Efficacy of World Health Organization-Recommended Homemade Hand Sanitizer Against Bacteria and Fungus
Abstract
Introduction: Handwashing is among the best practices to prevent the transmission of various diseases especially during the pandemic. Handwashing with soap can reduce respiratory tract infections. The World Health Organization (WHO) released guidelines for making homemade hand sanitizer. Objective: This study aimed to analyze the effectiveness of antibacterial hand- rub, as recommended by WHO, containing ethanol, hydrogen peroxide, and glycerol in varying concentrations against bacteria and fungus. Methods: This experimental laboratory study was designed to assay the efficacy of hand sanitizer ingredients—96% ethanol, 3% hydrogen peroxide, and 98% glycerol, as recommended by WHO—against Escherichia coli, Staphylococcus aureus, and Candida albicans. Commercial hand rubs were used in this study for comparison. Result: Minimum inhibitory concentration (MIC) testing showed that the WHO hand rub at 25% concentration inhibited E. coli and S. aureus growth, while 12,5% concentration inhibited C. albicans. Conclusion: The WHO-recommended homemade hand sanitizer containing ethanol, hydrogen peroxide, and glycerol at a concentration of 50% is effective in eliminating Escherichia coli, Staphylococcus aureus, and concentration of 25% is effective on Candida albicans. Further study is needed to analyse these materials against other bacteria and viruses.
References
World Health Organization. State of health inequality: Indonesia. Geneva: World Health Organization; 2017.
World Health Organization. WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care - Transmission of pathogens by hands. Geneva: World Health Organization; 2009 [Accessed 2020 Apr 27]. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK144014/
Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt W-P. The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health. 2011;8:97–104.
The United States Centers for Disease Control and Prevention (CDC). Zoonotic diseases. Atlanta: The United States Centers for Disease Control and Prevention (CDC); 2020
World Health Organization. Regional Office for Europe & International Federation of Red Cross and Red Crescent Societies. Infections and infectious diseases: a manual for nurses and midwives in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2001.
Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA. Hand washing promotion for preventing diarrhoea. Cochrane Database Syst Rev. 2015;2015(9):CD004265.
Evans DJ, Evans DG. Escherichia coli in diarrheal disease. In: Baron S (ed). Medical microbiology. Galveston: University of Texas Medical Branch at Galveston; 1996 [Accessed 2020 Apr 27]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK7710/
Taylor TA, Unakal CG. Staphylococcus aureus. [Updated 2020 Aug 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [Accessed 2020 Apr 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441868/
Castro A, Komora N, Ferreira V, Lira A, Mota M, Silva J, et al. Prevalence of Staphylococcus aureus from nares and hands on health care professionals in a Portuguese Hospital. J Appl Microbiol. 2016;121(3):831-9
Tuchscherr L, Löffler B. Staphylococcus aureus dynamically adapts global regulators and virulence factor expression in the course from acute to chronic infection. Curr Genet. 2016;62(1):15-7.
Balasubramanian D, Harper L, Shopsin B, Torres VJ. Staphylococcus aureus pathogenesis in diverse host environments. Pathog Dis. 2017;75(1):ftx005.
Sakr A, Brégeon F, Mège JL, Rolain JM, Blin O. Staphylococcus aureus nasal colonization: an update on mechanisms, epidemiology, risk factors, and subsequent infections. Front Microbiol. 2018;9:2419.
Maertens J, Vrebos M, Boogaerts M. Assessing risk factors for systemic fungal infections. Eur J Cancer Care (Engl). 2001;10(1):56–62.
Mayer FL, Wilson D, Hube B. Candida albicans pathogenicity mechanisms. Virulence. 2013;4(2): 119-28.
Rabie T, Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review. Trop Med Int Health. 2006;11(3):258–267.
Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. 2008;98(8):1372–81.
Curtis VA, Danquah LO, Aunger RV. Planned, motivated and habitual hygiene behaviour: an eleven countries review. Health Educ Res. 2009;24(4):655-73.
Widmer AF. Replace hand washing with use of a waterless alcohol handrub? Clin Infect Dis. 2000;31(1):136-43.
Babeluk R, Jutz S, Mertlitz S, Matiasek J, Klaus C. Hand hygiene–evaluation of three disinfectant hand sanitizers in a community setting. PLoS One. 2014;9(11):e111969.
World Health Organization. Guide to local production: WHO-recommended handrub formulations. Geneva: World Health Organization; 2010
Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chinese Med Assoc. 2020;83(3):217.
