February 25, 2019
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Spray bleach significantly reduces C. difficile spores in non-CDI rooms

A recent study found that using a spray bleach for post-discharge cleaning significantly reduced the recovery of Clostridioides difficile spores in non-C. difficile infection rooms compared with a non-sporicidal quaternary ammonium disinfectant.

Yilen K. Ng Wong, MD, and colleagues conducted the study at the Louis Stokes Cleveland Veterans Affairs Medical Center, an acute-care facility with 215 beds. Prior to the study, environmental service (EVS) staff at the hospital used commercial bleach wipes to clean CDI rooms and quaternary ammonium disinfectant applied with microfiber clothes to clean non-CDI rooms after patient discharge, the researchers explained.

Beginning May 1, 2018, EVS staff began using Clorox Healthcare Fuzion Cleaner Disinfectant (0.39% sodium hypochlorite) to clean and disinfect both CDI and non-CDI post-discharge rooms. For the study, the researchers compared the frequency of environmental contamination with C. difficile spores and MRSA in the 3-week periods before and after the change to spray bleach. One culture was taken from surfaces in the patient’s room and another was taken from surfaces in the bathroom. Cultures were not taken from shared bathrooms.

The researchers cultured 51 non-CDI rooms after discharge during the period that EVS staff were using the quaternary ammonium disinfectant, and 39 non-CDI rooms after discharge when staff were using the spray bleach spray.

When the quaternary ammonium disinfectant was being used, 24% of rooms were contaminated with C. difficile at one or both sites, and 10% were contaminated with MRSA, the researchers found. During the period that spray bleach was used, however, contamination with C. difficile was significantly lower than the baseline period (5% vs. 24%; P = .02) and MRSA contamination also was reduced (10% vs. 0%; P = .07).

“Our results suggest that use of sporicidal disinfectants for all post-discharge room disinfection might be helpful in reducing the risk for C. difficile transmission from contaminated surfaces,” the researchers concluded. “Future studies are needed to determine if routine use of sporicidal disinfectants in non-CDI rooms will result in a reduction in rates of CDI.” – by Erin Michael

Disclosures: The study was supported by the U.S. Department of Veterans Affairs and by a grant from the Clorox Company to Donskey. Clorox did not provide any input on the study design, data analysis, writing or editing of the manuscript. Donskey reports receiving research funding from Clorox, GOJO and PDI.