Tackling C difficile with environmental cleaning.

BACKGROUND: Chlorine-based cleaning products are often used in acute settings for high-level disinfection of the environment to help control C difficile. However, these products must be used at high concentrations, making them irritant, toxic and corrosive. This means they are inappropriate for the near-patient environment, and can lead to user resistance and non-compliance. More recently, products using peracetic acid and hydrogen peroxide have become available, which are highly effective even under conditions of heavy soiling. AIM: To determine whether peracetic acid sporicidal wipes could help reduce rates of C difficile at an acute London trust.
METHOD: An observational study of C difficile rates was carried out at an acute London trust between 2006 and 2010. All inpatients aged two years and over were monitored. Chlorine-based cleaning regimens and products were changed to peracetic acid sporicidal wipes in April 2008 and monitored for 18 months. Inpatient bed days were also monitored to ensure findings were not affected by changing patient numbers.
RESULTS: The mean C difficile rate per 1000 patients fell from six to two following the 2008 introduction of the sporicidal wipes. In the first half of 2009, this rate dropped to below two. The overall rate of C difficile infection was reduced by 72% following the introduction of the wipes.
CONCLUSION: The introduction of sporicidal wipes resulted in a significant reduction in C difficile rates. This supports the need to review and enhance traditional environmental cleaning regimens for preventing and controlling C difficile in acute settings