Overuse of antibiotics have led to drug-resistant bacteria. As people find they cannot gain access to the H1N1 vaccine, and fear builds, people are wondering about similar hand sanitizer overuse.

It’s also true that some are concerned about the H1N1 vaccine itself. Given that, using as many alternatives as possible is not necessarily a bad thing.

It’s true, that the same experts have said that washing your hands is important in preventing not just H1N1 swine flu transmission, but seasonal flu and colds. Not, however, to the point of OCD hand-washing behavior. Hand sanitizer overuse, as to be honest, is another possible fear-reaction.

Hand sanitizer overuse is probably not going to result in the same types of superbugs that overuse of antibiotics have. However, the germ-killing ingredients in hand sanitizers simply isn’t that strong. If it were, you wouldn’t want to be casually using it on your hands.

In fact, nothing is going to make you completely safe against swine flu. You won’t be able to kill enough of the germs with hand sanitizer, overuse or no, to make a difference. Viruses are harder to kill, as well, and let’s not forget that flu is caused by a virus, not a bacteria.

The biggest threat with hand sanitizer overuse is cracking and drying out of your hands. That would be the same issue if you overwashed your hands, as someone with obsessive-compulsive disorder (OCD) might do.

Just remember that an effective hand sanitizer should be at least 60 percent alcohol based. That alone should warn you off of hand sanitizer overuse, as you probably know what pure alcohol would do to your hands if you used it as a disinfectant.

Hands Hygiene: Don’t Overuse your Hand Sanitizer

According to research performed by the U.S. Centers for Disease Control and Prevention, hand sanitizer is considered as effective at killing germs as washing your hands with soap and water, unless hands are visibly soiled. Clean hands are very important for stopping the spread of germs. Hand soap and cleansers need to not only wash away dirt and grime, but kill the germs and prevent them from spreading from one person to another.

Here’s ways on keeping your hands hygiene without overusing your hand sanitizer:

• Wet your hands with warm water and then lather up with soap. Soap kills germs.
• Rub your hands together and scrub all the surfaces, including your palms, wrists, between your fingers, and under your nails.
• Rub and scrub for about as long as it takes to whistle one verse of “Row, Row, Row Your Boat.”
• Rinse and then dry your hands on a paper towel or clean cloth.
• In public bathrooms, turn off the water using a paper towel to avoid getting germs on your clean hands.
• You can use the same towel to open the door. Door handles are great carriers of germs.
• When you can’t wash your hands with soap and water, a good alternative is to use a hand-sanitizing wipe or gel.

It sounds almost too simple to be true. But, an important part of staying healthy this flu season is to wash your hands. Try it! You won’t be sorry you did!”

Hand sanitizers contain alcohol and other agents that are known to kill certain germs that are easily transmitted. Studies have shown that families who use hand sanitizer containing 40% ethanol are 59% less likely to spread sickness to other members of their family who also use hand sanitizers than they are to spread it to people outside of the family who do not use hand sanitizer.

Keep a portable size hand sanitizer in your purse, diaper bag and car to make sure you have it whenever you may need it and soap and water is not available to use. How many times have you used a public restroom to find there is no soap to wash your hands with? Squirt a small amount of your hand sanitizer into the palm of your hand and spread all over both hands to effectively kill most germs you may have on your hands. You do not need to rinse off the sanitizer- it dries quickly and as it does, gets rid of the germs.

As a warning, when purchasing hand sanitizers, it is important to check their alcohol concentration. Only sanitizers with a minimum of 60% ethyl alcohol, ethanol or isopropanol can effectively kill the most harmful bacteria. These items should be kept away from children, since the high concentration of alcohol could result in alcohol poisoning if ingested. However, hand sanitizers are not cleaning agents. Therefore, when removing blood or other bodily fluids from your hands, you must wash your hands first in order for the alcohol in the sanitizer to be effective.

Art That Illustrates the Danger of Antibacterial Everything

What you’re looking at is the art of bacterial adaptation. It’s beautiful. It should also make you a little uncomfortable, and a little hopeful. Part of a collaboration between Professor Eshel Ben-Jacob, of Tel-Aviv University, and Professor Herbert Levine of UCSDs National Science Foundation Frontier Center for Theoretical Biological Physics, these pictures are a visual representation of the way bacteria evolve to overcome life-threatening obstacles—like, say, hand gel. The art is also about the way bacteria fight back, which involves a form of communication. The researchers hope to use that skill against the bacteria to create a new generation of antibacterial weaponry.