Fritz KS, Petersen DR. An overview of the chemistry and biology of reactive aldehydes. Free Radic Biol Med. 2013;59:85–91.
Posada AC, Kolar SL, Dusi RG, Francois P, Roberts AA, Hamilton CJ, et al. Importance of bacillithiol in the oxidative stress response of Staphylococcus aureus. Infect Immun. 2014;82(1):316-32.
Maras B, Angiolella L, Mignogna G, Vavala E, Macone A, Colone M, et al. Glutathione metabolism in Candida albicans resistant strains to fluconazole and micafungin. PLoS One. 2014;9(6):e98387.
Gulati M, Nobile CJ. Candida albicans biofilms: development, regulation, and molecular mechanisms. Microbes Infect. 2016;18(5):310-21.
Sherrington SL, Sorsby E, Mahtey N, Kumwenda P, Lenardon MD, Brown I, et al. Adaptation of Candida albicans to environmental pH induces cell wall remodelling and enhances innate immune recognition. PLoS Pathog. 2017;13(5):e1006403.
Hoyer LL, Green CB, Oh SH, Zhao X. Discovering the secrets of the Candida albicans agglutinin-like sequence (ALS) gene family--a sticky pursuit. Med Mycol. 2008;46(1):1-15.
Staab JF, Datta K, Rhee P. Niche-specific requirement for hyphal wall protein 1 in virulence of Candida albicans. PLoS One. 2013;8(11):e80842.
Tan L, Li SR, Jiang B, Hu XM, Li S. Therapeutic targeting of the Staphylococcus aureus accessory gene regulator (agr) system. Front Microbiol. 2018;9:55.
McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev. 1999;12(1):147-79.
Ingram LO, Buttke TM. Effects of alcohols on micro-organisms. Adv Microb Physiol. 1984;25:253-300.
Chatterjee I, Somerville GA, Heilmann C, Sahl HG, Maurer HH, Herrmann M. Very low ethanol concentrations affect the viability and growth recovery in post-stationary-phase Staphylococcus aureus populations. Appl Environ Microbiol. 2006;72(4):2627-36.
Huffer S, Clark ME, Ning JC, Blanch HW, Clark DS. Role of alcohols in growth, lipid composition, and membrane fluidity of yeasts, bacteria, and archaea. Appl Environ Microbiol. 2011;77(18):6400-8.
Hugo WB. The mode of action of antibacterial agents. J Appl Bacteriol. 1967;30(1):17-50.
Yang NJ, Hinner MJ. Getting across the cell membrane: an overview for small molecules, peptides, and proteins. Methods Mol Biol. 2015;1266:29-53.
Elzain AM, Elsanousi SM, Ibrahim MEA. Effectiveness of ethanol and methanol alcohols on different isolates of staphylococcus species. J Bacteriol Mycol Open Access. 2019;7(4):71‒73.
Peters BM, Ward RM, Rane HS, Lee SA, Noverr MC. Efficacy of ethanol against Candida albicans and Staphylococcus aureus polymicrobial biofilms. Antimicrob Agents Chemother. 2013;57(1):74-82.
Finnegan M, Linley E, Denyer SP, McDonnell G, Simons C, Maillard JY. Mode of action of hydrogen peroxide and other oxidizing agents: differences between liquid and gas forms. J Antimicrob Chemother. 2010 ;65(10):2108-15.
Linley E, Denyer SP, McDonnell G, Simons C, Maillard JY. Use of hydrogen peroxide as a biocide: new consideration of its mechanisms of biocidal action. J Antimicrob Chemother. 2012;67(7):1589-96.
Batt MD, Davis WB, Fairhurst E, Gerrard WA, Ridge BD. Changes in the physical properties of the stratum corneum following treatment with glycerol. J Soc Cosmet Chem. 1988;39:367-81.
Batt MD, Fairhurst E. Hydration of the stratum corneum. Int J Cosmet Sci. 1986;8(6):253-64.
Vargas G, Chan EK, Barton JK, Rylander HG 3rd, Welch AJ. Use of an agent to reduce scattering in skin. Lasers Surg Med. 1999;24(2):133-41.
Na GC. Interaction of calf skin collagen with glycerol: linked function analysis. Biochemistry. 1986;25(5):967-73.
Fluhr JW, Gloor M, Lehmann L, Lazzerini S, Distante F, Berardesca E. Glycerol accelerates recovery of barrier function in vivo. Acta Derm Venereol. 1999;79(6):418-21.
