Killing Environmental C. difficile spores

Clostridium difficile has emerged as a substantial antimicrobial-resistant threat to healthcare, with a mortality rate in Australia of 5%. Environmental disinfection using the right product, process and proof of compliance, is critical. Sporicide Plus™ is a novel disinfectant that finally addresses the age old dichotomy: choosing a powerful disinfectant that kills bacterial spores but has a good safety profile.

C. difficile is a Gram positive bacillus transmitted by the faecal-oral route. Healthy individuals become asymptomatic carriers. But after antibiotic administration, the vegetative C. difficile bacillus proliferates, forming spores. The patient then manifests symptomatic C. difficile infection (CDI) and sheds spores faecally.

The spores adhere to linen, fingertips and surfaces, from where they are transferred. Medical treatment of CDI involves another antibiotic, vancomycin, and surgical treatment is associated with poor outcomes. Prevention is the best treatment.

Disinfectants are designed to kill. Yet paradoxically they must be safe for surfaces and safe for users. Accelerated Hydrogen Peroxide (AHP) is the active ingredient in Sporicide Plus™, a new registered Hospital Grade Disinfectant that cleans surfaces and kills C. difficile spores in one-step.

Sporicide Plus™ does not bleach or degrade surfaces. It disinfects without creating destructive microcracks that harbour pathogens. And unlike quaternary ammonium (quat) chemicals, it  does not leave a residual buildup on surfaces.

Sporicide Plus™ biodegrades to just oxygen and water, leaving no residual active for C. difficile to interact with. This is important because prolonged exposure to low levels of disinfectant residue are thought to be necessary for organisms to develop resistance.

Sporicide Plus™ is an oxidiser. It interacts with micro-organisms through multiple modes of action. Even if a bacterium could develop resistance to one route of attack, it is unlikely that it could evolve resistance to multiple modes of attack simultaneously.

Some C. difficile strains are able to form a biofilm matrix that allows them to communicate and evolve. Bacteriae within biofilms are more resistant to high levels of vancomycin, giving them significant intractability. Biofilm occurs on surfaces that are constantly bathed in fluid (traditional biofilm in sinks and drains) and on cyclically wet and dry surfaces (“buildup biofilm” on endoscopes and ultrasound probes).¹ Thus choosing the right sporicide is critical. GE Healthcare recently approved AHP for ultrasound probes disinfection, illustrating its suitability on valuable surfaces.

Remember the “3Ps” of disinfection:

• The right product: Sporicide Plus™ kills C. difficile in 1 minute² without damaging surfaces
• The right process: Use Sporicide Plus™ liquid for general cleaning. Use Sporicide Plus™ Wipes on high-touch surfaces at the point of care
• Proof: Validate disinfection with a fluorescent ink audit tool such as Vericlean™.

45% of the people who enter a patient room are Nurses. 23% are visitors. The patient’s bed rail is touched up to 256 times per day by different people.³ Yet it is disinfected only once. And in many cases, probably not at all. Thus we should not be surprised that high touch surfaces in the patient zone contribute to infection risk. It follows that more frequent disinfection at the point of care is important if we are to lower HAI rates and optimise patient outcomes.

For more information on how Diversey Care can help you deliver an optimal cleaning and disinfection program please contact:

AU 1800 647 779                                       NZ 0800 803 615                              vericlean.com.au

About Diversey Care

We are the leading provider of smart, sustainable solutions for cleaning and hygiene. Through the integration of new technology-enabled services and systems, our solutions drive increased productivity, food safety and infection prevention to ultimately enhance the end-user experience.

References:

1. Alfa MJ, Howie R. Modelling Microbial Survival in Buildup Biofilm for Complex Medical Devices. BMC Infectious Diseases, 2009; 9: 56.
2. In clean condition
3. Cohen, et al. Frequency of patient contact with healthcare personnel and visitors: Implications for infection prevention. Joint Commission Journal of Quality and Patient Safety, 2012; 38 (12): 560-565.

Ivan Obreza is an Infection Prevention Consultant and the Senior Clinical Advisor for Diversey Care, Australia. He has previously worked as a Cardiac Intensive Care Nurse, Intensive Care Ambulance Paramedic and Editor of the Institute of Ambulance Officers Journal.