Press Release: NHS hand-wash “ineffective” against superbugs

For immediate release • Flagship NHS hand-gel “powerless once it has dried” • New technology available in fight against superbugs

The NHS’s frontline defence against the hospital superbug has been called into question by new research suggesting that Britain’s hospitals are using sub-standard infection control technology. An independent scientific investigation, reported in today’s Sunday Express, found that the Health Service’s “gold standard” hand-wash, used to stop germs spreading inside wards, is far less effective than widely available alternatives. Alongside regular cleaning of hospital wards with antibacterial agents, hand-wash use by NHS staff, patients and visitors is regarded as critical in halting superbug infections such as C difficile and MRSA, which claim more than 7,000 lives a year and infect many more patients. The research, carried out by the Agri-Food and Biosciences Institute (AFBI), on behalf of anti-infection firm Byotrol, measured Byotrol hand-foam, NHS hand-gel (Spirigel), Vick’s First Defence and Dettol hand-foam on their performance in killing dangerous viruses 24 hours after application. The tests looked at which products prevent viruses returning for up to 24 hours after application. Worryingly, the NHS “gold standard” hand-gel offered no residual effect whatsoever. After 24 hours, First Defence continued to be effective against 90 per cent of the sample, a surrogate for Norovirus (Feline Calicivirus), with Dettol hand-foam remaining 50 per cent effective and the NHS standard hand-gel offering no ongoing protection at all. Byotrol hand-foam, the only product not based on alcohol, remained effective with a 99.9 per cent kill rate, 24 hours after application. The results are in line with last year’s study at Manchester Royal Infirmary, which showed Byotrol performed much better than the NHS gold standard cleaner in reducing levels of the hospital superbug on wards. Manchester-based Byotrol plc commissioned the research study from AFBI in Belfast to compare its alcohol-free technology with alcohol-based alternatives, Spirigel, used in NHS hospitals, Vick’s First Defence, and Dettol hand-foam. AFBI said: “The Agri-Food and Biosciences Institute developed a model system based on the pre-treatment of plastic surfaces with anti-viral products in order to demonstrate their residual efficacy by subsequent assessment, after 24 hours, of their abilities to inactivate Feline Calcivirus (a surrogate of Norovirus), which is a difficult virus to kill. “Using this model, it was shown that plastic surfaces that had been treated 24 hours earlier with Byotrol foam displayed sufficient residual virus-killing activity to inactivate more than 99.9% of infectious feline calicivirus. “Under similar test conditions pre-treatments with Vicks First Defence and Dettol foam products inactivated approximately 90 per cent and less than 50 per cent of the infectious feline calcivirus respectively, whereas pre-treatments with a Spirigel (the NHS hand-gel) displayed no residual virus-killing activities.” Byotrol’s inventor, microbiologist Stephen Falder, said: “It’s very gratifying to have our work confirmed by an independent and industry-leading laboratory like AFBI. “We believe that alcohol is a product of the past; Nurses complain of dry and damaged skin caused by alcohol hand-gel and it isn’t even very effective when you consider that it stops working as soon as it evaporates – which is almost immediately. In contrast, our product is water-based and its strength comes from its structure. It represents the future of anti-viral and anti-infection products. “Frankly, which would you prefer your doctors used? A hand-wash that kills germs then leaves hands vulnerable again, or one that kills germs and then protects hands for hour after hour?” An 11-month study at the Manchester Royal Infirmary, which was widely reported in late June 2009 (see Notes), showed that Byotrol was over 30 per cent more effective than NHS “gold standard” bleach in reducing MRSA on the wards. Similar tests at Monroe Hospital in Indiana, America, have resulted in there being no cases of hospital-acquired infections for over 3 years since Byotrol became their standard cleaning product. Dr James Ballard, Monroe Hospital’s Infection Preventionist, said “the evidence clearly demonstrates that micro-organisms simply cannot remain present on surfaces days after being cleaned with the Byotrol technology.” Byotrol’s strength comes from its unique micro-structure, which forms an invisible protective barrier on any surface, be it human hands or a hospital floor. Previous independent laboratory tests have demonstrated Byotrol’s effectiveness as it keeps on working after it has dried unlike conventional disinfectants which stop working when dry. This means that it remains effective for hours on skin and days on hard surfaces, whilst