Restroom Infection Control: Chlorhexidine, the final frontier (50m Lecture)

Session Description/Teaser: Pioneering award-winning (BMJ and HAI Watchdog Awards 2013) work at the Queen Elizabeth Hospital, UK has demonstrated the remarkable residual antimicrobial activity of chlorhexidine on surfaces thereby maintaining their continuous cleanliness over time. The final point of contact of cleansed hands is the pathogen-rich restroom door handle. In this context, we present a new double-blinded-randomized-crossover trial in a school setting demonstrating significant improvements in continuous cleanliness of handles during use using this simple, cheap technique

ABSTRACT: Chlorhexidine (CHG) wipes offer a cheap and effective environmental cleaning solution in specific situations. We made a chance finding during a laboratory study validating iPads for cleaning efficacy and long-term tolerance to cleaning products. We unexpectedly discovered a previously unreported, powerful residual antimicrobial effect demonstrated by CHG, that was not occurring with any other cleaning agents. Once wiped with a standard CHG swab (SaniCloth CHG 2%, PDI, Nice-pak, New York) we were unable to grow bacteria on the iPads for 6 hours despite the repeated application of high colony counts of a wide range of pathogens. Chlorhexidine has a known residual antimicrobial effect on skin, but the discovery of the effect on objects is novel. We hypothesized that this residual effect could be very important on objects that are, of necessity, repeatedly handled prior to use between sterilization episodes or disposal and that if objects could be kept clean during use this could offer a fundamental advantage (for many applications) in addition to current infection control techniques and in tandem with substantial cost savings thereby providing real and widespread patient benefit across the healthcare, social care and wider sanitary environments. We have published successful trials examining objects handled in the hospital environment (Howell et al. Eur J Anaesthesiol. 2013 May;30(5):216-21 and Cummings et al. Anaesthesia. 2013 Aug;68(8):830-4, and 4 in press or preparation). The body of work has attracted two national awards in the UK (BMJ and HAI Watchdog Awards 2013). In addition to presentation and interactive discussion of this body of work and the wider applications, we will present new data at NEHA’s 78th Annual Educational Conference from our double-blinded-randomized-crossover trial in a school setting demonstrating significant improvements in continuous cleanliness of restroom door handles during use using this simple, cheap technique.