Gut bacteria developing tolerance to hand sanitizer

[Rex Sanders]

Researchers found that antibiotic-resistant bacteria responsible for gut infections are becoming much more tolerant to alcohol-based hand sanitizers:

https://www.npr.org/sections/goatsandsoda/2018/08/02/635017716/some-bacteria-are-becoming-more-tolerant-of-hand-sanitizers-study-finds

“I always thought of alcohol as being like a sledgehammer,” says Price, who was not affiliated with the study. “But clearly, these are innovative organisms. And evolution happens pretty fast when you’re dealing with populations that can double every 30 minutes and travel in packs of billions.”

Like your mom or sister told you – wash your hands with soap!

— Rex

https://www.youtube.com/watch?v=–1QQY74Whc&t=8s

 

[David Thomas]

Maybe they’ll up the percentage of alcohol in hand sanitizer from the currently crappy 55-63% (sometimes you can find some 70% stuff) to 90% and then we can use it as stove fuel – available wherever groceries and toiletries are sold.

Apparently there’s no denaturing ingredients in hand sanitizer – no methanol (you’d absorb some through your skin) or any emetic (vomit-inducing compound).  In remote Alaskan clinics, especially in dry towns, they have to refill the dispensers every day because people are ingesting shots of hand sanitizer.

[MJ H]

Jet the gel, or also the foam kind? Asking for a friend.

[Jerry Adams]

They say not to use antibiotics excessively because the bacteria will develop tolerance

Is that the same here?  Quit using sanitizer because it’s creating super bugs?

[Rex Sanders]

Gel vs foam doesn’t matter if it’s using alcohol as the killing agent. Some foams use other chemicals.

Quit using sanitizer because it’s creating super bugs?

Unless hand sanitizer has life-saving properties I don’t know about, avoiding it’s use to prevent bacterial tolerance or resistance doesn’t seem like a big deal. At some point, using hand sanitizer will be about as effective as wishing the bacteria would go away. We probably won’t know until people start dying.

Antibiotics are a whole different story. A post-antibiotic world could be very grim indeed.

— Rex

[David Thomas]

Yeah, look at the label for the active ingredient.  55-70% ethyl alcohol is typical,

For most of us, hand sanitizer just avoids a case of the runs or catching a cold.  Not life or death if you’re otherwise healthy with an intact immune system.  And mostly, we *could* do the same thing with soap and water, but hand sanitizer is portable and available in places without running water.

For the elderly, HIV+, transplant patients, etc, avoiding your cold or a case of dysentery could be life-saving.  Medical workers therefore use hand sanitizer routinely between patients.

Agreed, losing antibiotic effectiveness would be a bigger problem.  But losing a convenient, effective way to reduce transmission of common diseases would result in more deaths.

The surprising thing to me (and the researchers) is that bacteria were able to evolve tolerance to alcohol which was considered to be intrinsically poisonous to them.

[Jerry Adams]

Then maybe lower concentration alcohol would be better at training bacteria to be tolerant

Higher concentration alcohol would be less likely

I just wash with soap or detergent.  Try to get the organic matter off my hands.  “They” say that mechanical scrubbing is what’s good.  Long enough to sing “happy birthday” (yeah, who has the patience to do that : ).  You don’t need anything more than water.

[Lester Moore]

Good old soap and water does more than wash away organic matter – it also washes away the vast majority of bacteria and viruses too. The CDC recommends hand washing as a first-line method for microbial control of hands after using the restroom and recommends sanitizing only when hands cannot be washed.

https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html

https://www.cdc.gov/handhygiene/providers/index.html

[Adam Kilpatrick]

In medical situations you are meant to wash properly with soap and water first prior to using the hand sanitizer. If this is done then the hand sanitizer only has to deal with the miniscule fraction of remaining infectants. Which, increases its effectiveness, and also greatly reduces the statistical chance of evolution happening. If everyone washed their hands, even quickly and tokenly, prior to using the hand sanitiser, then the rate of evolution would be greatly diminished.

[John S.]

I quit drinking hand sanitizer for that very reason.

[Tom K]

“The surprising thing to me (and the researchers) is that bacteria were able to evolve tolerance to alcohol which was considered to be intrinsically poisonous to them.”

+1  The mechanism by which alcohol killed bacteria was supposed to be by physical destruction of their cellular membranes.  That they have developed resistance to a physical attack, as opposed to an attack on their biological system(sub systems) is profoundly disturbing, but, I guess, not completely unexpected.  It is, and always has been, an arms race.  Whither hence…..

