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

Carine A Nkemngong,Gurpreet K Chaggar,Xiaobao Li,Haley F Oliver,Peter J Teska

doi:10.1186/s13756-020-00844-0

Carine A Nkemngong, Gurpreet K Chaggar + Show 3 more

Open Access

https://doi.org/10.1186/s13756-020-00844-0

Copy DOI

Abstract

BackgroundPre-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.MethodsWe 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.ResultsWe 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.ConclusionRegardless 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.

Highlights

Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAIs)
A disinfectant wipe transferred a mean of 0.13 ± 0.12 and 0.34 ± 0.27 log10 Colony forming unit (CFU)/100 cm2 from the i-zone to the 0.5 m2 and 2.0 m2 risk surfaces respectively
There were no statistically significant differences among the C. difficile spore log10 CFU/100 cm2 transferred to the 1.5 m2 and 2.0 m2 surfaces and the log10 CFU/100 cm2 detected from the i-zone after the wiping process (P ≥ 0.05)

Summary

Introduction

Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAIs). 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. Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to disinfect equipment and environmental surfaces proximal to patients to reduce the Nkemngong et al Antimicrob Resist Infect Control (2020) 9:176 and Prevention (CDC) estimated that in 2017 there were approximately 223,900 hospitalized patients with C. difficile infections in the US with at least 12,800 deaths [6]. The persistence of C. difficile spores on environmental surfaces has been associated with the use of non-sporicidal cleaning agents such as quaternary ammonium compounds, which may increase C. difficile sporulation rates [14]. The use of disinfectant wipes with C. difficile sporicidal claims have been recommended to reduce the incidence of HAIs [15], as wipes have been suggested to increase compliance with standard cleaning and disinfection protocols [16]

Objectives

Methods

Results

Discussion

Conclusion