Efficacy of Silver Nanoparticle Gel on Bacterial Hand Flora
Name: Michael Schlicher
Organization: The Geneva Foundation
Performance Site: Madigan Army Medical Center and University of Washington
Year Published: 2007
Abstract Status: Final
Background: Healthcare associated infections (HAIs) in the United States affect more than 2 million patients each year leading to approximately 90,000 unnecessary deaths. HAIs have increased in army medical centers who received injuried patients from Iraq. The increased incidence of HAIs has been linked to the hands of healthcare providers. Infection control is a main concern for all military medical professionals and good hand hygiene is one way to decrease the tranmission of infectious microbes. Few antibacterial hand hygiene agents, including alcohol based hand gels, are available in the field and many contain harsh chemicals damaging to the skin so their use in the military is limited. Investigation exploring alternative antimicrobial gels is needed. Research of novel technologies to reduce the transmission of infectious microbes from the hands of healthcare providers is warranted to decrease HAIs and improve patient safety. One novel therapy involves the use of silver nanoparticles but a comparison is lacking of antimicrobial efficacy and user acceptance with alcohol gel as the standard of care.
Purpose: The purpose of this study is to compare the antimicrobial efficacy of silver nanoparticle gel to an alcohol-based hand gel on bacterial counts isolated from the hands of 90 volunteers seeded with S. marcescens, a transient microbe marker.
Aims: Specific aims are to compare immediate (Aim 1) and sustained (Aim 2) antimicrobial efficacy of a one-time application of silver nanoparticle gel versus an alcohol-based hand gel in reducing transient bacterial counts isolated from hands seeded with S. marcescens, and to compare user acceptibility (Aim 3) between gel groups using a self-assessment questionnaire.
Methods:The study will be conducted in two phases. For the first phase, a pilot test will be conducted to assess feasibility of the procedure, assure elimination of bacteria at the end of the testing period, and establish technical consistency of the protocols. For the second phase, the efficacy study will be conducted whereby each eligible subject will participate in an orientation/enrollment session involving 1 hour, a washout period of one week, and a testing period involving approximately 2-3 hours. A randomized controlled, double blinded, 2-group (silver nanoparticle vs alcohol-based hand gel) by 3-condition (baseline, immediate, sustained) experimental group design will include a pilot and efficacy phase of study. Each subject will be randomly allocated to group and will receive random order of condition (immediate vs sustained).
Sample: For the pilot phase, ten adults will be enrolled during the month of August 2007. For the efficacy study, a convenience sample of 100 adults will be enrolled from September through November 2007. The sample of 100 subjects allows for potential attrition of ten subjects, leaving a target sample of 90 (45 per group) for the final data analysis.
Analysis: Microbial efficacy will be determined from a modified "glove juice" technique. Each subject will participate in a 1-hr enrollment session, a 1-week washout period, and a 2-3 hr testing period. Unpaired Student's t-test and ANOVA will be used for data analysis.
Significance: This study has important relevance for both military and public health communities as it offers a novel non-pharmacological alternative to current hand hygiene therapies and may ultimately help improve patient safety.
Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2013101321.xhtml