Disinfection of Hands: Removal of Transient Organisms

Antiseptic detergent mixtures containing hexachlorophane or iodine have been found to cause a large reduction in the " resident " skin flora when used repeatedly for washing the handsan effect which was not obtained by the use of ordinary soap and water (Traub, Newhall, and Fuller, 1944 ; Seastone, 1947; Lowbury, Lilly, and Bull, 1963). Hexachlorophane has little immediate effect after a single application, but repeated use of the antiseptic causes a progressive reduction in the number of resident organisms. The poor activity of hexachlorophane against Gram-negative bacilli is another limitation which does not affect its value in reducing the resident flora, among which Staphylococcus aureus is the only common pathogen. Suppressing or removing " transient " organisms from the skin presents a different problem. The transient flora include any bacteria that are deposited on the skin, such as Pseudomonas pyocyanea and strains of salmonella, shigella, and Escherichia coli which may be carried on the hands of nurses in wards where infection with these pathogens occurs ; Staph. aureus may also be carried as a transient organism. Antiseptics and ablutions are required to remove these organisms rapidly rather than to suppress them by a progressive or cumulative action residual antiseptic on the skin may, nevertheless, be useful in preventing contamination or in destroying contaminants which are deposited after antiseptic ablutions or treatment with antiseptic creams. In this paper we report a comparative study on alternative methods for the removal of transient flora ; we also describe experiments on the survival of bacteria deposited on the skin after treatment with antiseptics.