Evaluation of 15-second alcohol-based hand rub efficacy: a multi-laboratory study using a modified EN 1500 protocol
K-M. Roescha,b ∙ J. Gebela,b ∙ A. Boltenc ∙ M. Cavallerid ∙ B. Christiansenb ∙ F. Droopa ∙ B. Eiltse ∙ M. Exnerb,f ∙ H. Gabrielg ∙ C. Hildebrandth ∙ T. Koburger-Jansseni ∙ K. Konratj ∙ C.S. Leek ∙ J. Lenzl ∙ H. Martinyb ∙ M. Meckelm ∙ N.T. Muttersa ∙ S. Pahln ∙ L. Paßvogelo ∙ C. Schartnerp ∙ F. Seyringerq ∙ K. Steinhauerr ∙ L.J. Vecchios ∙ L. Vossebeinb,t ∙ A. Willeu ∙ A. Kramerb,v,1 ∙ M. Suchomelb,w,1
Affiliations & Notes
aInstitute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany bAssociation for Applied Hygiene, Bonn, Germany cBODE Chemie GmbH, Hamburg, Germany dEurofins Biolab Srl, Part of Eurofins Scientific Inc, Milan, Italy eHochschule Albstadt-Sigmaringen, Sigmaringen, Germany fUniversity Bonn, Bonn, Germany gDr. Brill + Partner GmbH, Hamburg, Germany hHygCen Germany GmbH, Schwerin, Germany iHygiene Nord GmbH, Greifswald, Germany jRobert Koch-Institute, Hospital Hygiene, Infection Prevention and Control, Berlin, Germany kTecolab Sdn Bhd, Kuala Lumpur, Malaysia lChemische Fabrik Dr. Weigert GmbH & Co.KG, Hamburg, Germany miki - Institut für Krankenhaushygiene & Infektionskontrolle GmbH, Gießen, Germany nEcolab Deutschland GmbH, Monheim, Germany oSchülke & Mayr GmbH, Norderstedt, Germany pW.H.U. GmbH, Bischofshofen, Austria qHydrologische Untersuchungsstelle Salzburg GmbH, Salzburg, Austria rbactologicum GmbH, Itzehoe, University of Applied Sciences Kiel, Kiel, Germany sChelab srl - Mérieux Nutrisciences, Italy tUniversity of Applied Science Niederrhein - Textile Technology, Textile Examinations and Quality Management, Mönchengladbach, Germany uInstitut für Hygiene und Umwelt, Freie Und Hansestadt Hamburg, Germany vInstitute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany wInstitute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria 1These authors contributed equally.
SummaryIntroduction
Hands are a key vector for pathogen transmission in healthcare, making effective hand antisepsis crucial for infection prevention. According to the European standard EN 1500, the reference method for evaluating hand antiseptics, a minimum rub-in time of 30 s is required. However, observations show healthcare workers typically spend less time on hand antisepsis.
Method
To assess the feasibility of a reduced rub-in time under standardized conditions, the German Association for Applied Hygiene conducted a multi-centre ring trial in 14 laboratories using a modified EN 1500 protocol (15 s, 3 mL of 60% v/v propan-2-ol). In a randomized crossover design, volunteers’ hands were contaminated with Escherichia coli K12 and treated either with the reference (2 × 3 mL/2 × 30 s) or the test protocol (1 x 3 mL/15 s). Microbial reduction was measured and non-inferiority statistically analysed.
Results
The 15-second protocol yielded significantly lower log10 reductions than the reference in 13 out of 14 laboratories but demonstrated consistent reproducibility and satisfactory interlaboratory performance. Challenges in completing the full rub-in technique within 15 s were reported, indicating the need for targeted training.
Conclusion
These findings support the methodological feasibility of a shortened protocol and are consistent with evolving clinical guidelines advocating reduced rub-in times, as well as with real-world practice, where healthcare workers typically spend less than 30 s on hand antisepsis. Nonetheless, any revision of EN 1500 should proceed cautiously to ensure antimicrobial efficacy, emphasizing complete hand coverage and strict adherence to technique.
