Clostridium difficile (CD) hospital acquired infection (HAI) Rates unaffected by switch from Bleach (B) to Hydrogen Peroxide (H2O2) and Peracetic acid (PA) Based Disinfectants – The New Smell of Clean
Background: CD continues to plague patients who are frequently exposed to healthcare settings, remaining the 3rd mostly common HAI, reaching historically high prevalence levels. Because CD is a spore former, the microorganism is particularly resistant to disinfection. Until recent years options for sporocides have been limited to sodium hypochlorite (B) based products. Though sporicidal, B based products are caustic to the environment (i.e., furniture, mattresses, equipment, etc.) and leaves a salt precipitate. In recent years, H2O2 based products have received Environmental Protection Agency approval for use in healthcare settings. Some products are combined with PA which decreases contact time (≤ 5 minutes) by disrupting cell wall permeability. H2O2/PA use has been limited because of its vinegar odor. This study was done to determine if an H2O2/PA product was acceptable for use in healthcare and assess CD HAI rate after disinfectant change.
Methods: CD HAI rates were compared over 2 periods (Ps) across the same patient care areas. P1 (B) = 1/06 – 11/12. Washout (W) includes 8 months where both products were used. P2 (H2O2/PA) = 8/12 - 4/14
1. CD Environmental Services (EVS) staff educated on the use of H2O2/PA.
2. All staff, including Admin. were engaged.
3. Infection Preventionists (IPs) and EVS promoted H2O2/PA products.
4. Ongoing education provided to staff on efficacy, safety, and smell , “the new smell of clean”.
5. EVS, clinical staff and patient feedback was noted
During P2, overall perception of less damage to the environment, odor appreciated but diffused quickly, and environment cleaner.
HA CDI rates were not significantly different after switching to H2O2/PA products (OR=0.86, CI,0.61-1.2, p=0.43). WP CD HAI rate was similar to P1 and P2.
· H2O2/PA products were not associated with a significant increase in CD HAIs.
· IPs, EVS and Admin. were instrumental in promoting the new smell of clean.
· To date there has been no damage to furniture or equipment, there is no precipitate to remove and the patient care area appears cleaner.
· Despite the change in smell, staff were accepting of the H2O2/PA product.
A. Querry, None
D. Gasparovic, None
B. Depalma, None
L. Rack, None