Savica S, Tamburic S, Savic M, Cekic N, Milic J, Vuleta G. Vehicle-controlled effect of urea on normal and SLS-irritated skin. Int J Pharm. 2004;271(1-2):269-80.
Suchomel M, Rotter M, Weinlich M, Kundi M. Glycerol significantly decreases the three hour efficacy of alcohol-based surgical handrubs. J Hosp Infect. 2013;83(4):284-7.
World Health Organization. WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care - Transmission of pathogens by hands. Geneva: World Health Organization; 2009 [Accessed 2020 Apr 27]. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK144014/
Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt W-P. The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health. 2011;8:97–104.
The United States Centers for Disease Control and Prevention (CDC). Zoonotic diseases. Atlanta: The United States Centers for Disease Control and Prevention (CDC); 2020
World Health Organization. Regional Office for Europe & International Federation of Red Cross and Red Crescent Societies. Infections and infectious diseases: a manual for nurses and midwives in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2001.
Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA. Hand washing promotion for preventing diarrhoea. Cochrane Database Syst Rev. 2015;2015(9):CD004265.
Evans DJ, Evans DG. Escherichia coli in diarrheal disease. In: Baron S (ed). Medical microbiology. Galveston: University of Texas Medical Branch at Galveston; 1996 [Accessed 2020 Apr 27]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK7710/
Taylor TA, Unakal CG. Staphylococcus aureus. [Updated 2020 Aug 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [Accessed 2020 Apr 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441868/
Castro A, Komora N, Ferreira V, Lira A, Mota M, Silva J, et al. Prevalence of Staphylococcus aureus from nares and hands on health care professionals in a Portuguese Hospital. J Appl Microbiol. 2016;121(3):831-9
Tuchscherr L, Löffler B. Staphylococcus aureus dynamically adapts global regulators and virulence factor expression in the course from acute to chronic infection. Curr Genet. 2016;62(1):15-7.
Balasubramanian D, Harper L, Shopsin B, Torres VJ. Staphylococcus aureus pathogenesis in diverse host environments. Pathog Dis. 2017;75(1):ftx005.
Sakr A, Brégeon F, Mège JL, Rolain JM, Blin O. Staphylococcus aureus nasal colonization: an update on mechanisms, epidemiology, risk factors, and subsequent infections. Front Microbiol. 2018;9:2419.
Maertens J, Vrebos M, Boogaerts M. Assessing risk factors for systemic fungal infections. Eur J Cancer Care (Engl). 2001;10(1):56–62.
Mayer FL, Wilson D, Hube B. Candida albicans pathogenicity mechanisms. Virulence. 2013;4(2): 119-28.
Rabie T, Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review. Trop Med Int Health. 2006;11(3):258–267.
Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. 2008;98(8):1372–81.
Curtis VA, Danquah LO, Aunger RV. Planned, motivated and habitual hygiene behaviour: an eleven countries review. Health Educ Res. 2009;24(4):655-73.
Widmer AF. Replace hand washing with use of a waterless alcohol handrub? Clin Infect Dis. 2000;31(1):136-43.
Babeluk R, Jutz S, Mertlitz S, Matiasek J, Klaus C. Hand hygiene–evaluation of three disinfectant hand sanitizers in a community setting. PLoS One. 2014;9(11):e111969.
World Health Organization. Guide to local production: WHO-recommended handrub formulations. Geneva: World Health Organization; 2010
Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chinese Med Assoc. 2020;83(3):217.
Fritz KS, Petersen DR. An overview of the chemistry and biology of reactive aldehydes. Free Radic Biol Med. 2013;59:85–91.
Posada AC, Kolar SL, Dusi RG, Francois P, Roberts AA, Hamilton CJ, et al. Importance of bacillithiol in the oxidative stress response of Staphylococcus aureus. Infect Immun. 2014;82(1):316-32.
Maras B, Angiolella L, Mignogna G, Vavala E, Macone A, Colone M, et al. Glutathione metabolism in Candida albicans resistant strains to fluconazole and micafungin. PLoS One. 2014;9(6):e98387.
Gulati M, Nobile CJ. Candida albicans biofilms: development, regulation, and molecular mechanisms. Microbes Infect. 2016;18(5):310-21.
Sherrington SL, Sorsby E, Mahtey N, Kumwenda P, Lenardon MD, Brown I, et al. Adaptation of Candida albicans to environmental pH induces cell wall remodelling and enhances innate immune recognition. PLoS Pathog. 2017;13(5):e1006403.
