hospital. N Z Vet J 2017; 65:242-247. [PMID: 28614973 DOI: 10.1080/00480169.2017.1342175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS To investigate the efficacy of an alcohol gel-based hand antisepsis protocol compared with a traditional chlorhexidine-based protocol under conditions of routine clinical contamination, and following heavy faecal contamination. METHODS Twelve adult participants were recruited and on four separate days completed a hand sanitation protocol using a chlorhexidine scrub or an alcohol-based gel, with hands that were grossly clean but contaminated or with faecal contamination. Bacterial samples were obtained from participants' hands before sanitation, immediately after and then 2 hours later. All samples were cultured on blood and MacConkey agar and bacterial colonies counted after 48 hours. RESULTS for clean contaminated hands, the percentage reduction in bacterial colonies on blood agar immediately after hand sanitation was similar for both protocols (p=0.3), but was greater for the alcohol gel than chlorhexidine after 2 hours (p=0.005). For hands with faecal contamination, the percentage reduction in bacterial colonies on blood agar was similar for both protocols immediately and 2 hours after sanitation (p>0.2), but positive cultures were obtained on blood agar from samples collected after both protocols, for almost all participants. CONCLUSIONS The results indicate equivalent efficacy of the alcohol-based gel and the pre-surgical chlorhexidine protocol. CLINICAL RELEVANCE The alcohol-based gel protocol is an effective hand asepsis technique for grossly clean contaminated hands and those following faecal contamination, with comparable efficacy to chlorhexidine based scrub.
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Affiliation(s)
- R A Edwards
- a Institute of Veterinary, Animal and Biomedical Sciences, Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand.,b Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine , Utrecht University , Utrecht , The Netherlands
| | - C B Riley
- a Institute of Veterinary, Animal and Biomedical Sciences, Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand
| | - L Howe
- a Institute of Veterinary, Animal and Biomedical Sciences, Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand
| | - E A Burrows
- a Institute of Veterinary, Animal and Biomedical Sciences, Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand
| | - K T Riley
- a Institute of Veterinary, Animal and Biomedical Sciences, Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand
| | - L Frellstedt
- a Institute of Veterinary, Animal and Biomedical Sciences, Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand
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Li YJ, Pan CZ, Fang CQ, Zhao ZX, Chen HL, Guo PH, Zhao ZW. Pneumonia caused by extensive drug-resistant Acinetobacter baumannii among hospitalized patients: genetic relationships, risk factors and mortality. BMC Infect Dis 2017; 17:371. [PMID: 28558660 PMCID: PMC5450129 DOI: 10.1186/s12879-017-2471-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 05/16/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The clonal spread of multiple drug-resistant Acinetobacter baumannii is an emerging problem in China. We analysed the molecular epidemiology of Acinetobacter baumanni isolates at three teaching hospitals and investigated the risk factors, clinical features, and outcomes of hospital-acquired pneumonia caused by extensive drug-resistant Acinetobacter baumannii (XDRAB) infection in Guangzhou, China. METHODS Fifty-two A. baumannii isolates were collected. Multilocus sequence typing (MLST) was used to assess the genetic relationships among the isolates. The bla OXA-51-like gene was amplified using polymerase chain reaction (PCR) and sequencing. The resistance phenotypes were determined using the disc diffusion method. A retrospective case-control study was performed to determine factors associated with XDRAB pneumonia. RESULTS Most of the 52 A. baumannii isolates (N = 37, 71.2%) were collected from intensive care units (ICUs). The respiratory system was the most common bodily site from which A. baumannii was recovered (N = 45, 86.5%). Disc diffusion classified the isolates into 17 multidrug-resistant (MDR) and 35 extensively drug-resistant (XDR) strains. MLST grouped the A. baumannii isolates into 5 existing sequence types (STs) and 7 new STs. ST195 and ST208 accounted for 69.2% (36/52) of the isolates. The clonal relationship analysis showed that ST195 and ST208 belonged to clonal complex (CC) 92. According to the sequence-based typing (SBT) of the bla OXA-51-like gene, 51 A. baumannii isolates carried OXA-66 and the rest carried OXA-199. There were no significant differences with respect to the resistance phenotype between the CC92 and non-CC92 strains (P = 0.767). The multivariate analysis showed that the APACHE II score, chronic obstructive pulmonary disease (COPD) and cardiac disease were independent risk factors for XDRAB pneumonia (P < 0.05). The mortality rate of XDRAB pneumonia was high (up to 42.8%), but pneumonia caused by XDRAB was not associated with in-hospital mortality (P = 0.582). CONCLUSIONS ST195 may be the most common ST in Guangzhou, China, and may serve as a severe epidemic marker. SBT of bla OXA-51-like gene variants may not result in sufficient dissimilarities to type isolates in a small-scale, geographically restricted study of a single region. XDRAB pneumonia was strongly related to systemic illnesses and the APACHE II score but was not associated with in-hospital mortality.
