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Effect of airborne hydrogen peroxide on spores of Clostridium difficile

Effekt von gasförmigem Wasserstoffperoxid auf Sporen von Clostridium difficile

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Summary

Background

Contamination of surfaces by spores of Clostridium difficile is a major factor influencing the spread of healthcare-associated C. difficile infection. The aim of this study was to test the effect of an automated room disinfection system that provides an aerosol of 7.5 % hydrogen peroxide (H2O2) disinfectant, on spores of two different strains of C. difficile, and to evaluate the impact of biological soiling on the efficacy of H2O2 disinfection.

Material and method

The strains used were a C. difficile PCR ribotype 027 and a C. difficile ATCC 9689. Spore suspensions of each strain were applied to ceramic tiles and exposed to aerosolized H2O2 at different locations in a test room. Biological soiling was simulated by bovine serum albumin and sheep erythrocytes. At set time points spores were recovered, plated onto Columbia 5 % sheep blood agar, and surviving bacteria were counted as colony-forming units (cfu).

Results

No viable spores of either strain were recovered after a 3 h exposure to gaseous H2O2. Spores located inside a drawer showed recovery of approximately 1E5 cfu/ml for C. difficile ribotype 027 after 1 h. In the presence of organic matter, a more than fivefold log reduction compared with not exposed controls could be observed for spores of either strain tested.

Conclusion

Appropriate decontamination of surfaces exposed to spores of C. difficile is challenging for conventional cleaning methods. Aerosolized H2O2 delivered by automated room disinfection systems could possibly improve surface decontamination and thereby reduce transmission of healthcare-associated C. difficile infection. Also in the presence of organic matter H2O2 disinfection appears to be an effective adjunct for decontamination of environmental surfaces.

Zusammenfassung

Hintergrund

Kontamination von Oberflächen mit Sporen von Clostridium difficile ist ein wesentlicher Faktor für die Entstehung nosokomialer C. difficile Infektionen. Zum Zwecke der Raumdekontamination stehen automatisierte Systeme zur Verfügung, welche Lösungen von Wasserstoffperoxid vernebeln. Das Desinfektionspotential eines solchen Systems wurde hinsichtlich seiner Wirkung auf unterschiedliche C. difficile Stämme, in An- und Abwesenheit organischer Verunreinigung, untersucht.

Material und Methode

Es wurden Sporensuspensionen zweier C. difficile Stämme, Ribotyp 027 sowie ATCC 9689, auf Keramikkacheln aufgebracht und an verschiedenen Positionen eines Versuchsraumes platziert. Die anschließende Begasung erfolgte mit einem Aerosol einer 7,5 %igen H2O2 Lösung. Zur Simulation organischer Verunreinigung wurden den Sporensuspensionen Rinderalbumin sowie Schaferythrozyten beigemengt. Zu definierten Zeitpunkten erfolgten eine Resuspendierung der Sporen und die Anzüchtung rekultivierbarer Bakterien.

Ergebnisse

Nach dreistündiger Begasung konnten keine lebensfähigen Sporen beider C. difficile Stämme resuspendiert werden. Der sporizide Effekt war geringer auf Sporen, die im Inneren einer Lade platziert waren; hier ließen sich nach einer Stunde Begasung noch 1E5 KBE/ml C. difficile RT 027 rekultivieren. Bei Simulation organischer Verunreinigung konnte eine über fünffache log-Reduktion im Vergleich zu nicht exponierten Kontrollen beobachtet werden.

Schlussfolgerung

Die Vernebelung eines Aerosols von Wasserstoffperoxid hat das Potential, die Oberflächenkontamination mit C. diffile zu reduzieren und somit die Übertragung nosokomialer C. difficile Infektionen hintanzuhalten. Auch bei organischer Verunreinigung scheint die Begasung mit H2O2 eine wirksame Ergänzung zur herkömmlichen Oberflächendekontamination zu sein.

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Authors and Affiliations

  1. Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Beethovenstraße 6, 8010, Graz, Austria

    Georg Steindl MD, Anita Fiedler, Steliana Huhulescu MD,  Günther Wewalka MD &  Franz Allerberger MD

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  1. Georg Steindl MD
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  2. Anita Fiedler
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  3. Steliana Huhulescu MD
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  4. Günther Wewalka MD
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  5. Franz Allerberger MD
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Correspondence to Georg Steindl MD.

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Steindl, G., Fiedler, A., Huhulescu, S. et al. Effect of airborne hydrogen peroxide on spores of Clostridium difficile . Wien Klin Wochenschr 127, 421–426 (2015). https://doi.org/10.1007/s00508-014-0682-6

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  • DOI: https://doi.org/10.1007/s00508-014-0682-6

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