Introduction
Hand hygiene is widely recognized as the most important means of preventing infection. Use of effective hand hygiene agents is required as part of comprehensive hand hygiene programs implemented to reduce infections in health care settings. Hand hygiene is also a critical component of occupational safety programs in high-risk settings, in the food service industry, and as a public health measure during outbreaks. With increasing concern about the burden of healthcare-associated infections and the development of antibiotic resistant organisms, improving hand hygiene by health care workers has been identified as a major patient safety initiative throughout the world [1].
Currently available hand hygiene products include soaps and alcohol-based hand rubs such as gels, lotions, foams, and liquids. Standardized methods are used to evaluate the antimicrobial properties of these products by regulatory and governmental agencies prior to approval. [2]-[5] Methods to demonstrate efficacy include using the pads of the fingers from test subjects or the recovery of bacteria using the “glove juice method” in which organisms are recovered from hands placed in oversized gloves containing sampling fluid. The sampling fluid is formulated to remove bacteria from the skin while neither promoting, nor inhibiting bacterial growth. [3] World Health Organization guidelines on hand hygiene programs recommend ongoing studies to evaluate and amend protocols to obtain valid estimates of product efficacy [1].
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In glove juice protocols, specifications for reagents and sampling supplies have been developed to permit product comparison. Gloves used for sampling are generally required to be loose and un-powdered. The current ASTM International standard for surgical hand scrub preparations, ASTM Standard E1115, specifies that gloves for sampling should be “loose-fitting, unlined, powder-free latex gloves which possess no antimicrobial properties, or equivalent”. [3] Furthermore, E1115 specifies a sole source for these latex surgical gloves.
However, latex allergy represents a serious concern, particularly for health care workers. It is estimated that up to 12% of all health care workers experience a range of reactions to latex including skin irritation, local itching and burning, and allergic symptoms. [6] Death from anaphylaxis of both health care workers and patients has been reported in the literature.
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Alternatives to latex gloves include those composed of nitrile, vinyl and other synthetic materials. Given the risk of latex allergy and the availability of substitute synthetic materials, non-latex alternatives would be preferred if these materials have no impact on bacterial recovery and perform well during the manipulation required for sampling.
Because latex allergy poses risk of allergic reactions, other materials would be preferred if they also meet the criteria of being easily acquired, are appropriate to the test protocol, and do not exhibit antimicrobial properties. Thus, the goal of this project was to evaluate the properties of two types of sterile nitrile gloves as an alternative to the ASTM Standard E1115-specified latex gloves.
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