DIV14/42: Just A Minute To Deal With C.Diff (19 February 2015)

Issue Date: 19 February 2015
Ref: DIV14/42

Disinfectants with Accelerated Hydrogen Peroxide as the active ingredient offer a simpler, safer and more sustainable alternative to traditional chlorine-based products.

Just A Minute To Deal With C.Diff
An innovative alternative to traditional infection prevention
By Katie Pett, Health Care Sector Marketing Manager, Diversey Care

No infection or illness acquired during a stay in hospital is ever welcome, but one that can be more problematic and potentially more dangerous than many others is C.Diff, more formally known as Clostridium Difficile. A total of 13,361 cases were reported across the NHS in England during the year ending March 2014, a reduction of three quarters over 2007/8 levels. This was largely achieved through better understanding of the illness and in particular managing the use of the antibiotics which increase susceptibility to the infection. Improved hand hygiene and environmental cleaning have also contributed and this is an area where there may be potential for further improvement. 

Infection prevention and housekeeping teams, indeed all hospital staff, should remain vigilant to keep C.Diff under control and continue the current downward trend. They must do this while meeting the challenge to clean more frequently and quickly without impacting on the day-to-day running of the hospital. They are seeking alternatives to traditional bleaches that support modern approaches to infection prevention. One such solution is a disinfectant with Accelerated Hydrogen Peroxide (AHP) as the active ingredient which offers a simpler, safer and more sustainable alternative to traditional chlorine-based products.

C.Diff is a spore-forming bacteria that can be found in healthy people as well as those that are ill. Like many infections it is often spread by hand-to-hand contact and by touching contaminated surfaces and equipment. The infection attacks the digestive system and one of the first, often most severe, symptoms is likely to be explosive diarrhoea. For this reason the illness is often spread by what is called the “faecal-oral” route. The majority of NHS-reported cases are among the elderly and people whose immune or digestive system has been compromised, typically through the use of certain antibiotics that suppress the natural bacteria in the gut that normally protect against infections.

Clearly, as should be understood by anyone working in a healthcare setting, effective hand hygiene is always an important part of the defence against infections including C.Diff. If follows that, with continued antibiotic stewardship, improved hand hygiene will help maintain the downward trend in infection rates. A number of excellent products are available to make this essential task as simple and convenient as possible.

The other principal defence against the threat and spread of C.Diff is the efficient cleaning and disinfection of general surfaces and equipment used for patient care. Although all surfaces can harbour an infection, it is often advisable to concentrate on toilets (flush handles, grab bars and toilet seats etc) and other frequent touch areas such as furniture, bed frames, light switches, and door handles and release buttons.

For some time now the disinfectant of choice in healthcare has contained a chlorine compound. While there is little doubt that chlorine disinfectants can be effective against C diff, these products have some drawbacks that reduce their effectiveness. 

The first is that, at the recommended concentrations, many have unsuitable contact or dwell times. This is the time the product must be left on the surface and remain wet to achieve the desired disinfection. In busy hospitals where there are a myriad of other demands, spraying enough product onto a surface to remain wet, and leaving it there, for two or three minutes is not always easy. The result is that, even in the best organisations, short-cuts will be made that compromise the effectiveness of infection prevention processes. A product with similar performance in a shorter time is desirable because it helps ensure compliance.
The second drawback of chlorine products is that they can be obtrusive. Many have unpleasant odours which can be upsetting for patients, particularly if used frequently or close-by. They can also give off fumes which are irritants to the respiratory system and can aggravate conditions such as asthma. This is neither ideal for the vulnerable or the people that care for them and products without these side effects would be preferred.

The third potential drawback is that they can corrode and otherwise damage the surfaces being cleaned. This can affect the appearance of fixtures and fittings, which can lead to additional maintenance and renewal costs as well as negatively impacting perceptions among patients, visitors and staff. There is also a concern that damaged surfaces may be harder to clean and thus may represent an increased risk of infection. Something which can be used safely on a wider range of surfaces would represent a smart investment.

An increasingly popular alternative to chlorine products is one containing AHP, a patented blend containing hydrogen peroxide as the active disinfecting agent. Products with this innovative formulation have been shown to have strong sporicidal and disinfecting properties against a wide range of pathogens with few of the drawbacks associated with chlorine-based alternatives. The very latest formulations contain AHP at concentrations which deliver proven, laboratory-verified performance against C.Diff with a contact or dwell time of just one minute.

The active AHP ingredient breaks down to water and oxygen alone shortly after use which means these products are less obtrusive and do not produce any irritant fumes. There is also reduced risk of corrosion to fixtures and fittings.