Efficacy of hospital cleaning agents and germicides against epidemic Clostridium difficile strains
Efficacy of hospital cleaning agents and germicides against epidemic Clostridium difficile strains
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DOI：
10.1086/519201
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发表时间：
2007-08-01
影响因子：
4.5
通讯作者：
Wilcox, Mark H.
中科院分区：
文献类型：
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作者：
Fawley, Warren N.;Underwood, Sarah;Wilcox, Mark H.
目标。目的比较医院清洁剂和杀菌剂对艰难梭菌流行株存活的影响。我们比较了5种清洗剂和/或杀菌剂(3种含氯，1种只含洗涤剂，1种含过氧化氢)对艰难梭菌流行株和非流行株的繁殖态和芽胞形态(各3株)的活性和影响。我们使用一种人类粪便乳剂进行了体外暴露实验，以模拟现场发现的条件。与孢子相比，清洗剂和杀菌剂暴露实验对艰难梭菌繁殖体细胞产生了非常不同的结果。所有药物的工作强度浓度都能抑制艰难梭菌在培养中的生长。然而，当在推荐的工作浓度下使用时，只有氯基杀菌剂能够灭活艰难梭菌的孢子。艰难梭菌流行株的产孢率高于非流行株。在没有接触任何清洁剂或杀菌剂的所有菌株中，平均产孢率(以孢子形态的细胞群比例表示)为13%，而暴露于单独含有洗涤剂或杀菌剂的清洗剂或杀菌剂(34%)、洗涤剂与次氯酸盐的组合(24%)或过氧化氢(33%)时，平均产孢率显著增加。相比之下，平均产孢率在接触含有洗涤剂和二氯异氰尿酸酯(9%)或单独使用二氯异氰尿酸酯(15%)的杀菌剂后没有显著变化。这些结果突出了清洁剂和杀菌剂对艰难梭菌孢子的活性差异，以及其中一些产品促进孢子形成的潜力。
Objective. To compare the effects of hospital cleaning agents and germicides on the survival of epidemic Clostridium difficile strains.Methods. We compared the activity of and effects of exposure to 5 cleaning agents and/or germicides (3 containing chlorine, 1 containing only detergent, and 1 containing hydrogen peroxide) on vegetative and spore forms of epidemic and non-epidemic C. difficile strains (3 of each). We carried out in vitro exposure experiments using a human fecal emulsion to mimic conditions found in situ.Results. Cleaning agent and germicide exposure experiments yielded very different results for C. difficile vegetative cells, compared with those for spores. Working-strength concentrations of all of the agents inhibited the growth of C. difficile in culture. However, when used at recommended working concentrations, only chlorine-based germicides were able to inactivate C. difficile spores. C. difficile epidemic strains had a greater sporulation rate than nonepidemic strains. The mean sporulation rate, expressed as the proportion of a cell population that is in spore form, was 13% for all strains not exposed to any cleaning agent or germicide, and it was significantly increased by exposure to cleaning agents or germicides containing detergent alone (34%), a combination of detergent and hypochlorite (24%), or hydrogen peroxide (33%). By contrast, the mean sporulation rate did not change substantially after exposure to germicides containing either a combination of detergent and dichloroisocyanurate (9%) or dichloroisocyanurate alone (15%).Conclusions. These results highlight differences in the activity of cleaning agents and germicides against C. difficile spores and the potential for some of these products to promote sporulation.