Abstract
Objective: Clostridioides difficile (formerly Clostridium difficile) is among the most reported hospital and community-acquired gastrointestinal infections. Spores produced by this bacterium cause the initial disease and recurrent C. difficile infections (rCDI) and survive for long periods in the environment. Killing of C. difficile spores in carpeting and upholstery is very challenging without destruction or alteration of the fiber matrix material. In this study, we evaluated a fiber-safe standardized method for inhibiting germination of C. difficile spores recovered from in carpeting and upholstery material and thereby reduce the risk of disease incidence in households and nursing care facilities. Methods and Results : In this study, we found that the most effective procedure for the recovery of C. difficile spores from short-fiber textile surfaces used an ammonium phosphate-gelatin buffer, stainless steel beads to extract the spores from the carpet samples, and the addition of a heat activation step prior to plating. Virasept®, a known sporicide containing hydrogen peroxide and peroxyacetic acid, was evaluated for marked reduction of viable C. difficile spore number in carpet and fabric models. After a 30 min contact time, application of the sporicide at ~ 75 ml m2 of carpet (or 51.2 ml m2 upholstery fabric) resulted in a 3-log reduction in germination of five different C. difficile spore types (a ~99.9% decrease), representing five different Nap biotypes. Despite effective inhibition of C. difficile spore germination, Virasept treatment did not visibly damage or discolor carpet or fabric fibers. Conclusions: Results of this study show the potential effectiveness of a robust regimen for the practical treatment of carpeting and upholstery fabric in nursing care facilities, and residential homes to prevent community- and environmentally-acquired reinfection and recurrence of CDI in susceptible individuals.
Highlights
Clostridioides difficile is among the most common cause of antibiotic-associated hospital and community-acquired gastrointestinal infections [1,2,3].Infection is transmitted to susceptible individuals from the environment by C. difficile spores, which are highly resistant to environmental stress and common disinfectants [4,5,6]
Clostridioides difficile is among the most reported hospital and community-acquired gastrointestinal infections. Spores produced by this bacterium cause the initial disease and recurrent C. difficile infections and survive for long periods in the environment
In this study, we found that the most effective procedure for the recovery of C. difficile spores from shortfiber textile surfaces used an ammonium phosphate-gelatin buffer, stainless steel beads to extract the spores from the carpet samples, and the addition of a heat activation step prior to plating
Summary
Clostridioides difficile (formerly Clostridium difficile) is among the most common cause of antibiotic-associated hospital and community-acquired gastrointestinal infections [1,2,3]. Infection is transmitted to susceptible individuals from the environment by C. difficile spores, which are highly resistant to environmental stress and common disinfectants [4,5,6]. The annual incidence of C. difficile infection (CDI) has increased over the past two decades to ~500,000 cases in the US, resulting in ~ 29,000 deaths [3]. 25% of these cases were estimated to be due to community acquired infection [3]. Recurrent C. difficile infection (rCDI) is especially challenging, and in recent years the incidence of rCDI has risen approximately 4-fold faster than CDI alone [7]. Recurrence is likely driven by residual C. difficile spores, and it is not known whether the main source of these spores is in the patient’s own intestinal tract or their immediate environment
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