Spore Busters L élimination des spores de Clostridium difficile Het verwijderen van Clostridium difficile sporen Johan Van Broeck Laboratoire de référence C. difficile Referentielaboratorium UCL Brussel Bruxelles 15 / 11 / 28
Resistant to: spores Alcohol Heat Dry-out Detergent Antiseptic s 15 / 11 / 28
Important contamination of the room Toilet Sink Bathroom Floor Already 24 H after patient isolation Persistant up to 4 day s Mulligan M. et al Current Microbiology 1979; 3: 173-5 15 / 11 / 28
Evaluation of Hospital Room Assignment and Acquisition of Clostridium difficile Associated Diarrhea M. SHAUGHNESSY 1, R. MICIELLI 1, D. DEPESTEL 1, J. ARNDT 1, C. STRACHAN 1, K. WELCH 2, C. CHENOWETH 1 1 Univ. of Michigan Hlth.Systems, Ann Arbor, MI, 2 Ctr. for Statistical Consultation and Res., Ann Arbor, MI. Number of patients who catched CDIF diarrhea Was more than double when assigned in A room where former occupant had CDAD. (study on 136 CDAD cases) 15 / 11 / 28
REWARD: $ $ $ 15 / 11 / 28
Dr A. Simon J. Van Broeck 15 / 11 / 28
BENOR AOAC ENOR EN 13727 AFNOR QUID? EN 1276 EN 165 EINECS EN 61-6-2 DIN EN 374-3 Directive 92/32/EEC DO THEY WORK Dia 7 IN PRACTISE? EN 61-6-4 ELINCS 73/23/EC EN 6947-1 Directive 93/21/EEC 89/336/EC 15 / 11 / 28
Broth of C. difficile Anaerobic incubation (1 day s at 37 C) reduced 1 X by centrifugation 1 ml C. difficile + 9 ml absolute ethanol Evaporation 15 / 11 / 28
Once the active product dried on the Petri plates + 1 ml Letheen broth (in order to neutralise) Spread out 2 µl of successive dilutions on CCFA + Taurocholate, incubate 48h at 37 C 15 / 11 / 28
Hymetec TECare Control TECare Ultra Micromist Anios Anioxyspray Dismozon Multi-eco-surface Nocospray Ecomed Tristel Fuse for surfaces Duo foam Bleach 15 / 11 / 28
Sporicidal activity Bleach 5 ppm on C. difficile 1 1 1 1 1 1 1 1 1 contrôle 5' 1' 15' dry-out NAP1/27 (1165) ATCC43596 spores NAP1/27 (1165) ATCC43596 control 115 126 5' 1' 15' dry-out 15 / 11 / 28
Anios Anioxyspray H 2 O 2 5% Ethanol 91.6 mg/g tensio-actif amphotere ph 7.5 C. difficile control plate anioxy-spray serotype A 4 serotype C 37 serotype G 52 serotype D 39 serotype F 51 VPI 5 CL252 (27) 48 CL262 (27) 43 223 (27) 44 167 (27) 51 1165 (27) 47 15 / 11 / 28
Hymetec Sporicidal activity of Eco-Surface-Desinfectant (Hymetec-belgium) on C. difficile spores 1 1 1 1 1 1 1 1 1 control contrôle Multi-eco-surface NAP1/27 (167) VPI1463 spores NAP1/27 (167) VPI1463 control Multi-eco-surface 132 143 15 / 11 / 28
Ecomed Tristel fuse for surfaces Tristel duo foam 15 / 11 / 28
Sporicidal activity of Tristel Duo (liquid) (Liquid or foam) Ecomed 1 1 1 1 1 1 1 1 1 control Tristel Duo NAP1/27 (1165) VPI 1463 Active component : Chlorinedioxide 15 / 11 / 28
Ecomed Sporicidal activity of Tristel fuse for surfaces 25 times diluted on C. difficile 1 1 1 1 NAP1/27 (1165) ATCC43596 1 contrôle control 5' 1' 15' dry-out 15 / 11 / 28
Sporicidal activity of dilutions from Tristel fuse for surfaces on C. difficile 1 Ecomed 1 1 1 1 1 1 NA P 1/27 (1165) A TCC43596 1 1 ccontrol ontrôle 1/1 1/5 1/1 1/15 1/2 1/25 15 / 11 / 28
Dismozon actif for disinfecting tools and surfaces Actif Substance: Magnesium-monoperoxyphtalate C. difficile control Dismoson 1165 (27) 1 CL 1764 (27) 3 5 CL1761 (27) 5 CL1767 (27) 1 3 CL 262 (27) 5 5 CL 252 (27) 2 3 167 (27) 1 25 sérotype A (ATCC43594) 4 sérotype C (ATCC43596) 1 2 sérotype F (ATCC43598) 4 6 sérotype D (ATCC43597) VPI (1463) 8 3 9 15 / 11 / 28
