Bacteria which are highly resistant to antibiotics are not resistant hydro-alcoholic products.

BACKGROUND: Preventing the emergence of antibiotic-resistant bacteria requires strict adherence to standard precautions, including hand hygiene by hydro-alcoholic friction, a technique now recommended. Our study evaluates the in vitro efficacy of an hydro-alcoholic product on four emerging resistant bacteria. METHODS AND MATERIALS: The product was tested using the dilution-neutralization method using the NF/EN 13727+A2 standard on Staphylococcus epidermidis which is resistant to methicillin and has a reduced reaction to glycopeptide antibiotics, on Enterococcus faecium which is resistant to glycopeptides, as well as on Klebsiella pneumoniae and Pseudomonas aeruginosa which produce carbapenemases. Each of the steps was performed as a blind test on the test product as on the comparator. The surviving bacteria count was measured after 24 and 48 hours' incubation and the rate of reduction was calculated. RESULTS: A reduction which was higher than 5 decimal logarithms was observed 30seconds after contact. The test product had an 80% bactericidal concentration on Pseudomonas aeruginosa and 40% on the three other germs. The bactericidal concentration of the comparator was 80% on the four micro-organisms. DISCUSSION: The present study confirms the effect of hydro-alcoholic products on emerging resistant bacteria. The results make it possible to answer questions from healthcare professionals who often confuse antibiotics and antiseptics and question whether using hydro-alcoholic hand sanitizer is worth it. Proof of efficacy at 30seconds is reassuring since this time is close to that observed when evaluating practices. The data could be completed by performing in vitro tests using the NF/EN 1500 standard.

Effectiveness of respirator masks for healthcare workers, in France.

OBJECTIVE: The authors had for objective to evaluate the air-tightness of FFP2 respirator masks used by healthcare workers, with a quantitative fit-test protocol. MATERIALS AND METHODS: This test measures the number of ambient particles inside and outside the respirator mask. The ratio between both is called fit-factor. The fit-test is successful for an FFP2 respirator mask when the fit-factor is equal or superior to 100. The tests were performed in three hospitals. Nine types of FFP2 respirator masks were fit-tested, classified in three groups: hard shell, duckbill, and flat-fold respirator masks. RESULTS: One hundred and eighty fit-tests were performed. Less than a third of the fit-tests were successful (35/130). The rate of successful tests was higher with flat-fold (57.5%, 23/40) than with duckbill (18.3%, 11/60), or hard shell respirator masks (3.3%, 1/30), (P<0.05). Zero to 60% of healthcare workers had a successful fit-test with the respirator masks used in each hospital. This percentage increased with the number of tested respirator masks. No 100% success rate was ever reached in any hospital with the three tested respirator masks. CONCLUSION: Duckbill, and flat-fold respirator masks seem to be better adapted for healthcare workers than hard shell respirator masks. It seems necessary to implement new recommendations for respiratory protection in France. At least two types of respirator masks with various sizes and shape should be available and fitting controls should be performed with respirator masks that are worn by healthcare workers exposed to infectious risks.

[Use of respiratory masks in healthcare workers]. / Utilisation des masques de protection respiratoire chez les soignants.

Two different types of filtering respiratory masks are available in healthcare settings. The first ones are used to protect patients from droplets coming from the mouth of healthcare workers (HCW) and the second ones are protective masks. For the moment, we lack information regarding application of Ministry of Health recommendations and on adherence of HCW to mask use. Geres, the HCW exposure risk study group, and the INRS, are now conducting a survey in several hospitals in France to evaluate the use of respiratory masks in healthcare settings. Two phases are planned. Phase I is a self survey using a questionnaire for occupational doctors and hygienists and phase II includes three steps on HCW behavior: evaluation of knowledge and practice concerning respiratory masks, evaluation of respiratory mask use, evaluation of wear and fit test in a context of airborne isolation with a FFP1 and FFP2 respiratory mask. Phase I is finished and phase II is beginning. The first phase I data show that the Ministry's recommendations are observed: respiratory masks are available, written recommendations are present; information and training are organized for healthcare workers. Phase II results are not available yet.