Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping Review
This scoping review addresses bacterial contamination of antiseptics, low-level disinfectants, and hand hygiene products in healthcare settings in high-income countries. Over 70 years, 114 articles were found: 68 outbreaks, 13 pseudo-outbreaks and 33 cross-sectional surveys. Outbreaks affected media...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Hygiene |
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| Online Access: | https://www.mdpi.com/2673-947X/3/2/12 |
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| author | Palpouguini Lompo Anne-Sophie Heroes Esenam Agbobli Vera Kühne Halidou Tinto Dissou Affolabi Jan Jacobs |
| author_facet | Palpouguini Lompo Anne-Sophie Heroes Esenam Agbobli Vera Kühne Halidou Tinto Dissou Affolabi Jan Jacobs |
| author_sort | Palpouguini Lompo |
| collection | DOAJ |
| description | This scoping review addresses bacterial contamination of antiseptics, low-level disinfectants, and hand hygiene products in healthcare settings in high-income countries. Over 70 years, 114 articles were found: 68 outbreaks, 13 pseudo-outbreaks and 33 cross-sectional surveys. Outbreaks affected median 29 (1–151) patients, extended for 26 (1–156) weeks and had a case fatality of 0.0% (0.0–60.0%). Most (72.8%) (pseudo-)outbreaks were caused by water-based chlorhexidine (CHG), quaternary ammonium compounds (QUAT) and the combination CHG–QUAT. Contaminating bacteria were nonfermentative Gram-negative rods (87.6% (pseudo-)outbreaks), mainly <i>Burkholderia cepacia</i>, <i>Pseudomonas aeruginosa</i> and <i>Achromobacter</i> spp.) and Enterobacterales (29.6%, 24/81), mostly <i>Serratia</i> spp.). Risk factors were at the level of the bacteria (natural resistance to CHG and QUAT), containers (design and functioning, presence of cork and cotton, biofilm formation), preparation (nonsterile water, overdilution) and practices (too long expiry dates, inappropriate container reprocessing, topping up of containers and deviation from procedures). Transmission occurred through direct contact (antiseptics), contact with semicritical items (disinfectants) and were handborne (soaps). During recent decades, reports of soap contaminated with Enterobacterales emerged and nationwide outbreaks of intrinsically contaminated CHG occurred. Outstanding issues comprise intrinsic contamination, implementation of antiseptic stewardship, the role of unit doses and sterile products, transmission studies, biofilm control and understanding healthcare providers’ perceptions. |
| first_indexed | 2024-03-11T02:22:46Z |
| format | Article |
| id | doaj.art-b4d800265a214a95afd36aeb2def28ac |
| institution | Directory Open Access Journal |
| issn | 2673-947X |
| language | English |
| last_indexed | 2024-03-11T02:22:46Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hygiene |
| spelling | doaj.art-b4d800265a214a95afd36aeb2def28ac2023-11-18T10:42:48ZengMDPI AGHygiene2673-947X2023-04-013213617510.3390/hygiene3020012Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping ReviewPalpouguini Lompo0Anne-Sophie Heroes1Esenam Agbobli2Vera Kühne3Halidou Tinto4Dissou Affolabi5Jan Jacobs6Institut de Recherche en Science de la Santé (IRSS), Clinical Research Unit of Nanoro, Nanoro (CRUN), Ouagadougou 11 BP 218, Burkina FasoDepartment of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, BelgiumCentre National Hospitalier Universitaire Hubert Koutoukou Maga, Cotonou 03 BP 2819, BeninDepartment of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, BelgiumInstitut de Recherche en Science de la Santé (IRSS), Clinical Research Unit of Nanoro, Nanoro (CRUN), Ouagadougou 11 BP 218, Burkina FasoCentre National Hospitalier Universitaire Hubert Koutoukou Maga, Cotonou 03 BP 2819, BeninDepartment of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, BelgiumThis scoping review addresses bacterial contamination of antiseptics, low-level disinfectants, and hand hygiene products in healthcare settings in high-income countries. Over 70 years, 114 articles were found: 68 outbreaks, 13 pseudo-outbreaks and 33 cross-sectional surveys. Outbreaks affected median 29 (1–151) patients, extended for 26 (1–156) weeks and had a case fatality of 0.0% (0.0–60.0%). Most (72.8%) (pseudo-)outbreaks were caused by water-based chlorhexidine (CHG), quaternary ammonium compounds (QUAT) and the combination CHG–QUAT. Contaminating bacteria were nonfermentative Gram-negative rods (87.6% (pseudo-)outbreaks), mainly <i>Burkholderia cepacia</i>, <i>Pseudomonas aeruginosa</i> and <i>Achromobacter</i> spp.) and Enterobacterales (29.6%, 24/81), mostly <i>Serratia</i> spp.). Risk factors were at the level of the bacteria (natural resistance to CHG and QUAT), containers (design and functioning, presence of cork and cotton, biofilm formation), preparation (nonsterile water, overdilution) and practices (too long expiry dates, inappropriate container reprocessing, topping up of containers and deviation from procedures). Transmission occurred through direct contact (antiseptics), contact with semicritical items (disinfectants) and were handborne (soaps). During recent decades, reports of soap contaminated with Enterobacterales emerged and nationwide outbreaks of intrinsically contaminated CHG occurred. Outstanding issues comprise intrinsic contamination, implementation of antiseptic stewardship, the role of unit doses and sterile products, transmission studies, biofilm control and understanding healthcare providers’ perceptions.https://www.mdpi.com/2673-947X/3/2/12antisepticdisinfectanthand hygieneintrinsicin-useoutbreak |
| spellingShingle | Palpouguini Lompo Anne-Sophie Heroes Esenam Agbobli Vera Kühne Halidou Tinto Dissou Affolabi Jan Jacobs Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping Review Hygiene antiseptic disinfectant hand hygiene intrinsic in-use outbreak |
| title | Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping Review |
| title_full | Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping Review |
| title_fullStr | Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping Review |
| title_full_unstemmed | Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping Review |
| title_short | Bacterial Contamination of Antiseptics, Disinfectants and Hand Hygiene Products in Healthcare Facilities in High-Income Countries: A Scoping Review |
| title_sort | bacterial contamination of antiseptics disinfectants and hand hygiene products in healthcare facilities in high income countries a scoping review |
| topic | antiseptic disinfectant hand hygiene intrinsic in-use outbreak |
| url | https://www.mdpi.com/2673-947X/3/2/12 |
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