Am Fam Physician. 2004 Nov 1;70(9):1797.
Even with intensive education, physician compliance with handwashing and glove changing after patient contact is spotty. Alcohol-based hand rubs are an improvement over handwashing with soap and water but do not address the problem of contaminated gloves causing nosocomial infections. Barza described a recently patented technology for adding an antibacterial coating to standard hospital gloves.
Chlorine dioxide (ClO2) is a water-soluble gas with broad activity against bacteria and viruses. The author states that ClO2 is environmentally friendly and well tolerated by humans in low dosages. Microspheres designed to slowly release ClO2 were incorporated into standard vinyl and polyethylene hospital gloves. The author conducted two experiments with volunteers who wore coated gloves.
In the first experiment, volunteers donned regular and coated gloves that were then coated with bacterial suspensions of Escherichia coli or Salmonella. After exposure to 40-watt fluorescent lights for zero, five, 20, and 45 minutes, the gloves were removed and cultured for remaining bacteria. Initial bacterial counts on both gloves were greater than 107 colonies per mL for E. coli and Salmonella. After five minutes of light exposure, the E. coli counts decreased by 1.5 logs (i.e., 10- to 100-fold), and Salmonella decreased by 0.5 logs on the coated gloves. Twenty minutes of light exposure decreased bacterial counts by 4 logs (10,000-fold) for E. coli and by 1 log for Salmonella on the coated gloves, with the regular gloves serving as controls.
In the second experiment, the bare hands of volunteers were inoculated withE. coli or Staphylococcus aureus bacterial suspensions. The volunteers then donned a coated glove on one hand and a standard glove on the other. Again, the gloved hands were exposed to fluorescent lighting for various intervals, and the gloves were cultured for remaining bacteria. Before any light exposure, the bacterial counts were greater than 107 colonies per mL for E. coli and S. aureus. After five minutes of light, the coated gloves decreased bacterial counts by 1 log for E. coli and by 0.3 logs for S. aureus. Further decreases of 1.5 logs for E. coli and 1.1 logs for S. aureus occurred after 20 minutes.
Neither the coated vinyl nor the polyethylene gloves caused any skin irritation on intact skin. With abraded skin, erythema was noted 24 hours after exposure, but it subsided within 72 hours.
The author concludes that use of standard hospital gloves impregnated with micro-spheres that release ClO2 gas decreases bacterial contamination of hand and glove surfaces.
Barza M. Efficacy and tolerability of ClO2-generating gloves. Clin Infect Dis. March 15, 2004;38:857–63.
editor’s note: While these surrogate experiments cannot be substituted for an actual trial of coated gloves in a hospital setting, the encouraging results suggest that further study is warranted. Certainly the status quo (often repeated and usually ignored admonitions regarding handwashing and glove changing) could benefit from some technologic assistance. Bacterial resistance to antibiotics is a problem that is here to stay, and the easiest infection to treat is the one that is never nosocomially transmitted in the first place.—b.z.
Copyright © 2004 by the American Academy of Family Physicians.
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