How reliable are test results from 17 laboratories on the basis of EN 1500 for a hand rub based on 80% (w/w)?

J Hosp Infect. 2024 May:147:188-196. doi: 10.1016/j.jhin.2024.01.022. Epub 2024 Feb 17.

Abstract

Introduction: A ring trial organized by the Association of Applied Hygiene (VAH) on the bactericidal efficacy of an ethanol-based hand rub was carried out in 17 laboratories according to EN 1500 with the aim of describing the variability of test results and fulfilment of the methodological acceptance criteria.

Method: As a test product, a hand rub based on 80% ethanol (w/w) was tested in comparison with the reference alcohol (60% iso-propanol, v/v) in a crossover design. After pre-washing and contamination following the norm, hands were treated either with the reference alcohol (2 × 3 mL for 2 × 30 s) or the test product (3 mL in 30 s). Post-decontamination values were determined immediately after the rub-in period. Validated neutralizers were used. The arithmetic means of all individual log10 pre-values, post-values and reduction values were calculated per laboratory. Non-inferiority was assumed when the Hodges-Lehmann 97.5% confidence limit was <0.6 in comparison with the reference. A z-score was calculated to determine the laboratory performance.

Results: Two laboratories did not meet the acceptance criteria and were excluded from the analysis. The bactericidal efficacy of the test product was non-inferior to the reference product in four laboratories and not non-inferior in 11 laboratories. The z-score for the Hodges-Lehmann 97.5% confidence limit indicated a satisfactory performance in all laboratories.

Conclusion: We consider the EN 1500 test method to be robust in terms of the variability of test results. For products of borderline efficacy, the evaluation should be based on more than one test.

Keywords: EN 1500; Ethanol; Hygienic hand disinfection; Ring trial.

MeSH terms

  • Cross-Over Studies*
  • Disinfectants / pharmacology
  • Ethanol* / pharmacology
  • Hand Disinfection* / methods
  • Hand Disinfection* / standards
  • Humans
  • Laboratories / standards
  • Reproducibility of Results