ABSTRACT
Decontamination of hands is accomplished by hand washing with soap or by use of waterless hand sanitizers. Hand sanitizers is formulated and used to reduce bacterial load on the skin. This study is aimed at comparing the activity of six alcohol based hand sanitizers (DETTOL, TONAK, HIGEEN, PURELL, LOVEILLEA and BLACKBERRY GERM BLASTER )sold in Umuahia, Abia state, Nigeria, against clinical bacterial isolates (Staphylococcus aureus and Pseudomonas aeruginosa). Susceptibility of the bacterial isolates was evaluated using the agar well diffusion method by measuring the zones of inhibition observed after 24hours of incubation. Their minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) were also determined using the broth dilution technique. TOK® and BBG® hand sanitizer had the highest zones of inhibition (30mm) against Staphylococcus aureus and an average of 20mm against Pseudomonas aeruginosa. PURELL hand sanitizer indicated highest antibacterial potency as it completely inhibited the test organisms. Thus PURELL hand sanitizer was the most effective of all the tested hand sanitizer with a MIC and MBC of 1.52% and 3.125% both for Staphylococcus aureus and Pseudomonas aeruginosa. These studies shows that alcohol based hand sanitizers have different potency to achieve effective hand hygiene.
TABLE OF CONTENTS
CHAPTER ONE 1
Title page i
Certification ii
Dedication iii
Acknowledgment iv
Table of content v
Abstract
1.1 Introduction 1
1.2 Aims 3
1.3 Objectives of this study 3
CHAPTER TWO
2.0 Literature Review 4
2.1 Types of hand
sanitizers 5
2.2 Uses of hand
sanitizers 7
2.3 Areas of application 8
2.4 Safety 9
2.5 Effectiveness 11
2.6 The organisms used 13
CHAPTER THREE
3.0 Materials and methods 17
3.1 Assessment of
Antibacterial potency of Hand Sanitizers 19
3.2 Determination of
minimum concentration (MIC) and Minimum
Bactericidal Concentration (MBC) 20
CHAPTER FOUR
4.0 Results 21
CHAPTER FIVE
5.0 Discussion and
Recommendations 28
5.1 Conclusions 29
5.2 Recommendations 29
References 30
LIST OF TABLES
Table 1: Chemical
composition of different sanitizer screened for antibacterial activity 18
Table 2: Zone of
inhibitions in Millimetres (mm) for DETTOL as a hand sanitizer
tested
against bacterial isolates 21
Table 3: Zone of
inhibitions in Millimetres (mm) for TONAK as a
hand
sanitizer tested against bacterial isolates 22
Table 4: Zone of
inhibitions in Millimetres (mm) for HIGEEN as a
hand
sanitizer tested against bacterial isolates 23
Table 5: Zone of
inhibitions in Millimetres (mm) for PURELL as a
hand
sanitizer tested against bacterial isolates 24
Table 6: Zone of
inhibitions in Millimetres (mm) for LOVILLEA as a
hand
sanitizer tested against bacterial isolates 25
Table 7: Zone of
inhibitions in Millimetres (mm) for BLACK-BERRY
GERM
BLASTER (BBG) as a hand sanitizer tested against bacterial isolates 26
Table 8: Minimum
Inhibitory Concentration and Minimum Bactericidal
concentrations
of selected hand sanitizer tested against Bacterial Isolates 27
CHAPTER ONE
1.0 INTRODUCTION
Hand washing is one of the most important steps to
avoid spreading microorganisms such as, bacteria and viruses that may lead to
harmful diseases. Skin is one of the most exposed part of
the body requires protection from the pathogens. To prevent spreading of many
contagious diseases, hand washing is absolutely an important precaution. Normal
human skin is colonized by bacteria, with total aerobic bacterial counts
ranging from more than 1 x 106 colony forming
units (CFU)/cm2 on the scalp, 5 x 105 CFU/cm2 in
the axilla, and 4 x 104 CFU/cm2 on the abdomen to 1 x 104
CFU/cm2 on the forearm (Kampf . G, and Kramer,
A., 2004).
Alcohol-based waterless hand sanitizers
for hand decontamination are an alternative to soap and water hand
washing. Today, hygiene is
associated with disease prevention and health promotion, and the importance of
hygiene is universally recognized and evidence based. Effective hand hygiene is
a key intervention in disease prevention (Aiello et al, 2002).
Studies on the effectiveness of hand sanitizers
have been somewhat conflicting. Some findings suggest that sanitizers are
actually better than normal hand washing at killing microorganisms while others
have discovered that hand washing is still superior. These researches indicate
that there are many variables that would be causing these discrepancies. First
of all, the concentration of alcohol based sanitizer’s needs to be at least 60%
to be effective. Alcohol based sanitizers at this concentration or higher are
very effective at killing microorganisms but the alcohol evaporates quickly on
the hands and may not be present on the skin long enough for adequate
protection.
Chemicals used in hand hygiene exhibit bactericidal
or bacteriostatic properties depending on their concentrations (Boyce and
Pittet, 2002; McDonald, 2003; David and Famurewa, 2006).
Alcohol is used as the main antibacterial component
of most waterless hand sanitizer’s agents due to its antimicrobial properties
(Boyce and Pittet, 2002). Some alcohol-based hand sanitizers have been reported
to kill up to 99.9% of organisms within 15 s of application (Larson, 1995;
Aiello and Larson, 2002)
Hand washing
and/or the use of hand sanitizer remains the major way of breaking transmission
of infection (Pedersen et al., 2005b;
CDC, 2009; Alex-Hart and Opara, 2011; Omogbai et al., 2011). Different antimicrobial agents have been
incorporated into hand sanitizers to increase its performance (Mathieu, 2009).
Hand sanitizers have been reported not only to reduce hand bacterial contamination
but also enhance hand hygiene compliance (Fendler et al., 2002; Mody et al., 2003). Despite the widespread
use of hand sanitizers in Nigeria (especially with the Ebola virus scare) there
is dearth of information in the open scientific literature that could
substantiate its use. Therefore, this study was aimed at investigating the
antibacterial activity of commonly used hand sanitizers in Umuahia, Abia State,
Nigeria on some selected common pathogenic bacteria.
For
centuries, hand washing with soap and water has been considered a measure of
personal hygiene (Anonymous, CDC; 2004) but the link between hand washing
and the spread of disease has only been established in the last 200 years. Products containing antimicrobial agents that kill,
inhibit or reduce the number of microorganisms on the hand are topical hand
sanitizers (Pedersen et al., 2005) Although normal flora can display agonistic
affects, where one organism forms a symbiotic relationship with another organism,
the flora may also serve as a source of infection for the host. There are two
types of normal flora on the skin: transient and resident flora. Resident flora
can be persistently found on the skin, while transient floras are contracted
from the external environment. The current standards for hand sanitizers only
require the elimination of transient microorganisms. Hand sanitizers products
have been found to eliminate bacteria in two ways. The use of active
ingredients found in the actual product and the washing, rinsing and drying
process help to eliminate flora on the hands. The most effective way active
ingredients kill the flora is by breaking down the bacterium’s cell membrane (Pedersen
et
al.,2005)
1.1 Aim
The aim of this study is to determine the
effectiveness of hand sanitizers.
1.2 OBJECTIVES OF THE STUDY
To compare
the activity of six different alcohol based hand sanitizers
(DETTOL, TONAK, HIGEEN, PURELL,
LOVEILLEA and BLACK-BERRY GERM BLASTER sold in Umuahia, Abia State, Nigeria, against clinical
bacterial isolates (Staphylococcus aureus and Pseudomonas aeruginosa).
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