Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2025-01-03T22:50:20.323Z Has data issue: false hasContentIssue false
  • English
  • Français

Activity of Three Disinfectants and Acidified Nitrite Against Clostridium difficile Spores

Published online by Cambridge University Press:  02 January 2015

Marlene Wullt ,
Inga Odenholt  and
Mats Walder
Marlene Wullt*
Affiliation:
Departments of Infectious Diseases and Clinical Microbiology, Lund University, Malmö University Hospital, Malmö, Sweden
Inga Odenholt
Affiliation:
Departments of Infectious Diseases and Clinical Microbiology, Lund University, Malmö University Hospital, Malmö, Sweden
Mats Walder
Affiliation:
Departments of Infectious Diseases and Clinical Microbiology, Lund University, Malmö University Hospital, Malmö, Sweden
*
Department of Infectious Diseases, Malmö University Hospital, SE- 205 02 Malmö, Sweden
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To identify environmentally safe, rapidly acting agents for killing spores of Clostridium difficile in the hospital environment.

Design:

Three classic disinfectants (2% glutaraldehyde, 1.6% peracetyl ions, and 70% isopropanol) and acidified nitrite were compared for activity against C. difficile spores. Four strains of C. difficile belonging to different serogroups were tested using a dilution–neutralization method according to preliminary European Standard prEN 14347. For peracetyl ions and acidified nitrite, the subjective cleaning effect and the sporicidal activity was also tested in the presence of organic load.

Results:

Peracetyl ions were highly sporicidal and yielded a minimum 4 log10 reduction of germinating spores already at short exposure times, independent of organic load conditions. Isopropanol 70% showed low or no inactivation at all exposure times, whereas glutaraldehyde and acidified nitrite each resulted in an increasing inactivation factor (IF) over time, from an IF greater than 1.4 at 5 minutes of exposure time to greater than 4.1 at 30 minutes. Soiling conditions did not influence the effect of acidified nitrite. There was no difference in the IF among the 4 strains tested for any of the investigated agents. Acidified nitrite demonstrated a good subjective cleaning effect and peracetyl ions demonstrated a satisfactory effect.

Conclusions:

