Monday, May 2, 2011

When soap goes bad

Photo: Funny Blog
A new paper in the Journal of Applied and Environmental Microbiology (free full text here) describes a trial in which liquid soap was intentionally contaminated in grade school restrooms. The investigators found that when children washed their hands with contaminated soap there was a 26-fold increase in gram-negative rods on the hands. On the other hand, when uncontaminated soap was used there was a 2-fold reduction in hand contamination. It has previously been shown that soap dispensers which require refilling have been linked to outbreaks, and CDC recommends that soap not be added to partially empty dispensers (i.e., topping off). The solution to this problem is to use sealed soap-dispensing systems.


  1. so here is my question you all of you. I know it is sort of off the soap question (which we DO use in sealed soap-dispensers)

    ABHR- 5 moments of hand hygiene almost requires personal sized containers. The program is set up so that it can be used anywhere in the world, even in resource poor areas or areas where the water probably has NDM-1 and who knows what else

    Very expensive to keep getting new bottles... SO the option is to refill them- I can't advertise that I do that at my facility (I run my personal ABHR plastic bottles through the dishwasher first- and get a new one if the plastic lid starts to wear)-

    any comments?? Observations??? Suggestions???

  2. The implicated contaminated soaps in the refillable containers are nonmedicated products. Personal containers holding waterless hand hygiene agents are alcohol based products. To my knowledge, alcohol based products have not been shown to be contaminated (Dan & Eli correct me if you know otherwise). So I know of no reason why personal containers of alcohol-based sanitizers cannot be refilled.

    From reading this blog, you must be aware of how strongly I believe that hand hygiene is the major solution to preventing the transmission of infections in hospitals. However, I'm not sure that 5 moments is a concept that is grounded in reality. Perhaps we would be better off focusing on driving compliance with hand hygiene simply before and after patient contact to near perfect levels, before attacking the others. Watching the recent New England Journal video on hand hygiene demonstrates how cumbersome the 5 moments can be.