While the colors and shading are artistic additions, the image templates are actual colonies of tens of billions of these microorganisms. The colony structures form as adaptive responses to laboratory-imposed stresses that mimic hostile environments faced in nature. They illustrate the coping strategies that bacteria have learned to employ, strategies that involve cooperation through communication. These selfsame strategies are used by the bacteria in their struggle to defeat our best antibiotics. Thus, if we understand the mechanisms behind the patterns, we can learn how to outsmart the bacteria – for example, by tampering with their communication – in our ongoing battle for our health.

The once controversial idea that bacteria cooperate to solve challenges has become commonplace, with the discovery of specific channels of communication between the cells and specific mechanisms facilitating the exchange of genetic information. Retrospectively, these capabilities should not have been seen as so surprising, as bacteria set the stage for all life on Earth and indeed invented most of the processes of biology. As we try to stay ahead of the disease-causing varieties of these versatile creatures, we must use our own intelligence to understand them.

See more by following the link to Prof. Ben-Jacob’s site.

Ten Steps to Preventing Infection in Hospitals

Too many patients get sick in the very places that are supposed to heal them

By STEPHANIE SIMON

The facts are frightening: As many as one in 10 patients hospitalized in the U.S. will come down with an infection—often due to the very care that is supposed to be restoring health.

These infections afflict nearly two million patients a year, cause close to 100,000 deaths and cost up to $6.5 billion.

But they are not inevitable.

Here are 10 ways to prevent infection in health-care settings—a list gleaned from conversations with doctors, nurses, administrators, the nonprofit Committee to Reduce Infection Deaths, and the Association for Professionals in Infection Control and Epidemiology.

We’ve divided the list into two parts: first, promising new technologies, and second, a look at back-to-basics techniques that many hospitals have reinvigorated, with great success.

NEW TECHNOLOGIES

1. UNDERCOVER AGENTS

Some of the most vicious vectors of infection can survive for weeks on medical equipment and in patient rooms. The culprits include the drug-resistant MRSA bacteria, which can cause staph infections, and the nasty Clostridium difficile, or C. diff, which causes severe diarrhea.

Hospitals, of course, have rigorous protocols for cleaning. But how well are they doing?

To find out, Philip Carling, an epidemiologist at Caritas Carney Hospital in Dorchester, Mass., went undercover. He developed an invisible solution with fluorescent markers and sprayed it all over patient rooms in dozens of hospitals. Then he let cleaning crews do their thing. Afterward, he went over each room with a black light. Any spot the crews missed would glow fluorescent.

Turned out they missed a lot.

Toilets sparkled. But bathroom light switches and door knobs did not. Telephones, nurse-call buttons and grab rails were all routinely contaminated.

Showing the results to cleaning crews—and training them to do better—helped a great deal, boosting compliance with proper cleaning techniques to 77% from 44%. Dr. Carling has licensed the fluorescent solution and a training program to Ecolab Inc., a global sanitation company.

View Full Image

Stuart Bradford

2. ROBOTIC HELPERS When surgeon Bolanle Asiyanbola tested emergency-room equipment that had been disinfected by hand, she found one in four pieces was still contaminated with bacteria.

Enter SUDS, a shower-sized cubicle with a fogging mechanism inside.

Dr. Asiyanbola led the team at Johns Hopkins that developed SUDS to disinfect even the most hard-to-clean equipment, such as electrocardiogram wires. She recently published a study showing that devices cleaned in SUDS stayed clean for two days, even after they’d been reused.

SUDS is not yet on the market. But other systems are, among them the Bioquell Z, a little machine that sprays a disinfecting hydrogen-peroxide vapor—and looks an awful lot like the Star Wars robot R2D2.

Crews wheel the Bioquell Z, which is made by Bioquell Inc., of Horsham, Pa., into a patient’s room and seal the door. About 90 minutes later, the room and any equipment inside are disinfected, with no residual smell.

