Comparison of the antibacterial efficacy of 4% chlorhexidine gluconate and 1% triclosan handwash products in an acute clinical ward

The antibacterial efficacy of 4% chlorhexidine gluconate (CHG) and 1% triclosan as handwash antiseptics is well established. Few published studies have identified hand bacteria found in glove juice samples, and most studies have used nonclinical study subjects. We report a longitudinal comparative study to determine the effect of 4% CHG and 1% triclosan on the composition of the hand bacterial flora of clinical staff in a specialist surgical unit. Prehandwash and posthandwash samples were collected on 3 separate occasions throughout each day by using the glove juice method and a supervised handwashing technique. Total bacterial counts were determined as well as counts for specific pathogens including methicillin-resistant Staphylococcus aureus and coliforms. Both 4% CHG and 1% triclosan were found to effectively reduce the total hand bacterial count preduty ( P = .0001). Four percent CHG also was consistently more effective at reducing the total count than was 1% triclosan. However, 1% triclosan eliminated methicillin-resistant S aureus , whereas 4% CHG failed to do so ( P = .0001). Gram-negative bacteria were more likely to be eliminated after the use of 4% CHG compared with 1% triclosan. This study is the first to report the effects of 1% triclosan on the bacterial flora present on the hands of clinical staff and demonstrates the ability of 1% triclosan to eliminate methicillin-resistant S aureus. (AJIC Am J Infect Control 1999;27:320-6)