Disinfectant wipes transfer Clostridioides difficile spores from contaminated surfaces to uncontaminated surfaces during the disinfection process

Abstract

Background Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAIs). However, HAIs are still a major problem in the US with Clostridioides difficile being the most common cause, leading to approximately 12,800 deaths annually in the US. An underexplored risk when using disinfectant wipes is that they may cross-contaminate uncontaminated surfaces during the wiping process. The objective of this study was to determine the cross-contamination risk that pre-wetted disinfectant towelettes may pose when challenged with C. difficile spores. We hypothesized that although the tested disinfectant wipes had no sporicidal claims, they will reduce spore loads. We also hypothesized that hydrogen peroxide disinfectant towelettes would present a lower cross-contamination risk than quaternary ammonium products. Methods We evaluated the risk of cross-contamination when disinfectant wipes are challenged with C. difficile ATCC 43598 spores on Formica surfaces. A disinfectant wipe was used to wipe a Formica sheet inoculated with C. difficile. After the wiping process, we determined log10 CFU on previously uncontaminated pre-determined distances from the inoculation point and on the used wipes. Results We found that the disinfectant wipes transferred C. difficile spores from inoculated surfaces to previously uncontaminated surfaces. We also found that wipes physically removed C. difficile spores and that hydrogen peroxide disinfectants were more sporicidal than the quaternary ammonium disinfectants. Conclusion Regardless of the product type, all disinfectant wipes had some sporicidal effect but transferred C. difficile spores from contaminated to otherwise previously uncontaminated surfaces. Disinfectant wipes retain C. difficile spores during and after the wiping process.

A transversal overview of Intensive Care Units environmental microbiome and antimicrobial resistance profile in Brazil

“…Despite product contamination, as demonstrated by Serratia marcescens and Achromobacter xylosoxidans presence in a quaternary ammonium disinfectant and its cleaned surfaces (58), the cleaning process should also be effective and standardized. Other studies demonstrated carryover contamination by cleaning wipes when the process is not well established (59) and when there is a greater compliance in the cleaning process by healthcare workers, it was possible to drastically reduce HAI caused by C difficile, MRSA, and VRE (60). The presence of nosocomial pathogens in some sanitizer samples raises concerns about their effectiveness in controlling bacterial growth, and the detection of antimicrobial resistance genes in sanitizer samples further emphasizes the importance of assessing the efficacy of sanitization protocols.…”

16S rRNA amplicon sequencing and antimicrobial resistance profile of intensive care units environment in 41 Brazilian hospitals

“…Despite product contamination, as demonstrated by Serratia marcescens and Achromobacter xylosoxidans presence in a quaternary ammonium disinfectant and its cleaned surfaces ( 59 ), the cleaning process should also be effective and standardized. Other studies demonstrated carryover contamination by cleaning wipes when the process is not well established ( 60 ) and when there is a greater compliance in the cleaning process by healthcare workers, it was possible to drastically reduce HAI caused by C. difficile, MRSA, and VRE ( 61 ). The presence of nosocomial pathogens in some sanitizer samples raises concerns about their effectiveness in controlling bacterial growth, and the detection of antimicrobial resistance genes in sanitizer samples further emphasizes the importance of assessing the efficacy of sanitization protocols.…”

Investigation and analysis of status of mechanical prevention of venous thrombosis in ICU

“…For instance, the surface of the object would not be damaged; it has the ability of fast sterilization, and exhibits no corrosivity and toxicity; it does not need cleaning treatment before and after disinfection; it has the effect of cleaning and disinfection; the residual ammonium salt components possess antibacterial ability, which contribute to avoid cross pollution and significantly improve the compliance. Studies (Nkemngong et al, 2020) indicated that the positive rate of bacteria decreased after disinfection when wipes containing quaternary ammonium disinfectants were employed to wipe and disinfect the surface of the objects. It was also found that nurses of 65 ICUs disinfected mechanical prevention devices before use (52.0%), 118 ICUs after use (94.4%) and 65 ICUs before and after use (52.0%).…”