Evaluation of a benzalkonium chloride hand sanitizer in reducing transient Staphylococcus aureus bacterial skin contamination in health care workers

Am J Infect Control. 2020 May;48(5):522-526. doi: 10.1016/j.ajic.2019.08.030. Epub 2019 Oct 25.


Background: This study was performed to evaluate the effectiveness of a new commercially available hand sanitizer using 0.12% benzalkonium chloride (BZK) as the active ingredient in reducing transient skin contamination with Staphylococcus aureus in health care workers (HCWs), as compared with the effectiveness of a 70% ethanol-based hand sanitizer.

Methods: Fingertip touch culture plates were obtained from 40 HCWs in which all HCWs used antimicrobial soap containing 0.6% chloroxylenol for handwashing according to the Centers for Disease Control and Prevention guidelines for the entire study, while continuing to use the 70% ethanol-based hand sanitizer according to the Centers for Disease Control and Prevention guidelines for the first week. After the first week, the test subjects used the BZK hand sanitizer in place of the ethanol sanitizer. A paired sample t test was conducted to compare the mean bacterial colonies grown from HCWs fingertips during the use of the BZK and ethanol hand sanitizer.

Results: The results showed a significant reduction in total bacterial colony counts of S aureus during the week of BZK use as compared with the week of 70% ethanol sanitizer use.

Conclusions: There was a significant decrease in transient S aureus on the fingertips of HCWs in the BZK hand sanitizer use week as compared with the 70% ethanol hand sanitizer use week.

Keywords: Alcohol sanitizer; Antibacterial persistence; Benzalkonium chloride; Hand hygiene; Nosocomial infection; Staphylococcus aureus.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Anti-Infective Agents, Local / pharmacology*
  • Bacterial Load
  • Benzalkonium Compounds / pharmacology*
  • Ethanol / pharmacology
  • Female
  • Hand / microbiology
  • Hand Disinfection
  • Hand Sanitizers / chemistry
  • Hand Sanitizers / pharmacology*
  • Health Personnel
  • Humans
  • Male
  • Skin / microbiology
  • Soaps / chemistry
  • Soaps / pharmacology
  • Staphylococcal Infections / prevention & control*
  • Staphylococcus aureus / drug effects*


  • Anti-Infective Agents, Local
  • Benzalkonium Compounds
  • Hand Sanitizers
  • Soaps
  • Ethanol