SPORE BUSTERS 15 / 11 / 28
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Barcelona 28 15 / 11 / 28
STERINIS STERUSIL Components: H 2 O 2 5 % Silver kations 15 / 11 / 28
In situ efficacy in rooms of patients with CDAD In vitro activity on surfaces artificially contaminated by spores of C. difficile. 15 / 11 / 28
In vitro study :«quantitative spores carrier test» method (Majcher et al., AEM 27) 2 materials (4 cm2) were artificially contaminated with ~ 4.1 6 spores of CD : Polyvinyl chloride (PVC) Laminate 3 strains : VPI 1463 : reference strain of toxinotype Strain 167 : epidemic strain «27» CD 196 : historical strain «27» [Popoff et al., 1988] Each assay was repeated 4 times 15 / 11 / 28
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In situ 12 surfaces (1cm2) were swabbed, before / after disinfection : Direct inoculation on Taurocholate Cycloserine Cefoxitine agar (TCCA) plates Enriched in Taurocholate.5% enriched Schaedler broth Incubation 48 hours, 37 C, anaerobiosis 15 / 11 / 28
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Hymetec: Nocospray -6% H 2 O 2 - Silver kations ( < 5 ppm) Dry brumisation turbomotor 8 m/sec Preheated liquid 37 C programmable Tests in vitro at the Iris Bracops Hospital in collaboration with Dr Huybrechts 15 / 11 / 28
(spores) NAP1/27 (167) ATCC43598 Laboratory control 152 123 on the bed 1 On the floor under the bed 2 In the right corner from the room 3 In the hall 4 Sporicidal activity of Nocospray using 6 % hydrogen peroxide in a patient's room 1 1 1 1 1 1 NAP1/27 (167) ATCC43598 1 1 1 contrôle 1 2 3 4 15 / 11 / 28
TECare Control TECare Ultra chemical matrix with Antimicrobial or Antisporicidal substance 15 / 11 / 28
Sporicidal activity of TECare products on C. difficile 1 1 1 1 1 1 1 1 1 control TECare control TECare Ultra NAP1/27 (167) ATCC 43596 15 / 11 / 28
Prolonged activity of TECare Control Sporicidal activity of TECare Control in time 1 1 1 1 1 1 1 1 1 control incub. 5' incub. 24 h incub. 48 h NAP1/27 (167) ATCC 43596 15 / 11 / 28
Sporicidal activity of TECare Ultra dilutions on C. difficile 1 1 1 1 1 1 1 1 1 control 1/5 1/1 1/2 1/5 1/1 1/5 NAP1/27 (1165) VPI 1463 ( the product is not neutralizable, with Letheen broth) 15 / 11 / 28
Prolonged activity of TECare Ultra Sporicidal activity of TECare Ultra diluted 2 X in time 1 1 1 1 1 1 1 1 1 control 5' 24 h 48 h 72 h 96 h NAP1/27 (1165) VPI 1463 15 / 11 / 28
Sporicidal activity of TECare Ultra with Micromist 1 1 1 1 1 1 1 1 1 control 1/5 1/6 1/75 NAP1/27 (167) ATCC 43596 15 / 11 / 28
Sporicidal activity of TECare Ultra, coated,non-diluted, on a surface 1 1 1 1 1 1 1 1 control 5' 24 h 48 h NAP1/27 (1165) VPI 1463 15 / 11 / 28
Sporicidal activity of TECare Ultra, coated, diluted 2 X on a surface 1 1 1 1 1 1 1 1 control 5' 24 h 48 h NAP1/27 (1165) VPI 1463 15 / 11 / 28
Conclusion: To eliminate C. difficile spores Sporebusters with hydrogenperoxide are effective Dismozon works to disinfect tools Anioxyspray and Tristel Duo work as a sporicidal foams Tristel fuse for surfaces works up to 1 X diluted Sporebuster TECare Ultra is effective with prolonged antisporicidal activity Laboratoire de référence C. difficile Referentielaboratorium UCL Brussel Bruxelles 15 / 11 / 28