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Comparison of Susceptibility of Spores of Bacillus subtilis and Czech Strains of Clostridium difficile to Disinfectants


Authors: M. Votava 1;  B. Šlitrová 2
Authors place of work: Mikrobiologický ústav LF MU a FN u svaté Anny, Brno 1;  Fakulta chemická, VUT Brno 2
Published in the journal: Epidemiol. Mikrobiol. Imunol. 58, 2009, č. 1, s. 36-42

Summary

An important factor in the prevention of nosocomial outbreaks caused by Clostridium difficile ribotype 027 is the disinfection of a patient environment by reliable sporicidal disinfectants. Sporicidal activity of particular agents is tested on spores of Bacillus subtilis. Questions are brought up if the disinfectant which works on B. subtilis spores will be equally effective on the spores of C. difficile. Therefore we have compared the effects of five disinfectants available on the Czech market on the spores of collection strains of both microbes and on the spores of ten C. difficile field strains isolated from feces of hospitalized patients. The effective substances were: disinfectant No. 1 chloramine B, No. 2 chlorine dioxide, No. 3 formaldehyde and ethan-2-dion, No. 4 peracetic and acetic acids and hydrogen peroxide, No. 5 ethanol and propan-2-ol. The testing was performed using the dilution neutralization method according to ČSN EN 13704, the agent reducing the number of spores by more than 3 orders was considered sporicidal. In addition to the standard time 60 min a 15-minutes exposition was used and the effect was tested also under the protein burden. Disinfectant No. 1 showed better effect on the C. difficile than B. subtilis spores, even in lower (1%) concentration. Similarly, the sensitivity of the C. difficile spores to disinfectants No. 2 and 3 was somewhat higher. The sporicidity of the disinfectant No. 4 was so high that it reduced the number of spores of all strains within 15 minutes by more than 4 orders; possible difference in the susceptibility of spores was not observed. Whereas the disinfectant No. 5 was not reliably effective on the spores of B. subtilis, surprisingly it showed the sporicidal effect on the spores of field C. difficile strains. We conclude that spores of field C. difficile strains in particular turned out to be more sensitive to disinfectants than the spores of the collection strain of B. subtilis. Therefore B. subtilis remains the right species for testing the sporicidal activity of disinfectants.

Key words:
Clostridium difficile – Bacillus subtilis – spores – disinfection.


Zdroje

1. Barbut, P., Petit, J.-C. Epidemiology of Clostridium difficile-associated infections. Clin Microbiol Infect, 2001, 7, p. 405-410.

2. Bartlett, J.G., Perl, T.M. The new Clostridium difficile – what does it mean? N Engl J Med, 2005, 353, p. 2503-2505.

3. Block, C. The effect of Perasafe® and sodium dichlorisocyanurate (NaDCC) against spores of Clostridium difficile and Bacillus atrophaeus on stainless steel and polyvinyl chloride surfaces. J Hosp Inf, 2004, 57, p.144-148.

4. Bloomfield, S. F., Arthur, M. Interaction of Bacillus subtilis spores with sodium hypochlorite, sodium dichlorisocyanurate and chloramine T. J Appl Bact, 1992, 72, p. 166-172.

5. Coates, D., Death, J.E. Sporicidal activity of mixtures of alcohol and hypochlorite. J Clin Pathol, 1978, 31, p. 148-152.

6. ČSN EN 13704. Chemické dezinfekční přípravky – Kvantitativní zkouška s použitím suspenze ke stanovení sporicidního účinku chemických dezinfekčních přípravků používaných pro potraviny, průmysl, domácnosti a veřejné prostory – Zkušební metoda a požadavky (fáze 2/ stupeň 1). Brusel: CEN, 2002. 34 s.

7. Death, J.E., Coates, D. Effect of pH on sporicidal and microbicidal activity of buffered mixtures of alcohol and sodium hypochlorite. J Clin Pathol, 1979, 32, p. 148-153.

8. Dyas, A., Das, B.C. The activity of glutaraldehyde against Clostridium difficile. J Hosp Infect, 1985, 6, p. 41-45.

9. Džupová, O., Beneš, J. Clostridium difficile a klostridiová kolitida: co je nového. Klin Mikrobiol inf Lék, 2008, 14, 115-117.

