Effectiveness of various cleaning and disinfectant products on Clostridium difficile spores of PCR ribotypes 010, 014 and 027

Infections from Clostridioidies difficile (C. diff.), formerly named Clostridium difficile, are increasing worldwide in healthcare settings. There is a mortality risk of 15% or greater within 30 days of a patients suffering a C. diff infection. In this study, the authors reviewed the cleaning and disinfection abilities of four different products in both spray and wipes applications against C. diff. These are the key points:

• Patients with a C. diff. infection can excrete up to 1 x 10₇ spores per gram faeces.
• Effective cleaning and disinfection are essential to prevent the spread of C. diff in healthcare settings.
• The four different products tested were
  • Product A = Glucoprotamin 1.5%
  • Product B = Hydrogen peroxide 15mg/g
  • Product C = a mixture of Ethanol 140 mg/g, Propane-2-ol 100 mg/g; Propane-1-ol 60 mg/g, Nalkyl amino propyl glycine 5 mg/g
  • Product D = a mixture of Didecyldimonium Chloride, Benzalkonium Chloride, Polyaminopropyl, Biguanide, Dimenthicone
• Products A, B and C were tested in both spray and wipes forms, but product D was only available as a spray.
• Wipes B and C were available as ready-to-use wipes.
• Wipe A needed to be prepared in a reusable container.
• All the products tested had combined cleaning and disinfection properties.
• The chemical in products A and D contain cationic surfactants which damage the cell membranes.
• Product B contained hydrogen peroxide which kills bacteria by oxidising the cell wall.
• Product C contains alcohol which denaturises the protein causing cell damage and cell death but is known not to be sporicidal.
• Each product was tested using two different methods: adenosine triphosphate (ATP) to measure reduction of C. diff. and counting colony forming units (CFUs) to measure the killing of C. diff. spores
• Each product was tested against three different ribotypes; ribotype 010 (non-toxigenic strain) and ribotypes 027 (a hypervirulent strain) and 014 (a common pathogenic strain).
• The ready-to-use wipes outperformed the sprays with the coverage of the surface and the actual contact time.
• Wipe B containing hydrogen peroxide showed the best reduction in CFU with a 5.29 log₁₀
• Ready-to-use wipes removes the risk of human error which could make the disinfectant less effective or unnecessarily toxic.