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CLOSTRIDIUM DIFFICILE : PRESENT PRACTICE

# # # # # 90 DEATHS PER WEEK # # # # #

It is clear that effective hygiene is vital in both controlling and preventing outbreaks. However, the spores formed by C.difficile are very resistant to disinfection.

Within the NHS, the oxidising agent bleach (sodium hypochlorite) is widely used for controlling C.difficile.

Despite the low price of bleach, there are significant disadvantages. To be effective against C.difficile spores, it must be used (but seldom is) at the high concentration of 5000ppm of sodium hypochlorite. At this strength, there are many problems:

Release of gas from solution, which is unpleasant
Highly corrosive, destroys stainless steel
Forms carcinogens in combination with some chemicals (amines)
Rapidly inactivated by organic matter such as faeces, blood, vomit etc.
Only short term stability for products as supplied (6 month half-life)

Some of these problems can be reduced by using other forms of chlorine, like chlorine tablets which produce hypochlorous acid. However, similar concentrations are needed to achieve only a modest effect against bacterial spores.

For these reasons, companies have been searching for alternatives.

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