remaining completely harmless to people and the environment. ENDS For media enquires contact Christian May of Media Intelligence Partners on 020 300 88 147 or email Christian.may@media-intelligence-partners.com Notes for editors: Byotrol’s groundbreaking trial at the Manchester Royal Infirmary, June 2009: The Manchester Royal Infirmary study was designed to put the Byotrol technology through its paces in a ‘real life’ busy working hospital environment. It was led by Dr Andy Dodgson, a consultant microbiologist in charge of infection control at MRI, and was supported by Professor Curtis G Gemmell who is Professor of Bacterial Infection at St Andrews University. Using the regular staff and the regular cleaning equipment, no disturbance to the routine and no extra costs were incurred. Conventionally approximately 80 per cent of ‘low risk’ hospital cleaning is performed using just detergent and water with the additional 20 per cent of ‘high risk’ infection areas cleaned using the hazardous chemical products based on bleach. In this study Byotrol was compared with the NHS “Gold Standard” bleach cleaners (the product used in this study was Chlorclean which is hypochlorite based) to assess it against the highest standards of hospital cleaning. Starting in August 2008 and continuing until June 2009, Byotrol was used every single day to clean two general medical wards in a large, busy NHS hospital. Byotrol’s performance was compared with results from two other wards which were cleaned using the bleach-based technology. Also to ensure that no unusual factors affected the results, Manchester Royal Infirmary, which has a reputation as a ‘clean’ hospital, was chosen for the trial. After six months of the trial, the cleaning products were crossed over onto the corresponding wards to ensure scientific validity. The trial, which is the UK’s biggest of its kind, lasted over 330 days and over four thousand individual ‘sites’ were analysed in the hospital wards to look for microbes – a measure known as environmental bacterial load. Trained microbiologists swabbed ‘sites’ daily over the test and control wards to gather microbes and then analysed the number of microbes found in the laboratory. The study also involved looking not just at total germs (TVC’s = Total viable counts) but individual types such as MRSA. Microbiological results from the study  There was a significant 33 per cent reduction in environmental MRSA in the wards cleaned with Byotrol compared to the NHS gold standard bleach.  The effect was very quick and within five weeks of introducing Byotrol to the wards there was a significant reduction in environmental bacteria.  Throughout the trial, significant reductions in total environmental microbial load existed between the Byotrol-treated wards and those treated with bleach.  Following the crossover in the cleaning regimes , once again Byotrol proved superior to Chlorclean in reducing environmental bacterial loads. And it is also important to note that this trial showed that it outperformed the very best remedy in current use by a wide margin. Hence, when Byotrol is adopted as a replacement for soap and water the benefits can be expected to be even greater. (This was found in the earlier Glasgow Royal Infirmary pilot study, where Byotrol scored 50 per cent better than neutral detergent.) Commentary on the MRI results from Professor Curtis Gemmell: ‘’ It is clear that the microbiological cleanliness attained with Byotrol was superior to Chlorclean (hypochlorite) and the results obtained in this study warrant its adoption in hospitals. Byotrol is a safe alternative to Chlorclean and hitherto has not been shown to engender resistance or tolerance amongst hospital bacteria, nor does it damage inanimate surfaces. One benefit which is worth serious consideration as part of any hospital hygiene programme is the recognition that Byotrol displays residual anti-bacterial activity for at least 24 hours (and probably longer) after its application to inanimate surfaces unlike Chlorclean. The study shows that Byotrol Technology is a viable alternative to the current “gold standard” in hospital infection control and superior to neutral detergents. ’’ The image below demonstrate that with no sanitising treatment (post inoculation) the E. coli bacteria survive well on the hands during the test period. The use of 70 per cent alcohol hand rub removed a high proportion of the inoculated E. coli, while the use of a water based hand sanitiser (Assure mousse containing Byotrol technology as the active biocide) removed a much greater proportion of the inoculated E. coli. Use of the 70 per cent alcohol hand rub resulted in bacterial colonies, distinct from the seeded organism, appearing on test plates. These are thought to be resident skin flora organisms released by the action of alcohol on the epidermis. No such colonies were seen with the water based sanitiser treatment.