用抗菌肥皂洗手降低风险的定量评估。

L L Gibson, J B Rose, C N Haas, C P Gerba, P A Rusin
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摘要

美国疾病控制与预防中心(Centers for Disease Control and Prevention)估计,每年有371.3万例传染病与日托机构有关。本研究的目的是使用微生物定量风险评估方法来检查换尿布后使用不同肥皂配方所实现的风险降低。为了实现这一目标,使用了感染概率模型和基于微生物转移的暴露评估来评估不同肥皂配方在减少手接触肠道病原体后疾病概率方面的功效。基于该模型,确定了使用对照产品(不含抗菌成分的肥皂)为有症状的志贺氏菌病婴儿换尿布的感染概率为24/100 ~ 91/100,使用抗菌肥皂(氯己定4%)的感染概率为22/100 ~ 91/100,使用三氯生抗菌肥皂(1.5%)的感染概率为15/100 ~ 90/100。无症状志贺氏菌病患者使用非抗菌对照肥皂的风险在49/10万至53/100之间,使用含4%氯己定肥皂的风险在43/10万至51/100之间,使用1.5%三氯生肥皂的风险在21/10万至43/100之间。换尿布后充分洗手可降低风险,使用抗菌肥皂可进一步降低20%的风险。定量风险评估是评估家庭消毒剂和低风险结果的一种有价值的工具。
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Quantitative assessment of risk reduction from hand washing with antibacterial soaps.

The Centers for Disease Control and Prevention have estimated that there are 3,713,000 cases of infectious disease associated with day care facilities each year. The objective of this study was to examine the risk reduction achieved from using different soap formulations after diaper changing using a microbial quantitative risk assessment approach. To achieve this, a probability of infection model and an exposure assessment based on micro-organism transfer were used to evaluate the efficacy of different soap formulations in reducing the probability of disease following hand contact with an enteric pathogen. Based on this model, it was determined that the probability of infection ranged from 24/100 to 91/100 for those changing diapers of babies with symptomatic shigellosis who used a control product (soap without an antibacterial ingredient), 22/100 to 91/100 for those who used an antibacterial soap (chlorohexadine 4%), and 15/100 to 90/100 for those who used a triclosan (1.5%) antibacterial soap. Those with asymptomatic shigellosis who used a non-antibacterial control soap had a risk between 49/100,000 and 53/100, those who used the 4% chlorohexadine-containing soap had a risk between 43/100,000 and 51/100, and for those who used a 1.5% triclosan soap had a risk between 21/100,000 and 43/100. The adequate washing of hands after diapering reduces risk and can be further reduced by a factor of 20% by the use of an antibacterial soap. Quantitative risk assessment is a valuable tool in the evaluation of household sanitizing agents and low risk outcomes.

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