[Diane Pinkers]

However, in surgical scrubbing and prevention of post-surgery infections, a link has been found with *too* vigorous scrubbing, dryness and irritation of the surgeon’s hands, and the prevelance of post-surgical infection.  Gloves fail in about 30% of the cases, so proper hand antisepsis is still really important.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712995/#!po=10.4167

https://www.ncbi.nlm.nih.gov/pubmed/10926393

Removing or interrupting the skin’s natural defense mechanisms too much can promote bacterial colonization on the hands.  Surgery vs. backcountry applications are different populations of bacteria, and not a good correlation.  The harshness of the soap has a lot to do with it. Someone asked, “Why Dr. Bronner’s?” it is less irritating to the skin than so-called antibacterial soaps.  Not having a scrub brush irritating the skin also helps, although I will admit I carry a small portion of a scrub brush to get under my nails and cuticles before cooking. I moisturize during my daily routine to improve skin health, I don’t moisturize on trail, but maybe I need to.  The hand sanitizer I use for pre-surgery prep is much better than the crap we tend to carry on the trail.

[jscott]

“I carry a small portion of a scrub brush to get under my nails and cuticles before cooking.”

I play classical guitar and so have long nails on my right hand. Stuff readily gathers there. Diane, can you recommend a good scrub brush for under the nails?

[Greg Mihalik]

^^^

a toothbrush. cut down, of course.

[Diane Pinkers]

This is what I use, Jeffrey:

https://www.amazon.com/Povidone-Iodine-Surgical-Scrub-Sponge/dp/B00DGCHN40/ref=pd_sbs_121_4?_encoding=UTF8&pd_rd_i=B00DGCHN40&pd_rd_r=16fcd008-cdbd-11e8-a739-33eb8bfc8d81&pd_rd_w=apBpz&pd_rd_wg=sRinu&pf_rd_i=desktop-dp-sims&pf_rd_m=ATVPDKIKX0DER&pf_rd_p=7d5d9c3c-5e01-44ac-97fd-261afd40b865&pf_rd_r=W9E12R0R8KJQB229Q9XH&pf_rd_s=desktop-dp-sims&pf_rd_t=40701&psc=1&refRID=W9E12R0R8KJQB229Q9XH

There’s a better picture, here, but 30 seems like a lot:

https://www.amazon.com/Surgical-Scrub-Brush-pack-30/dp/B0013EMSMA/ref=pd_sim_328_2?_encoding=UTF8&pd_rd_i=B0013EMSMA&pd_rd_r=25e09c0a-cdbd-11e8-84cd-5d1350972647&pd_rd_w=bxAZJ&pd_rd_wg=xPNIS&pf_rd_i=desktop-dp-sims&pf_rd_m=ATVPDKIKX0DER&pf_rd_p=18bb0b78-4200-49b9-ac91-f141d61a1780&pf_rd_r=NV8TF36JTAQARHYC1ZXM&pf_rd_s=desktop-dp-sims&pf_rd_t=40701&psc=1&refRID=NV8TF36JTAQARHYC1ZXM

I have access to used ones, where the sponge is gone, and I can cut  just a portion of the plastic bristle side to carry.  But, see that blue plastic scraper in the front of the image?  That’s the magic device, right there.  It has a flat end, and the other has a point, with a gentle curve to the top, perfect for scraping out from beneath the nails. Scrub with the scrub brush, scrape with the plastic scraper, then scrub again: poof! Clean nails.  I have a disposable dog bowl I use as a basin, whole set up is about an ounce and a half.  If you just want the plastic scraper,  I could probably liberate another one, and send it to you.

[jscott]

a toothbrush. cut down, of course.

Possibly. I just tried one. But my nails are clean right now. I suspect that the bristles may be too soft. Maybe not! I love a quick solution.

 

edit: oops, Diane responded while I was writing the above! Yeah, I’m not doing surgery so your product may be overkill (don’t say that out loud while the patient isn’t yet sedated!). But the under nail scraper looks good. I was hoping for an easy brush but a brief look on Amazon suggests that this is more complicated than you’d think.

I have to look again but if one package for $4.50 has the blue thingy then I’ll just splurge and buy that. thanks for the offer and insight!

[Greg Mihalik]

^^^

“Soft” is what you should be using on your teeth.  “Firm” is also available.

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