MICROBIOLOGICAL TEST REPORT
DATE of REPORT: 26/11/14

 

CUSTOMER: Handle Hygiene Ltd., Unit 3, The Westway Centre, Ballymount
Avenue, Dublin 12. Attention: Mr Brian Cunningham


ANALYSES REQUIRED: Determination of antimicrobial efficacy of the Hygiene
Handle System in uncontrolled, in-use, community conditions.


TEST METHODS:
EN 1040 Basic Bactericidal Activity of Chemical Disinfectants
EN 13697 Quantitative Surface Test for the Evaluation of Bactericidal or Fungicidal
Activity


Customised swabbing and recovery protocol for irregular surfaces using neutralising
recovery buffer and L Agar incorporating same as per ISO 18593:2004


OPERATIVE: Catherine Hannon
DATE TESTING COMMENCED: 14/01/13 et seq 

 

Introduction


The Handle Hygiene System has been developed and refined over a period of
several years as a simple delivery mechanism to reduce contamination and
infectious risk associated with manually contacting door handles and push panels. It
is designed to work with many types of handles but is optimal when used with its
own design of handle. In summary, the system automatically delivers a metred
dose of antimicrobial to the manual contact point each time the door closes. This
sanitises the contact point, ready for the next user and will also transfer a thin film of
sanitiser to the user’s hand for additional protection.The system is designed to be
particularly effective in areas of high risk to hygiene e.g. doors in close proximity to
food preparation areas or in healthcare facilities or in areas where poor hygiene
practices may be prevalent e.g. heavily used or poorly maintained toilets. The
antimicrobial sanitiser may be calibrated to the location risk, compatability with
requirements or integrated as part of local infection control regimes.


Testing protocol


The approach taken to testing was as follows:


A range of antimicrobial solutions were subjected to several selection criteria at
their normal working strength and half their normal working strength.


Firstly, they were subjected to the EN1040 Standard test for basic bactericidal
activity of chemical disinfectants which requires a 5 log reduction in ≤5 minutes of
two bacterial species, Staphylococcus aureus and Pseudomonas aeruginosa.


Secondly, they were subjected to the EN 13697 Standard quantitative surface test
for evaluation of bactericidal and fungicidal activity which requires a 4 log
reduction of bacteria in ≤ 5 minutes and a 3 log reduction of fungi in ≤15 minutes.
The test panel of organisms included Staphylococcus aureus, Pseudomonas
aeruginosa, Enterococcus hirae, Escherichia coli, Candida albicans and
Aspergillus brasiliensis.


Two of the solutions (Byotrol, Daresbury and SureClean, Edmar Chemical Co.
Ohio) passed both of these tests at half their working strength and these were
used for field-testing the delivery system at their normal working dilution.
A number of moderate usage and heavy usage door handles were included in the
study. These were mainly of the pull handle variety and were located on male and
female toilet doors and laboratory doors in Trinity College.


In the study, baseline contamination levels were first determined over the course
of one week periods for each of the handles and at intervals thereafter, whenever
sanitising solutions were withdrawn.


Similar sampling was undertaken over the course of subsequent one week periods
when the respective sanitising solutions were in use with the Handle Hygiene
systems.


Sampling was carried out by swabbing standardised areas on the handles in a
reproducible manner over the course of the study and transferring to plates of L
Agar containing sanitiser neutralising agents. Results from the test plates were
compared with the baseline studies to indicate hygienic efficacy of the various
treatments.

RESULTS


The baseline studies in which no sanitiser was present showed that counts on the
handles of all of the gents toilets averaged around 70 bacteria per square
centimetre. This was regardless of whether the toilet was moderately busy (1) or
very busy (2 and 3).


The female toilets showed a different baseline pattern with counts averaging
around 120 bacteria per square centimetre on the handles. From observation,
approximately the same number of males and females were using the toilets.
Again, there seemed to be no significant difference in counts between the
moderately busy toilet (1) and the very busy toilets (2 and 3).
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The baseline counts on the laboratory door handle were quite low, never going
above 40 per square centimetre. This is probably due to the fact that most users
would have washed their hands prior to leaving as a routine action.


When the Handle Hygiene system was activated and using either of the sanitisers,
a great reduction in counts was noted in every single case with the counts coming
down to 20 per square centimetre or less. This was true for both the male and
female toilet door handles whilst the laboratory door handle counts reduced to an
average of 2 per square centimetre.


A slight difference in efficacy of the sanitising solutions was observed with Byotrol
performing slightly better than SureClean in each instance. It was noted that when
the sanitisers were removed, bacterial counts returned to the baseline levels
however, this took longer to occur with Byotrol than with SureClean.

 

Conclusions


The results clearly show that the handle hygiene system is effective in delivering
sanitiser to door handles with the concomitant reduction in bacterial counts. The
handles in both gents and ladies toilets (2 and 3) were very heavily used at times. The
location was in a student bar with toilet doors opening several times per minute during
busy periods. Despite this, bacterial counts remained quite low while the Handle
Hygiene system was actively dispensing sanitiser.


The observation that Byotrol’s effect lasted longer than SureClean after withdrawal
seems to indicate an ability to maintain some residual effect on the handle surface. This
would need further investigation, however the effect was noted on a number of
occasions.

Viable count or colony forming units per cm2 (cfu/ cm2) is the standardized measure of
how clean or dirty a surface is in microbiological terms. In the meat industry, >10 cfu/cm2
is regarded as unacceptable (a). In healthcare, <2.5 cfu/ cm2 is the required standard post-cleaning
with <5 cfu/ cm2 for hand contact surfaces (b) (c). It is probable that toilet door handles in this study are not much different from those in healthcare or food establishments. It is easy to see how implementation of the Handle Hygiene System could help improve hygiene and reduce risk in those environments.

The studies undertaken here were subject to many variables but reflect real usage. The
door handles were not altered in any way for the study but it is almost certain that the
results in this study could be improved on through the use of angled handles.

 

 

References
(a) Commission Decision (2001/471/EC)
(b) Dancer SJ. 2004. How do we assess hospital cleaning? A proposal for microbiological standards for surface
hygiene in hospitals. The Journal of Hospital Infection 56:10-15.
(c) Schmidt MG, Attaway HH, Sharpe PA, John J, Jr., Sepkowitz KA, Morgan A, Fairey SE, Singh S, Steed
LL, Cantey JR, Freeman KD, Michels HT, Salgado CD. 2012. Sustained Reduction of Microbial Burden on
Common Hospital Surfaces through Introduction of Copper. Journal of Clinical Microbiology 50:2217-2223.

  • Where is Handle Hygiene for?

    A Handle Hygiene systems is extremely important on high contact door handles where bacterial cross-contamination would present a potential health risk.

    • Hospitals
    • Retirement homes
    • Schools and educational facilities
    • Doctors surgeries
    • Dentists
    • Food industry
    • Nurseries
    • Restaurants
    • Public Bars
    • Cinemas
    • Sporting venues
    • Hotels
    • Day care facilities
    • Cruise ships
    • Office buildings
    • Coffee shops
    • Banks