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Hand hygiene 
In vitro and clinical investigations on a new non-alcoholic product

corresponding

MARCO BIAGI
Unit of Pharmaceutical Biology, Department of Environmental, Earth and Physical Sciences,
University of Siena, Via Laterina, 8, 53100 Siena.

Abstract

In recent years the importance of pathogens transmission by hands has been consolidated and, to date, hand hygiene is considered the single most important strategy to prevent infections. We previously reported preliminary antimicrobial investigations on a new interesting combination of natural products, 5-pyrrolidone-2-carboxylic acid and copper sulphate pentahydrate, which exhibited a strong antimicrobial synergistic effect. In this work we performed in vitro susceptibility tests using fourteen different microbial strains and, according to OMS hand hygiene guidelines and European Norm 1500, we further conducted the first clinical trial on this new formulation, compared to isopropanol 60% V/V as standard reference. The new product showed a broad-spectrum effectiveness on Gram + and Gram – species and resulted more effective and safer than reference standard.


INTRODUCTION
Microbial, viral and fungal infections represent an old and never solved issue despite new antibiotic drugs and better overall health conditions of world population (1). The most important obstacle to the effectiveness of drugs is microbiological resistance promoted by a misuse and abuse of antibiotic, mostly in finished food products and in agriculture (2). Pathogen transmission could happen in different way, but in developed countries hand transmission is the most important way, in particular in health associated facilities (3). World Health Organization (WHO) published several documents regarding hand hygiene and in 2009 guidelines provided to define possible strategies to prevent infections (4). In this documents, in chapter 10 to 15, WHO described methods to develop and evaluate antimicrobial agents and revised antimicrobial references such as water, plain soaps, alcohols, chloro and iodo derivatives and quaternary ammonium compounds. All of these antimicrobial agents have good to excellent inhibitory properties and affordable costs, but they also possess two big limits for their daily use, since they could be irritant to skin (5) and m ...