研究发现：清洁手部预防流感 肥皂效果优于酒精

gjs661

size=2]  据中国医学论坛报讯 澳大利亚学者评价了5种手的清洁方法，包括3种以酒精为主的擦手法，肥皂和水洗手，以及对照组（无清洁）。20名医务人员手掌被加上高浓度的流感病毒A（H1N1），研究者在手清洁前、后检测H1N1浓度。 结果表明，3种酒精擦手法和肥皂洗手均能有效降低手掌病毒浓度。但是，肥皂洗手比酒精擦手的效果更好。该文发表在《临床感染性疾病》[Clin Infect Dis 2009，48（3）:285]杂志上。

漫天飞雪

size=3]        流感病毒属于亲脂病毒，对消毒剂的敏感性最高，酒精擦手完全可以杀灭该病毒达到预防流感的目的。关键是应用方便，节约时间，对于工作繁忙的医务人员非常适用。对于家庭预防，如果有水又有时间还是应该首选肥皂洗手。

绿茵场

不是说明了一个问题呢：
即 清洁是消毒效果的重要保证呢！:handshake

icchina

建议大家看一下原文：http://www.journals.uchicago.edu/doi/abs/10.1086/595845
与对照组相比，皂液洗手和3种酒精擦手液洗手，均能有效和显著地低降低手上病毒的浓度。洗手比酒精擦手液更好，尽管差别不是很大。
大家千万不要以这篇文章，对酒精擦手液出现负面影响，相反更说明酒精擦手液对流感病毒也是高效的，应该积极推广使用。
WHO希望各国大力推广酒精擦手液，我们医院感染管理工作者，要建立正确的理念，并积极推动酒精擦手液在我国的应用。酒精擦手液在我国推广刚起步，与欧美国家相比，差距非常大。这几天在WHO总部参加工作会议，各国专家讨论踊跃，酒精擦手液的消耗量，很可能成为WHO评价医院感染控制工作好坏的一项重要监测指标。


Clinical Infectious Diseases 2009;48:285–291 © 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2009/4803-0003$15.00
DOI: 10.1086/595845

MAJOR ARTICLE
Efficacy of Soap and Water and Alcohol-Based Hand-Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human VolunteersM.
Lindsay Grayson,1,2,3
Sharmila Melvani,1
Julian Druce,4
Ian G. Barr,5
Susan A. Ballard,1
Paul D. R. Johnson,1,3,4
Tasoula Mastorakos,5 and
Christopher Birch4
1Infectious Diseases Department, Austin Health, 2Department of Epidemiology and Preventive Medicine, Monash University, 3Department of Medicine, University of Melbourne, and 4Victorian Infectious Diseases Reference Laboratory, Melbourne Health, and 5World Health Organization Collaborating Centre for Influenza, Melbourne, Australia

Background.

                               
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Although pandemic and avian influenza are known to be transmitted via human hands, there are minimal data regarding the effectiveness of routine hand hygiene (HH) protocols against pandemic and avian influenza.

Methods.

                               
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Twenty vaccinated, antibody-positive health care workers had their hands contaminated with 1 mL of 107 tissue culture infectious dose (TCID)50/0.1 mL live human influenza A virus (H1N1; A/New Caledonia/20/99) before undertaking 1 of 5 HH protocols (no HH [control], soap and water hand washing [SW], or use of 1 of 3 alcohol-based hand rubs [61.5% ethanol gel, 70% ethanol plus 0.5% chlorhexidine solution, or 70% isopropanol plus 0.5% chlorhexidine solution]). H1N1 concentrations were assessed before and after each intervention by viral culture and real-time reverse-transcriptase polymerase chain reaction (PCR). The natural viability of H1N1 on hands for >60 min without HH was also assessed.

Results.

                               
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There was an immediate reduction in culture-detectable and PCR-detectable H1N1 after brief cutaneous air drying—14 of 20 health care workers had H1N1 detected by means of culture (mean reduction, 103–4 TCID50/0.1 mL), whereas 6 of 20 had no viable H1N1 recovered; all 20 health care workers had similar changes in PCR test results. Marked antiviral efficacy was noted for all 4 HH protocols, on the basis of culture results (14 of 14 had no culturable H1N1;

                               
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) and PCR results (

                               
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; cycle threshold value range, 33.3–39.4), with SW statistically superior (

                               
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) to all 3 alcohol-based hand rubs, although the actual difference was only 1–100 virus copies/μL. There was minimal reduction in H1N1 after 60 min without HH.

Conclusions.

                               
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HH with SW or alcohol-based hand rub is highly effective in reducing influenza A virus on human hands, although SW is the most effective intervention. Appropriate HH may be an important public health initiative to reduce pandemic and avian influenza transmission.


Received 31 May 2008; accepted 3 October 2008; electronically published 30 December 2008.

Reprints or correspondence: Dr. M. Lindsay Grayson, Infectious Diseases Dept., Austin Health, Studley Rd., Heidelberg, Victoria 3084, Australia (Lindsay.Grayson@austin.org.au).

• Presented in part: 47th Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Illinois, September 2007 (abstract K-1796).

gjs661

看新闻稿，看不到此项研究的真正意义，谢老大的详细介绍。

楚楚

按照WHO的手卫生指南，洗手与卫生手消毒（即酒精剂揉搓）二者的手卫生效果差异没有显著性。此项研究存在差异是否有“体液等有机物”的影响存在，是否更进一步说明洗手和卫生手消毒适用于不同的场景，当手有可见污染时应洗手；否则应选用酒精揉搓剂~

星火

医院标准预防时，应推广使用酒精擦手液。