3. COMPUTER SURVEILLANCE One of the hottest new fields in infection prevention is data mining. Software such as CareFusion Corp.’s MedMined Data Surveillance tracks a hospital’s admission, discharge and transfer data and laboratory results.

The system might pick up on, say, a spike in urinary-tract infections on one floor. Doctors can then take immediate precautions—reviewing procedures, disinfecting equipment and checking for defective catheters.

Such software can cost tens of thousands of dollars to install and more to run, but devotees say it saves money and lives.

And don’t underestimate the motivational power of data. Stephen Streed, director of epidemiology at Lee Memorial Health System in Florida, tracks infection rate by surgeon—and then posts a list annually in his four hospitals. The list is coded to protect anonymity, but each surgeon knows his or her ranking.

“They growl a bit, but then they find their way to my office and ask, ‘Why am I in the bottom third of this list?’ ” Dr. Streed says. Those at the bottom soon improve. “It’s a very, very powerful tool,” he says.

4. BUG-BLASTING BATHS Recent research suggests that washing ill patients daily with a mild antibacterial soap can cut bloodstream infections dramatically.

The soap of choice, chlorhexidine glutonate, comes in several formulations, including a bar of soap and a baby-wipe cloth. It’s available over the counter.

Many doctors are wary about prescribing antibacterial agents because overuse can spur the rapid evolution of drug-resistant bugs. But some experts suggest it may be helpful for patients facing surgery to shower with chlorhexidine for two to four days before the operation.

5. REPORTING LAWS At least 25 states have passed laws requiring hospitals to report rates of common infections. In most cases, the reports are—or soon will be—publicly available. That, of course, is a big incentive for hospitals to improve. Another incentive: Medicare now limits reimbursement for treatment of hospital-associated infections.

All this is helping change hospital culture. “We used to think of this as the job of the infection-control nurse,” says Nancy Foster, a vice president at the American Hospital Association. “Now we know everyone needs to be involved.”

BACK TO BASICS

1. HAND HYGIENE David Hooper, the chief of infection control at Massachusetts General Hospital, says the key to preventing infection is simple: Listen to your mother. “Wash your hands and clean your room,” he says.

Hospitals that have placed dispensers of alcohol-based hand sanitizer at every turn—in patient rooms, in hallways, by elevators, at nursing stations—see a dramatic increase in compliance with basic hand hygiene, from less than 50% to 80% or more. That’s a huge step toward preventing infection.

2. CHECK-IT-TWICE LISTS Several years ago, Peter Pronovost, a critical-care specialist at Johns Hopkins Medical Center, began touting the humble checklist as a powerful tool to ensure procedures are done accurately and safely. (See the accompanying interview with Dr. Pronovost.)

Checklists are now common in intensive-care units and operating rooms—but they’re also starting to pop up in bedside medical charts.

Some hospitals require each shift nurse to review a checklist for each patient, answering questions such as: Does this patient have a catheter? If so, is it still necessary?

“Patients get all these tubes stuck in them and they stay there forever because people forget about them,” says Barbara DeBaun, a nurse who advises the Bay Area Patient Safety Collaborative in San Francisco. “That can be a major source of infection.”

3. CAN’T-MISS KITS Hospitals have begun to create portable kits filled with all the equipment needed for common procedures, such as inserting an intraveneous line or changing a dressing. That way, the nurse doesn’t have to run back to the supply closet mid-procedure because he’s forgotten a sterile drape or a skin-prep solution. And he’s less likely to forget those steps in the first place.

4. ORAL FIXATION Nurses can go a long way to preventing ventilator-associated pneumonia—one of the most common infections in intensive-care units—by regularly cleaning a patient’s mouth, gums and teeth. This keeps bacteria to a minimum.

Elevating the head of the patient’s bed at 30 to 35 degrees is also crucial. And patients should be weaned from sedation at regular intervals.

5. SWAB AND STUDY Quick diagnostic tests now allow hospitals to identify infected patients within hours, rather than days.

There’s still debate about whether all incoming patients should be tested for particularly nasty pathogens such as MRSA.

But at the very least, when patients who do show symptoms are tested, the quick results can shape an effective response. The pathogen C. diff, for instance, is not killed by alcohol-based scrubs, so health-care providers and visitors must wash with soap and water upon entering and exiting rooms of infected patients.