Evaluation of 15-second alcohol-based hand rub efficacy: a multi-laboratory study using a modified EN 1500 protocol

Area of Science:

• Infection Prevention and Control
• Microbiology
• Public Health

Background:

• Healthcare-associated infections are frequently transmitted via hands.
• Current European standards (EN 1500) mandate 30-second hand antisepsis.
• Healthcare workers often perform hand hygiene for less than the recommended duration.

Purpose of the Study:

• To evaluate the feasibility of a reduced 15-second hand antisepsis protocol.
• To assess microbial reduction efficacy compared to the standard 30-second method.
• To analyze the reproducibility of a shortened protocol in a multicenter setting.

Main Methods:

• A modified EN 1500 protocol using 15 seconds and 3 mL of 60% propan-2-ol was tested.
• A randomized crossover trial involved 14 laboratories and volunteers contaminated with E. coli K12.
• Microbial reduction was measured, and non-inferiority was statistically analyzed against the 30-second reference method.

Main Results:

• The 15-second protocol showed significantly lower microbial reduction than the 30-second method in most labs.
• Consistent reproducibility and satisfactory interlaboratory performance were observed for the shortened protocol.
• Difficulties in achieving full hand coverage within 15 seconds highlighted the need for technique-focused training.

Conclusions:

• A 15-second hand antisepsis protocol is methodologically feasible and aligns with clinical practice.
• Reduced rub-in times are supported by evolving guidelines but require cautious revision of EN 1500.
• Ensuring complete hand coverage and adherence to technique is critical for efficacy with shorter protocols.