Environmental Transmission of Clostridium difficile – further evidence
The role of the environment (i.e. hospital surfaces) in the transmission of Clostridium difficile has been reported and recognised in the literature for many years, with studies and analysis conducted by investigators such as Weber et al and Dubberke et al. A new study published in the American Journal of Infection Control adds more evidence to the level of Clostridium difficile contamination within the hospital environment.
Clostridium difficile (or C.diff as it is commonly known) is a global problem, associated with the use of antibiotics. C.diff can produce toxins and causes severe diarrhoea, which in weak or susceptible individuals can lead to death. The severe diarrhoea causes widespread distribution and contamination of the patient environment; and, as C.diff is a spore forming organism, can remain in a viable state on surfaces for a considerable period of time.
Morales et al conducted an analysis of a C.diff outbreak situation within medical, surgical and general wards of a Costa Rican Hospital during which patient mortality rates were 11%. Surface samples collected during the outbreak were compared to samples taken from equivalent surfaces 2 years after the outbreak had been brought under control. Surfaces were sampled on two different occasions during each time period and included walls, tables, bedrails, etc.
Using DNA-based real-time PCR analysis the authors found 40% of all samples collected were positive for C.diff, with 71% positive during the outbreak and 29% positive 2 years later (non-outbreak situation). There was a statistically significant difference (P=0.016) between the number of positive samples taken from the same ward during the outbreak (72.2% positive) and 2 years later (34.8% positive). Further, the authors found that during the outbreak, 66.7% of bedrails and walls sampled were positive for C.diff – this means that based on these sampling results, if you were a patient, visitor or nurse within those wards during the outbreak and you touched a wall or a bedrail, you were more likely than not to pick up C.diff. The authors note in their discussion that walls and bedrails are not intuitively recognised as typical reservoirs for C.diff by patients, visitors, healthcare workers and crucially cleaning staff. Based on their findings, the authors conclude that even during the non-outbreak situation, their C.diff detection rate was still 38% and strongly suggests that intrahospital transmission takes place.
Bioquell’s hydrogen peroxide vapour technology was been proven to be effective against C.diff and is able to contact all surfaces within a hospital ward or isolation room. It has been shown to significantly reduce the incidence of nosocomial C.diff when deployed in the hospital setting.