Selecting the Best Disinfectant/Application Method: Keeping C difficile and C auris at Bay

A recent study by NYU Langone investigators determined that disinfecting high-touch surfaces within patient rooms with NaDCC via wipes and electrostatic sprayers yielded lower mean bacteria colony counts.

Globally, environmental surfaces within patient rooms are a significant cause of health care-associated infections (HAIs). Even with improved and expanded mitigation strategies, HAIs remain, including Clostridioides difficile and Candida auris. In fact, C difficile can be spread via the hospital bed if not disinfected correctly.

Because sporicidal disinfectants are necessary to control C difficile and C auris, innovative application methods such as electrostatic sprayers may increase disinfection effectiveness. The investigators of a recent study published in the American Journal of Infection Control, “The Evaluation of Electrolyzed Water (EW), Sodium Dichloroisocyanurate (NaDCC), and Peracetic Acid (PAA/H2O2) with Hydrogen Peroxide for the Disinfection of Patient Room Surfaces,” used a standardized protocol to evaluate 3 sporicidal disinfectants, including electrolyzed water (EW), sodium dichloroisocyanurate (NaDCC; PURTABS, Earthsafe, Massachusetts), and peracetic acid/hydrogen peroxide (PAA/H2O2; Oxycide, Ecolab, Minnesota).

“In addition to developing environmental surveillance to assess disinfection of surfaces within patient care locations, new sporicidal chemical disinfectants, and application methods with minimal toxicity and surface damage profiles are needed to combat the rise of surface-persistent pathogens,” the investigators noted in the study. “EW, NaDCC, and PAA/H2O2 are less toxic and corrosive than bleach-based products, but efficacy data based on routine use in the health care setting is scarce.”

The investigators analyzed 774 samples. Overall, NaDCC-disinfected surfaces had a lower mean colony count (14 CFU) compared with PAA/H2O2 (18 CFU, P = .36) and EW (37 CFU, P < .001). PAA/H2O2 and EW had more samples with any growth (both P < .05) compared with NaDCC. NaDCC applied with wipes and an electrostatic sprayer had the lowest number of samples with no growth and < 2.5 CFU/CM2 (difference not statistically significant).

The study was conducted at 2 New York City hospitals with a combined 1082 beds over 18 months. The use of electrostatic sprayers was incorporated into EW and NaDCC. The investigators sampled five surfaces in randomly selected rooms for microbial colony counts after cleansing. Data analyses were performed using negative binomial logistic regression.

Infection Control Today® spoke with Rich Prinz, global vice president of sales for EvaClean (manufacturer of the PURTABS), and Brian Spada, area vice president, Mid-Atlantic, to further understand the implications of the data.