BACKGROUND Hand hygiene is crucial in infection prevention and control. It is unclear whether sprayed alcohol-based hand rub (ABHR) is non-inferior to the World Health Organization (WHO)-recommended method of handrubbing with poured ABHR. AIM To test whether sprayed ABHR can be an alternative (non-inferior) method for effective hand hygiene with/without handrubbing. METHODS A laboratory experiment was conducted with ABHR (isopropanol 60% v/v) according to European Norm 1500. Hand hygiene was performed by: (1) handrubbing with ABHR poured on to the palm of the hand; (2) handrubbing with sprayed ABHR; and (3) applying sprayed ABHR to hands without handrubbing. Hands were contaminated with Escherichia coli ATCC 10536, followed by hand hygiene and microbiological sampling. A generalized linear mixed model with a random intercept per subject was used to analyse the reduction in bacterial count following hand hygiene. FINDINGS In total, 19 healthcare workers participated in the study. Handrubbing with sprayed ABHR was non-inferior [margin log10 0.6 colony-forming units (cfu)/mL] to the WHO-recommended method of handrubbing with poured ABHR; bacterial count reductions were log10 3.66 cfu/mL [95% confidence interval (CI) 1.68-5.64] and log10 3.46 cfu/mL (95% CI 1.27-5.65), respectively. Conversely, non-inferiority was not found for sprayed ABHR without handrubbing [bacterial count reduction log10 2.76 cfu/mL (95% CI 1.65-3.87)]. CONCLUSION Handrubbing with sprayed ABHR was non-inferior to handrubbing with ABHR poured on to the palm of the hand to reduce bacterial counts on hands under experimental conditions. Handrubbing with sprayed ABHR may be an acceptable alternative hand hygiene method pending assessment in other settings and for other pathogens.

中文翻译：

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喷洒酒精基手部搓手液：有效手部卫生的另一种方法。

背景技术手卫生对于感染的预防和控制至关重要。尚不清楚喷洒的酒精基洗手液（ABHR）是否不逊于世界卫生组织（WHO）推荐的倒ABHR洗手液。目的测试喷洒的ABHR是否可以作为有/无手洗有效手部卫生的替代（非劣等）方法。方法按照欧洲规范1500，使用ABHR（60％v / v异丙醇）进行实验室实验。手部卫生通过以下方式进行：（1）将ABHR倒在手掌上进行手部擦洗；（2）用喷洒的ABHR擦手 （3）将ABHR喷洒在手上，请勿用手搓揉。手被大肠杆菌ATCC 10536污染，然后进行手卫生和微生物取样。每个受试者随机拦截的广义线性混合模型用于分析手卫生后细菌数量的减少。调查结果共有19名医护人员参加了该研究。与WHO推荐的倒ABHR手洗方法相比，喷ABHR手洗不差[margin log10 0.6菌落形成单位（cfu）/ mL]。细菌计数降低分别为log10 3.66 cfu / mL [95％置信区间（CI）1.68-5.64]和log10 3.46 cfu / mL（95％CI 1.27-5.65）。相反，未喷洒ABHR时未发现手感差的情况[细菌计数降低log10 2.76 cfu / mL（95％CI 1.65-3.87）]。结论在实验条件下，用喷洒的ABHR进行手擦不逊于将ABHR倒在手掌上以减少手上细菌的数量。