HPA Microbiological Services Division, Porton Down, Salisbury, UK.
J Hosp Infect. 2011 Sep;79(1):18-22. doi: 10.1016/j.jhin.2011.05.016. Epub 2011 Jul 28.
Decontamination of surfaces and medical equipment is integral to the control of Clostridium difficile transmission, and many products claim to inactivate this bacterium effectively. Thirty-two disinfectants were tested against spores of C. difficile in a suspension test based on European Standard BS EN 13704:2002, with contact times of 1 and 60 min in simulations of clean (0.3% albumin) and dirty (3% albumin) conditions. The addition of a 1-min contact time was chosen as a more realistic simulation of probable real-life exposures in the situation being modelled than the 60 min specified by the Standard. The manufacturer's lowest recommended concentrations for use were tested. Sixteen products achieved >10(3) reduction in viability after 60 min (the pass criterion for the Standard) under both clean and dirty conditions. However, only eight products achieved >10(3) reduction in viability within 1 min under dirty conditions. Three products failed to reduce the viability of the C. difficile spores by a factor of 10(3) in any of the test conditions. This study highlights that the application of disinfectants claiming to be sporicidal is not, in itself, a panacea in the environmental control of C. difficile, but that carefully chosen environmental disinfectants could form part of a wider raft of control measures that include a range of selected cleaning strategies.
表面和医疗设备的消毒是控制艰难梭菌传播的重要环节，许多产品声称能有效地灭活这种细菌。在基于欧洲标准 BS EN 13704:2002 的悬浮试验中，对 32 种消毒剂对艰难梭菌孢子进行了测试，接触时间分别为 1 分钟和 60 分钟，模拟了清洁（0.3%白蛋白）和脏污（3%白蛋白）条件。选择 1 分钟接触时间是为了更真实地模拟标准规定的 60 分钟接触时间以外的实际生活中可能的暴露情况。测试了制造商推荐的最低使用浓度。在清洁和脏污条件下，有 16 种产品在 60 分钟后（标准的合格标准）实现了 >10(3)的存活率降低。然而，只有 8 种产品在脏污条件下 1 分钟内实现了 >10(3)的存活率降低。在任何测试条件下，有 3 种产品都未能将艰难梭菌孢子的存活能力降低 10(3)倍。本研究强调，声称具有杀菌作用的消毒剂的应用本身并不能成为艰难梭菌环境控制的万能药，但精心选择的环境消毒剂可以成为更广泛的控制措施的一部分，其中包括一系列选定的清洁策略。
