Disinfectant Wipes Transfer Clostridioides difficile Spores from Contaminated Surfaces to Uncontaminated Surfaces during the Disinfection Process

Abstract

Background: Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAI). 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. Methods: We 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. Results: We 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. Conclusion: Regardless 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.

Efficacy of five ‘sporicidal’ surface disinfectants against Clostridioides difficile spores in suspension tests and 4-field tests

“…In clinical practice it will be relevant to avoid that the wiping itself contributes to the spread of the C. difficile spores on the treated surfaces [19]. That is why the results from test fields 2 to 4 have relevant practical implications.…”

Disinfecting hospital beds and mattresses: A time for change

“…Nkemngong and colleagues showed that cleaning cloths quickly become contaminated and spread MDRO from contaminated areas to non-contaminated areas. 2 Previous studies have shown that terminal cleaning fails to remove bacteria from surfaces, especially the bed. 3,4 It is interesting that the authors did not describe a different procedure for cleaning the mattress.…”