Surface

Kampf, G.
Clostridium difficile – what has to be kept in mind for effective disinfection?
Hyg Med 2008; 33 (4): 153 - 159.

Summary
As nosocomial pathogen the vegetative Clostridium (C.) difficile cell only shortly survives in an inanimate environment. Thus it normally does not survive gastric acid. Merely patients with atrophic gastritis or who are treated with proton pump inhibitors and H2 antagonists respectively are at risk of becoming infected.

However, the C. difficile spore is different: It is able to persist up to 5 months on inanimate surfaces, survives gastric acid even with a pH value of 1 and in the most instances germinates in the small intestine within 1 hour.

Hands are contaminated with C. difficile rather seldom. However, in case they are suspected of being contaminated, they should be disinfected first and then washed shortly and thoroughly. Only this way it can be ensured that the vegetative C. difficile cell is killed and that the number of spores is reduced as much as possible.

With a contamination of up to 30 percent also inanimate surfaces are a reservoir for new infections. However, highest contamination rates were found in the environment of patients with diarrhoea – in particular around toilets and bedpans. Here, sporicidal surface disinfection proved to be particularly effective; according to the majority of studies incidences with C. difficile could be reduced significantly.

These results allow us to conclude that – besides wearing protective gloves – sporicidal surface disinfection is the best infection prevention in case of an outbreak.

The article was published in German in:
Hygiene & Medizin, 2008; 33 (4): 153 - 159.