Clostridium Difficile Clinical Trial
Official title:
Influence of a New Polycationic Disinfectant on Clostridium Difficile Incidence and Environmental Colonisation
The aim of this study is to 1) test the efficacy of PHMG-based disinfectant against C. difficile spores, 2) test whether it reduces the incidence of C. difficile associated disease (CDAD) and 3) evaluate cost.
Environmental disinfection has been proved to be efficient when controlling epidemics caused
by C. difficile. In recent years its epidemiology has changed leading to increased morbidity
and mortality in many countries. C. difficile infections are often difficult to treat and
reinfections frequently occur. The major concern is a new strain of C. difficile, O27, which
produce many times more spores than other types and spreads easily in institutions. Patients
who have a C. difficile infection should be kept in contact isolation in hospitals and other
institutions.
C. difficile is a spore forming bacteria which is resistant to some normally used
disinfectants like alcohol and quats. Spores may remain viable for months in environment.
Disinfectants currently in use, like chloramines and glutaralde-hyde, are risk both for
workers and to environment because of their corrosive and irritating nature.
Polyhexamethyleneguanidine(PHMG) is a new disinfectant which is effective against microbes
including bacteria and bacterial spores, viruses and fungi, safe to people handling it and
friendly to environment and surfaces. It has been tested in the laboratory of Helsinki
University according to many EN-standards to disinfectants. It can be used as a hand
disinfectant, instrument disinfectant and surface disinfectant.
PHMG was introduced in three wards for hand hygiene and environmental disinfection in CDAD
patients' rooms. The rooms for showers and toilets were coated with biocide coating (PHMG)
as well as bed frames in investigational wards. Three wards were control wards and continued
using alcohol based hand disinfectants and routine environmental cleaning and disinfection
with quats/chloramines. After 6 month's intervention period, the incidence of CDAD cases
were compared to that during the preceeding 10 months. Surveillance for environmental and
HCWs´ hand contamination by C. difficile were performed by taking microbiological samples
both from environmental sites and hands twice before intervention and then twice in month
within intervention period.
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Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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