It's All in How You Swipe, Says Study Examining Antibacterial Products
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Reviewed By Louise Chang, MD
Latest Infectious Disease News
June 3, 2008 — Just how effective are those disinfecting wipes and hand sanitizers for preventing disease? Two newly reported studies that asked the question have come to different conclusions.
In a study that focused solely on wipes, researchers concluded that instead of preventing hospital-acquired infections like methicillin-resistant Staphylococcus aureus (MRSA) the wipes could actually be spreading bacteria when used improperly by hospital staffers.
But another study, reported Monday in the journal Pediatrics, suggests that frequent use of disinfecting wipes and hand sanitizers in the classroom can reduce school absenteeism caused by bacterial and viral illness.
Disinfecting wipes and alcohol-based hand gels are now widely used in hospitals, schools, and other public settings to kill the pathogens that cause infectious disease.
Americans now spend an estimated $1 billion a year on these and other antibacterial products, but their direct impact on the spread of infectious disease is not well understood.
Wipes Can Spread Bacteria
About 100,000 cases of invasive MRSA occur each year in the United States, according to the CDC, and the vast majority of these infections occur in hospitals and other health-care settings.
Disinfectant wipes are among the products used in such settings in an effort to prevent the spread of MRSA and other infectious pathogens.
But in a study presented today in Boston at the annual meeting of the American Society for Microbiology, researchers from Cardiff University's Welsh School of Pharmacy reported that when used improperly the wipes may spread bacteria rather than remove or kill them.
Researchers Jean-Yves Maillard, PhD, Gareth Williams, PhD, and colleagues observed hospital staffers as they used the wipes to disinfect hospital rooms.
"We saw that there was a tendency to use one wipe on consecutive surfaces, such as bed rails, computer monitors, and keyboards," Williams tells WebMD.
The researchers used the wipes in this way in laboratory tests designed to measure their ability to remove and kill the bacteria that cause staph infections, including MRSA.
While most of the wipes tested did remove large numbers of bacteria from contaminated surfaces, they also commonly transferred live bacteria to uncontaminated surfaces when used in more than one place. Even some wipes that claimed to kill bacteria were found to transfer live bacteria from one surface to another, the researchers report.
"Many of the wipes were effective, but the message is that they have to be used properly," Williams says.
That means using one swipe per wipe on a single surface, Maillard tells WebMD.
Targeting Germs in the Classroom
Frequent hand washing is one of the best ways to prevent the spread of infectious illness, but new research suggests that commercially available hand sanitizers and disinfecting wipes can also help reduce the spread of infectious disease in schools.
Researchers from Children's Hospital Boston conducted a randomized, controlled trial at an Ohio elementary school in which the wipes and sanitizers were used in some classrooms, but not in others.
For eight weeks, teachers in the intervention classrooms used the wipes to disinfect each student's desk once a day after lunch, and the students were told to use an alcohol-based hand sanitizer several times a day. The classes without hand sanitizer and disinfecting wipes followed usual cleaning procedures and hand hygiene practices.
There was no difference in the absentee rate due to respiratory illness between the intervention and non-intervention classes over the course of the study, but the extra sanitation did seem to reduce the incidence of GI illness.
Twenty-four percent of students in the classes that did not use the wipes and hand sanitizers were absent from school during the study because of gastrointestinal illness, compared to 16% of students in the intervention classrooms.
The study was funded by The Clorox Company, which manufactures the disinfecting wipes and hand sanitizer used by the researchers.
"Hand washing is really the best way to prevent the spread of infection, but this study suggests that hand sanitizers and disinfecting wipes can also play a role," researcher Thomas J. Sandora, MD, MPH, tells WebMD. "This is a relatively low cost and simple way for schools to help keep kids healthy."
Industry Responds to Studies
Soap and Detergent Association spokesman Brian Sansoni agrees.
"This research reinforces the commonsense message that proper and regular use of cleaning and hygiene products enhances public health," Sansoni tells WebMD. "Soap and water are the gold standard, but when they aren't available hand sanitizers are effective for killing germs."
Sansoni also agreed that proper use of disinfecting wipes in the hospital setting is key to their effectiveness.
"(The Welsh) study shouldn't be perceived as saying that these products aren't effective," he says. "But it is absolutely critical that they be used properly."
SOURCES: Sandora, T.J., Pediatrics, June 2, 2008; vol 121: pp e1555-e1562. Thomas J. Sandora, MD, MPH, staff physician, infectious diseases, Children's Hospital Boston. Gareth Williams, PhD, and Jean-Yves Maillard, PhD, microbiologists, Welsh School of Pharmacy, Cardiff University, Wales. Brian Sansoni, spokesman, Soap and Detergent Association.
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