The effect of hospital biocide sodium dichloroisocyanurate on the viability and properties of<i>Clostridium difficile</i>spores

Joshi, Lovleen Tina; Welsch, A. C.; Hawkins, Jennifer; Baillie, Les

doi:10.1111/lam.12768

Cited by 12 publications

(16 citation statements)

References 22 publications

(40 reference statements)

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“…Results also suggest that C. difficile spores, after microbicidal exposure to NaDCC at the recommended contact time and concentration, can continue to remain viable, adhere, and transmit via hospital gowns ( Fig. 4A and C) (1,28,33). This highlights the importance of ensuring that single-use surgical isolation gowns are used appropriately in infection prevention and control, i.e., that gowns are adorned upon entering and disposed of when exiting a single room to prevent onward spore transmission and incidence of CDI (34).…”

Section: Figmentioning

confidence: 89%

“…Spore suspensions (U and P) from strains DS1748, R20291, and DS1813 at a concentration of 1 ϫ 10 6 spores per ml were exposed to 1,000 ppm NaDCC for 10 min in liquid form (recommended contact time), neutralized with sodium thiosulfate, and deposited onto sterile gowns. Spores were recovered as described previously (1,22). Second, spores were also spiked onto the gown surface, as described in the spore transfer section above, and spores were spiked onto the surfaces of hospital stainless steel and hospital vinyl flooring for each biological repeat and allowed to dry for 120 min in a category 2 biosafety laminar flow cabinet.…”

Section: Methodsmentioning

confidence: 99%

“…Our previous study established that exosporiumpositive spores (DS1813) were more resistant to NaDCC at sublethal concentrations than exosporium-negative spores (DS1748) (1, 28), which appears to correlate with the theory that the exosporium layer confers a protective barrier to the spore, preventing it from being damaged (39). It has also been hypothesized that exposure of spores to NaDCC at inappropriate concentrations and contact times can alter and increase spore adhesion ability (1). In the present study, while we observed a lack of exosporiumnegative DS1748 and exosporium-positive DS1813 spore recovery from hospital stainless steel, scanning electron microscopy (Fig.…”

Section: Figmentioning

confidence: 97%

“…T he anaerobic spore-forming Gram-positive bacterium Clostridium difficile is the primary cause of antibiotic-associated diarrhea globally (1). C. difficile asymptomatically forms part of the microbiota of 1% to 3% healthy adults (2,3); however, if the microbiota of the intestine is disrupted, for example, as a result of broad-spectrum antibiotic treatment, colonization of the colon by vegetative cells of C. difficile can proceed and escalate into the onset of C. difficile infection (CDI) (4).…”

mentioning

confidence: 99%

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Biocide Resistance and Transmission of Clostridium difficile Spores Spiked onto Clinical Surfaces from an American Health Care Facility

Dyer

Hutt

Burky³

et al. 2019

Appl Environ Microbiol

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Clostridium difficile is the primary cause of antibiotic-associated diarrhea globally. In unfavorable environments, the organism produces highly resistant spores which can survive microbicidal insult. Our previous research determined the ability of C. difficile spores to adhere to clinical surfaces, finding that spores had markedly different hydrophobic properties and adherence abilities. Investigation into the effect of the microbicide sodium dichloroisocyanurate on C. difficile spore transmission revealed that sublethal concentrations increased spore adherence without reducing viability. The present study examined the ability of spores to transmit across clinical surfaces and their response to an in-use disinfection concentration of 1,000 ppm of chlorine-releasing agent sodium dichloroisocyanurate. In an effort to understand if these surfaces contribute to nosocomial spore transmission, surgical isolation gowns, hospital-grade stainless steel, and floor vinyl were spiked with 1 × 106 spores/ml of two types of C. difficile spore preparations: crude spores and purified spores. The hydrophobicity of each spore type versus clinical surface was examined via plate transfer assay and scanning electron microscopy. The experiment was repeated, and spiked clinical surfaces were exposed to 1,000 ppm sodium dichloroisocyanurate at the recommended 10-min contact time. Results revealed that the hydrophobicity and structure of clinical surfaces can influence spore transmission and that outer spore surface structures may play a part in spore adhesion. Spores remained viable on clinical surfaces after microbicide exposure at the recommended disinfection concentration, demonstrating ineffectual sporicidal action. This study showed that C. difficile spores can transmit and survive between various clinical surfaces despite appropriate use of microbicides. IMPORTANCE Clostridium difficile is a health care-acquired organism and the causative agent of antibiotic-associated diarrhea. Its spores are implicated in fecal to oral transmission from contaminated surfaces in the health care environment due to their adherent nature. Contaminated surfaces are cleaned using high-strength chemicals to remove and kill the spores; however, despite appropriate infection control measures, there is still high incidence of C. difficile infection in patients in the United States. Our research examined the effect of a high-strength biocide on spores of C. difficile which had been spiked onto a range of clinically relevant surfaces, including isolation gowns, stainless steel, and floor vinyl. This study found that C. difficile spores were able to survive exposure to appropriate concentrations of biocide, highlighting the need to examine the effectiveness of infection control measures to prevent spore transmission and to consider the prevalence of biocide resistance when decontaminating health care surfaces.