Hoyer LL, Green CB, Oh SH, Zhao X. Discovering the secrets of the Candida albicans agglutinin-like sequence (ALS) gene family--a sticky pursuit. Med Mycol. 2008;46(1):1-15.
Staab JF, Datta K, Rhee P. Niche-specific requirement for hyphal wall protein 1 in virulence of Candida albicans. PLoS One. 2013;8(11):e80842.
Tan L, Li SR, Jiang B, Hu XM, Li S. Therapeutic targeting of the Staphylococcus aureus accessory gene regulator (agr) system. Front Microbiol. 2018;9:55.
McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev. 1999;12(1):147-79.
Ingram LO, Buttke TM. Effects of alcohols on micro-organisms. Adv Microb Physiol. 1984;25:253-300.
Chatterjee I, Somerville GA, Heilmann C, Sahl HG, Maurer HH, Herrmann M. Very low ethanol concentrations affect the viability and growth recovery in post-stationary-phase Staphylococcus aureus populations. Appl Environ Microbiol. 2006;72(4):2627-36.
Huffer S, Clark ME, Ning JC, Blanch HW, Clark DS. Role of alcohols in growth, lipid composition, and membrane fluidity of yeasts, bacteria, and archaea. Appl Environ Microbiol. 2011;77(18):6400-8.
Hugo WB. The mode of action of antibacterial agents. J Appl Bacteriol. 1967;30(1):17-50.
Yang NJ, Hinner MJ. Getting across the cell membrane: an overview for small molecules, peptides, and proteins. Methods Mol Biol. 2015;1266:29-53.
Elzain AM, Elsanousi SM, Ibrahim MEA. Effectiveness of ethanol and methanol alcohols on different isolates of staphylococcus species. J Bacteriol Mycol Open Access. 2019;7(4):71‒73.
Peters BM, Ward RM, Rane HS, Lee SA, Noverr MC. Efficacy of ethanol against Candida albicans and Staphylococcus aureus polymicrobial biofilms. Antimicrob Agents Chemother. 2013;57(1):74-82.
Finnegan M, Linley E, Denyer SP, McDonnell G, Simons C, Maillard JY. Mode of action of hydrogen peroxide and other oxidizing agents: differences between liquid and gas forms. J Antimicrob Chemother. 2010 ;65(10):2108-15.
Linley E, Denyer SP, McDonnell G, Simons C, Maillard JY. Use of hydrogen peroxide as a biocide: new consideration of its mechanisms of biocidal action. J Antimicrob Chemother. 2012;67(7):1589-96.
Batt MD, Davis WB, Fairhurst E, Gerrard WA, Ridge BD. Changes in the physical properties of the stratum corneum following treatment with glycerol. J Soc Cosmet Chem. 1988;39:367-81.
Batt MD, Fairhurst E. Hydration of the stratum corneum. Int J Cosmet Sci. 1986;8(6):253-64.
Vargas G, Chan EK, Barton JK, Rylander HG 3rd, Welch AJ. Use of an agent to reduce scattering in skin. Lasers Surg Med. 1999;24(2):133-41.
Na GC. Interaction of calf skin collagen with glycerol: linked function analysis. Biochemistry. 1986;25(5):967-73.
Fluhr JW, Gloor M, Lehmann L, Lazzerini S, Distante F, Berardesca E. Glycerol accelerates recovery of barrier function in vivo. Acta Derm Venereol. 1999;79(6):418-21.
Savica S, Tamburic S, Savic M, Cekic N, Milic J, Vuleta G. Vehicle-controlled effect of urea on normal and SLS-irritated skin. Int J Pharm. 2004;271(1-2):269-80.
Suchomel M, Rotter M, Weinlich M, Kundi M. Glycerol significantly decreases the three hour efficacy of alcohol-based surgical handrubs. J Hosp Infect. 2013;83(4):284-7.
Published
2021-10-31
How to Cite
ROESLAN, Moehamad Orliando et al.
Efficacy of World Health Organization-Recommended Homemade Hand Sanitizer Against Bacteria and Fungus.
Journal of Indonesian Dental Association, [S.l.], v. 4, n. 2, p. 96-103, oct. 2021.
ISSN 2621-6175.
Available at: <http://jurnal.pdgi.or.id/index.php/jida/article/view/712>. Date accessed: 12 nov. 2024.
doi: https://doi.org/10.32793/jida.v4i2.712.
Section
Research Article
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