10. Eckstein, B.C., Adams, D.A., Eckstein, E.C., Rao, A. et al. Reduction of Clostridium difficile and vancomycin-resistant Enterococcus contamination of environmental surfaces after an intervention to improve cleaning methods. BMC Infect Dis, 2007, 7, 61. Available online: http://www.biomedcentral.com/1471-2334/7/61.

11. Gerding, D.N., Muto, C.A., Owens, R.C.Jr. Measures to control and prevent Clostridium difficile infection. Clin Infect Dis, 2008, 46, Suppl.1, p. S43-S49.

12. Kuijper, E.J., Barbut, F., Brazier, J.S., Kleinkauf, N. et al. Update of Clostridium difficile infection due to PCR ribotype 027 in Europe. Euro Surveill, 2008, 13(31):pii=18942. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18942.

13. Kuijper, E.J., Coignerd, B., Tüll, P. Emergence of Clostridium difficile-associated disease in North America and Europe. Clin Microbiol Infect, 2006, 12, Suppl. 6, p. 2-18.

14. Lambert, P.A. Resistance of bacterial spores to chemical agents. In Fraise, A.P. et al. (ed.): Principles and Practice of Disinfection, Preservation & Sterilization, 4th Ed. Oxford: Blackwell Publishing, 2004. 184-190. ISBN 1-4051-0199-7.

15. Mayfield, J.L.,Leet, T., Miller, J., Mundy, L.M. Environmental control to reduce transmission of Clostridium difficile. Clin Infect Dis, 2000, 31, p. 995-1000.

16. Nyč, O., Jindrák, V., Hedlová, D., Urbášková, P. Clostridium difficile – aktuální informace a výsledky předběžného dotazníkového šetření v nemocnicích ČR. Zprávy CEM (SZÚ, Praha), 2007, 16, s. 410-411.

17. Perez, J., Springthorpe, V.S., Sattar, S.A. Activity of selected oxidizing microbicides against the spores of Clostridium difficile: Relevance to environmental control. Am J Infect Control, 2005, 33, p. 320-325.

18. Rutala, W.A., Gergen, M.F., Weber, D.J. Inactivation of Clostridium difficile spores by disinfectants. Infect Control Hosp Epidemiol, 1993, 14, p. 36-39.

19. Sagripanti, J.-L., Bonifacino, A. Comparative sporicidal effect of liquid chemical germicides on three medical devices contaminated with spores of Bacillus subtilis. Am J Infect Control, 1996, 24, p. 364-371.

20. Shetty, N., Srinivasan, S., Holton, J., Ridgway, G.L. Evaluation of microbicidal activity of a new disinfectant: Sterilox® 2500 against Clostridium difficile spores, Helicobacter pylori, vancomycin resistant Enterococcus species, Candida albicans and several Mycobacterium species. J Hosp Infect, 1999, 41, p. 101-105.

21. Vonberg, R.-P., Kuijper, E.J., Wilcox, M.H., Barbut, F. et al. Infection control measures to limit the spread of Clostridium difficile. Clin Microbiol Infect, 2008, 14, Suppl. 5, p. 2-20.

22. Wheeldon, L.J., Worthington, T., Hilton, A.C., Lambert, P.A. et al. Sporicidal activity of two disinfectants against Clostridium difficile spores. Brit J Nursing, 2008, 17, p. 316-320.

23. Whitaker, J., Brown, B.S., Vidal, S., Calcaterra, M. Designing a protocol that eliminates Clostridium difficile: a collaborative venture. Am J Infect Control, 2007, 34, p. 310-314.

24. Wilcox, M.H., Fawley, W.N. Hospital disinfectants and spore formation by Clostridium difficile. Lancet, 2000, 356, p. 1324.

25. Wullt, M., Odenholt, I., Walder, M. Activity of three disinfectants and acidified nitrite against Clostridium difficile spores. Infect. Control Hosp Epidemiol, 2003, 24, p. 765-768.

26. Wutzler, P., Sauerbrei, A., Schau, H.-P. Monopercitric acid – a new disinfectant with excellent activity towards clostridial spores. J Hosp Infect, 2005, 59, p. 75-76.

Štítky
Hygiene and epidemiology Medical virology Clinical microbiology
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