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Section: Figmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Figmentioning

confidence: 97%

mentioning

confidence: 99%

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Biocide Resistance and Transmission of Clostridium difficile Spores Spiked onto Clinical Surfaces from an American Health Care Facility

Dyer

Hutt

Burky³

et al. 2019

Appl Environ Microbiol

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“…An interesting study evaluated the effects of a hospital biocide, sodium dichloroisocyanurate (NaDCC), on C. difficile spores. In this study, a 10x less lethal concentration of biocide was tested [65]. At this concentration, spores are not killed as effectively as the lethal concentration and the hydrophobicity of the spores was greatly reduced (to approximately 20%) [65].…”

Section: Discussionmentioning

confidence: 99%

The small acid-soluble proteins of Clostridioides difficile are important for UV resistance and serve as a check point for sporulation

Nerber

Sorg

2021

Preprint

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Clostridioides difficile is a nosocomial pathogen which causes severe diarrhea and colonic inflammation. C. difficile causes disease in susceptible patients when endospores germinate into the toxin-producing vegetative form. The action of these toxins results in diarrhea and the spread of spores into the hospital and healthcare environments. Thus, the destruction of spores is imperative to prevent disease transmission between patients. However, spores are resilient and survive extreme temperatures, chemical exposure, and UV treatment. This makes their elimination from the environment difficult and perpetuates their spread between patients. In the model spore-forming organism, Bacillus subtilis, the small acid-soluble proteins (SASPs) contribute to these resistances. The SASPs are a family of small proteins found in all endospore-forming organisms, C. difficile included. Although these proteins have high sequence similarity between organisms, the role(s) of the proteins differ. Here, we investigated the role of the main α/β SASPs, SspA and SspB, and two annotated SASPs, CDR20291_1130 and CDR20291_3080, in protecting C. difficile spores from environmental insults. We found that SspA is necessary for conferring spore UV resistance, SspB minorly contributes, and the annotated SASPs do not contribute to UV resistance. In addition, none of these SASPs contribute to the resistance of tested chemicals. Surprisingly, the combined deletion of sspA and sspB prevented spore formation. Overall, our data indicate that UV resistance of C. difficile spores is dependent on SspA and that SspA and SspB regulate / serve as a checkpoint for spore formation, a previously unreported function of SASPs.

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A sodium dichloroisocyanurate-based conditioning process for the improvement of sludge dewaterability and mechanism studies

Dong

Shen

et al. 2021

Journal of Environmental Management

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The effect of hospital biocide sodium dichloroisocyanurate on the viability and properties ofClostridium difficilespores

Cited by 12 publications

References 22 publications

Biocide Resistance and Transmission of Clostridium difficile Spores Spiked onto Clinical Surfaces from an American Health Care Facility

Biocide Resistance and Transmission of Clostridium difficile Spores Spiked onto Clinical Surfaces from an American Health Care Facility

The small acid-soluble proteins of Clostridioides difficile are important for UV resistance and serve as a check point for sporulation

A sodium dichloroisocyanurate-based conditioning process for the improvement of sludge dewaterability and mechanism studies

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