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Affiliation(s)
- Yu Jun Li
- The First Affiliated Hospital of Jinan University, the West of Huangpu Street, Guangzhou, China.,Department of Respiratory Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Panfu Road, Guangzhou, China
| | - Chu Zhi Pan
- Department of Hepatobiliary Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Tian He Road, Guangzhou, China
| | - Chang Quan Fang
- Department of Respiratory Medicine, Guangzhou Red Cross Hospital, Tong Fu Zhong Road, Guangzhou, China
| | - Zhu Xiang Zhao
- Department of Respiratory Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Panfu Road, Guangzhou, China
| | - Hui Ling Chen
- Department of Clinic Laboratory, Guangzhou First People's Hospital, Guangzhou Medical University, Panfu Road, Guangzhou, China
| | - Peng Hao Guo
- Department of Clinic Laboratory, the First Affiliated Hospital of Sun Yat-sen University, Zhong Shan Er Road, Guangzhou, China
| | - Zi Wen Zhao
- Department of Respiratory Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Panfu Road, Guangzhou, China.
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Kampf G, Kramer A, Suchomel M. Lack of sustained efficacy for alcohol-based surgical hand rubs containing ‘residual active ingredients’ according to EN 12791. J Hosp Infect 2017; 95:163-168. [DOI: 10.1016/j.jhin.2016.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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Oriel BS, Itani KM. Surgical Hand Antisepsis and Surgical Site Infections. Surg Infect (Larchmt) 2016; 17:632-644. [DOI: 10.1089/sur.2016.085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Brad S. Oriel
- Department of Surgery, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts
- Department of Surgery, Tufts University School of Medicine, Boston, Massachusetts
| | - Kamal M.F. Itani
- Department of Surgery, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts
- Department of Surgery, Tufts University School of Medicine, Boston, Massachusetts
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Verwilghen D, Kampf G, Doyle AJ. Antibacterial Efficacy of Several Surgical Hand Preparation Products Used by Veterinary Students. Vet Surg 2016; 45:1118-1119. [DOI: 10.1111/vsu.12566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/02/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Denis Verwilghen
- Associate Professor in Large Animal Surgery, Department of Large Animal Sciences; University of Copenhagen; Copenhagen Denmark
| | - Günter Kampf
- Professor for hygiene and environmental medicine; Knieler und Team GmbH, Infection Control Science; Hamburg Germany
- Ernst-Moritz-Arndt University, Institute for Hygiene and Environmental Medicine; Greifswald Germany
| | - Aimie J. Doyle
- Department of Health Management; Atlantic Veterinary Medicine; Charlottetown, Prince Edward Island, Canada
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Maiwald M, Petney TN, Assam PN, Chan ESY. Use of statistics as another factor leading to an overestimation of chlorhexidine's role in skin antisepsis. Infect Control Hosp Epidemiol 2014; 34:872-3. [PMID: 23838237 DOI: 10.1086/671282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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