Cidal activity was shown against C. difficile spores by glutaraldehyde, peracetyl ions, and acidified nitrite. As acidified nitrite and peracetyl ions are considered to be environmentally safe chemicals, these agents seem well suited for the disinfection of C. difficile spores in the hospital environment.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 10 , October 2003 , pp. 765 - 768
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.McFarland, LV, Surawicz, CM, Stamm, WE. Risk factors for Clostridium difficile carriage and C. difficile-associated diarrhea in a cohort of hospitalized patients. J Infect Dis 1990;162:678–684.Google Scholar
2.Fekety, R, Kim, KH, Brown, D, Batts, DH, Cudmore, M, Silva, J Jr. Epidemiology of antibiotic-associated colitis: isolation of Clostridium difficile from the hospital environment. Am J Med 1981;70:906–908.CrossRefGoogle ScholarPubMed
3.Kaatz, GW, Gitlin, SD, Schaberg, DR, et al.Acquisition of Clostridium difficile from the hospital environment. Am J Epidemiol 1988;127:1289–1294.Google Scholar
4.Samore, MH, Venkataraman, L, DeGirolami, PC, Arbeit, RD, Karchmer, AW. Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea. Am J Med 1996;100:32–40.Google Scholar
5.Clabots, CR, Johnson, S, Olson, MM, Peterson, LR, Gerding, DN. Acquisition of Clostridium difficile by hospitalized patients: evidence for colonized new admissions as a source of infection. J Infect Dis 1992;166:561–567.Google Scholar
6.McFarland, LV, Mulligan, ME, Kwok, RYY, Stamm, WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 1989;320:204–210.Google Scholar
7.Wullt, M, Laurell, MH. Low prevalence of nosocomial Clostridium difficile transmission, as determined by comparison of arbitrarily primed PCR and epidemiological data. J Hosp Infect 1999;43:265–273.Google Scholar
8.Rutala, WA, Gergen, MF, Weber, DJ. Inactivation of Clostridium difficile spores by disinfectants. Infect Control Hosp Epidemiol 1993;14:36–39.CrossRefGoogle ScholarPubMed
9.Rutala, WA, Gergen, MF, Weber, DJ. Sporicidal activity of chemical ster-ilants used in hospitals. Infect Control Hosp Epidemiol 1993;14:713–718.Google Scholar
10.Worsley, MA. Infection control and prevention of Clostridium difficile infection. J Antimicrob Chemother 1998;41(suppl C):59–66.Google Scholar
11.Global Consensus Conference. Final recommendations. Am J Infect Control 1999;27:503–513.CrossRefGoogle Scholar
12.Wilcox, MH, Fawley, WN. Hospital disinfectants and spore formation by Clostridium difficile. Lancet 2000;356:1324.Google Scholar
13.European Committee for Standardization. Chemical Disinfectants: Basic Sporicidal Activity—Test Method and Requirements (Phase 1). DRAFT prEN 14347. Brussels: European Committee for Standardization; 2001.Google Scholar
14.Walder, M, Myrbäck, K-E, Nilsson, B. A method to evaluate the cleaning and disinfectant action of surface disinfectants. J Hosp Infect 1989;13:149–159.Google Scholar
15.Mayfield, JL, Leet, T, Miller, J, Mundy, LM. Environmental control to reduce transmission of Clostridium difficile. Clin Infect Dis 2000;31:995–1000.Google Scholar
16.Babb, JR, Bradley, CR, Ayliffe, GAJ. Sporicidal activity of glutaraldehy-des and hypochlorites and other factors influencing their selection for the treatment of medical equipment. J Hosp Infect 1980;1:63–75.Google Scholar
17.Rutala, WA, Clontz, EP, Weber, DJ, Hoffmann, KK. Disinfection practices for endoscopes and other semicritical items. Infect Control Hosp Epidemiol 1991;12:282–288.Google Scholar
18.Benjamin, N, O'Driscoll, F, Dougall, H, et al.Stomach NO synthesis. Nature 1994;368:502.Google Scholar
19.Shank, JL, Silliker, JH, Harper, RH. The effect of nitric oxide on bacteria. Appl Microbiol 1962;10:185–189.Google Scholar
20.De Groote, MA, Fang, FC. NO inhibitions: antimicrobial properties of nitric oxide. Clin Infect Dis 1995;21(suppl 2):S162–S165.Google Scholar
21.O'Leary, V, Solberg, M. Effect of sodium nitrite inhibition on intracellular thiol groups and on the activity of certain glycolytic enzymes in Clostridium perfringens. Appl Environ Microbiol 1976;31:208–212.Google Scholar
22.Klebanoff, SJ. Reactive nitrogen intermediates and antimicrobial activity: role of nitrite. Free Radie Biol Med 1993;14:351–360.Google Scholar
23.Rutala, WA, Weber, DJ. Infection control: the role of disinfection and sterilization. J Hosp Infect 1999;43(suppl):S43–S55.Google Scholar
24.Dyas, A, Das, BC. The activity of glutaraldehyde against Clostridium difficile. J Hosp Infect 1985;6:41–45.Google Scholar
25.Russell, AD. Glutaraldehyde: current status and uses. Infect Control Hosp Epidemiol 1994;15:724–733.Google Scholar
26.Coates, D. Sporicidal activity of sodium dichloroisocyanurate, peroxy-gen and glutaraldehyde disinfectants against Bacillus subtilis. J Hosp Infect 1996;32:283–294.Google Scholar
27.Fraise, AP. Choosing disinfectants. J Hosp Infect 1999;43:255–264.Google Scholar
28.Cowan, RE, Manning, AP, Ayliffe, GA, et al.Aldehyde disinfectants and health in endoscopy units. Gut 1993;34:1641–1645.CrossRefGoogle ScholarPubMed
29.Delmée, M, Bulliard, G, Simon, G. Application of a technique for serogrouping Clostridium difficile in an outbreak of antibiotic-associated diarrhoea. J Infect 1986;13:5–9.Google Scholar
30.Toma, S, Lesiak, G, Magus, M, Lo, H-L, Delmée, M. Serotyping of Clostridium difficile. J Clin Microbiol 1988;26:426–428.Google Scholar
31. van Dijck, P, Avesani, V, Delmée, M. Genotyping of outbreak-related and sporadic isolates of Clostridium difficile belonging to serogroup C. J Clin Microbiol 1996;34:3049–3055.Google Scholar