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Table 2 Hand hygiene: materials and efficacy

From: Prevention and treatment of neonatal nosocomial infections

Agent Plain soap Antimicrobial soap with chlorhexidine Alcohol based hand sanitizer
Mode of action Detergent effect and mechanical friction Cationic bisguanide, disrupts cell membranes Disrupts membranes, denatures proteins, cell lysis
Reduction of bacterial load on hands 0.6 to 1.1 log10 CFU 2.1 to 3.0 log10 CFU; has persistent residual antiseptic activity on the skin which may last up to 30 min. 3.2 to 5.8 log10 CFU
Effective against Dirt, organic material Gram-positive cocci Gram-positive cocci, gram-negative bacilli, mycobacterium tuberculosis, fungi, viruses
Less effective against   Gram-negative bacilli, fungi and viruses, mycobacteria, spore forming bacteria such as Clostridium difficile Clostridium difficile,
Hepatitis A, rotavirus, enteroviruses, adenovirus, spores
Comments Trauma caused by frequent skin washing may lead to chapping of skin and shedding of resistant flora   Optimal antimicrobial activity at concentration of 60–90%
  1. (from ref [21] and [28])