Fran Lowry

May 19, 2015

ORLANDO, Florida — A novel sporicidal ethanol formulation applied to gloves before they are donned might prevent the contamination of hands with Clostridium difficile when the gloves are removed, researchers report.

"Together with good personal protective equipment, glove disinfection can reduce contamination to zero," said Myreen Tomas, MD, from the Cleveland Veterans Affairs Medical Center.

"You can still have C difficile spores on your hands after hand washing, so if you disinfect your gloves first and then wash your hands, this would give you an added layer of protection," she told Medscape Medical News.

"Alcohol by itself does not kill C diff spores, but the new formulation that we are developing gives alcohol that property. Eventually, we would like this to lead to the decreased acquisition of C diff on hands, and ultimately decrease C diff infection rates," Dr Tomas said here at the Society for Healthcare Epidemiology of America Spring 2015 Conference.

Dr Tomas and her team assessed spore contamination on the gloves of healthcare personnel interacting with patients infected with C difficile or working in the patient's environment.

Dr Myreen Tomas

They compared the reduction in spores on gloves inoculated with C difficile that had been treated with one of four applications for 30 or 60 seconds: the sporicidal ethanol formulation, 70% ethanol, and household bleach in 1:10 and 1:100 dilutions.

All solutions were applied to the gloves in two different ways — as a liquid and as a wipe.

The researchers also applied the different solutions to pieces of colored cloth to determine their potential for damaging or discoloring clothing.

With the sporicidal formulation, reductions in spore levels were 1.4 log with the 30 second liquid application, 2.0 log with the 60 second liquid application, 2.0 log with the 30 second wipe application, and 2.5 log with the 60 second wipe application. The formulation had no effect on the cloth samples.

With the 70% ethanol formulation, reductions in spore levels were less than 1.0 log with both liquid applications and both wipe applications.

The 1:100 dilution of bleach was similar to the sporicidal formulation at both 30 and 60 seconds. The 1:10 dilution was more effective, with a reduction in spores of more than 3.0 log. However, there was significant staining of the cloth samples.

Impact on C difficile Transmission

Dr Silvia Munoz-Price

"The fact that this novel sporicidal is not bleach is a very good advance," said Silvia Munoz-Price, MD, from Froedtert & the Medical College of Wisconsin in Milwaukee.

"The problem with bleach is that it destroys fabric. If for any reason you touch your clothes, they are going to end up being discolored, so there is an advantage to not using bleach," she told Medscape Medical News.

"The researchers showed that their formulation is effective in disinfecting gloves before they are removed. The next step is to figure out if that will impact the rate of contamination of the hands of the providers who wiped with this sporicidal solution," she explained.

In addition, it must determined whether "removing those C difficile spores from the gloves will then decrease transmission of C difficile among our patients," Dr Silvia Munoz-Price said.

Dr Tomas and Dr Munoz-Price have disclosed no relevant financial relationships.

Society for Healthcare Epidemiology of America (SHEA) Spring 2015 Conference: Abstract 7068. Presented May 15, 2015.


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