Impact of standard test protocols on sporicidal efficacy

Optimization of Sporulation and Purification Methods for Sporicidal Efficacy Assessment on Bacillus Spores

Validating the efficacy of sporicidal agents is a critical step in current good manufacturing practices for disinfection requirements. A limitation is that the poor quality of spores can lead to false positive sporicidal results. The aim of this study was to explore optimal sporulation and purification methods in Bacillus spores. Spores of seven Bacillus strains were produced in five different sporulation media. After density centrifugation, spore yields were measured by phase-contrast microscopy and enumeration assays. Effects of purification methods including heat, sonication and lysozyme, and maturation on spore qualities were determined by sodium hypochlorite sporicidal assay. Difco Sporulation Media was identified as the preferred sporulation medium for four out of seven tested Bacillus strains. Sporulation rates in B. cereus, B. sphaericus, and B. thuringiensis were higher at 30°C than the rates at 37°C at a difference of 5%, 65%, and 20%, respectively. B. licheniformis favored Mn2+-amended 10% Columbia Broth at 37°C for sporulation with 40-72% higher sporulation rates than other media. The maximum sporulation rates of B. cereus and B. thuringiensis were observed on double-strength Schaeffer's-glucose broth. All studied purification methods improved the spore purity with strain variations. However, intense heat (80°C for 20 min) and lysozyme (100 μg/mL) treatment impaired the spore quality of specific Bacillus strains by sensitizing them against sodium hypochlorite. The length of maturation period had impact on the spore resistance, and the most optimal maturation periods ranged from 7 to 21 days in Bacillus strains. The results of this study will pave the way for further evaluation of sporicidal activity of disinfectants.

Prevalence and Antimicrobial Resistance of Paeniclostridium sordellii in Hospital Settings

(1) Background: The purpose of this study was to determine the prevalence of clostridia strains in a hospital environment in Algeria and to evaluate their antimicrobial susceptibility to antibiotics and biocides. (2) Methods: Five hundred surface samples were collected from surfaces in the intensive care unit and surgical wards in the University Hospital of Tlemcen, Algeria. Bacterial identification was carried out using MALDI-TOF-MS, and then the minimum inhibitory concentrations (MICs) of various antimicrobial agents were determined by the E-test method. P. sordellii toxins were searched by enzymatic and PCR assays. Seven products intended for daily disinfection in the hospitals were tested against Clostridium spp. spore collections. (3) Results: Among 100 isolates, 90 P. sordellii were identified, and all strains were devoid of lethal and hemorrhagic toxin genes. Beta-lactam, linezolid, vancomycin, tigecycline, rifampicin, and chloramphenicol all proved effective against isolated strains. Among all strains tested, the spores of P. sordellii exhibited remarkable resistance to the tested biocides compared to other Clostridium species. The (chlorine-based 0.6%, 30 min), (glutaraldehyde solution 2.5%, 30 min), and (hydrogen peroxide/peracetic acid 3%, 15 min) products achieved the required reduction in spores. (4) Conclusions: Our hospital’s current cleaning and disinfection methods need to be optimized to effectively remove spores from caregivers’ hands, equipment, and surfaces.

Interlaboratory reproducibility of a test method following 4-field test methodology to evaluate the susceptibility of Clostridium difficile spores

BACKGROUND

Sporicidal surface disinfection is recommended to control transmission of Clostridium difficile in healthcare facilities. EN 17126 provides a method to determine the sporicidal activity in suspension and has been approved as a European standard. In addition, a sporicidal surface test has been proposed.

AIM

To determine the interlaboratory reproducibility of a test method for evaluating the susceptibility of a C. difficile spore preparation to a biocidal formulation following the 4-field test (EN 16615 methodology).

METHODS

Nine laboratories participated. C. difficile NCTC 13366 spores were used. Glutaraldehyde (1% and 6%; 15 min) and peracetic acid (PAA; 0.01% and 0.04%; 15 min) were used to determine the spores' susceptibility in suspension in triplicate.

FINDINGS

One-percent glutaraldehyde revealed a mean decimal log₁₀ reduction of 1.03 with variable results in the nine laboratories (0.37-1.49) and a reproducibility of 0.38. The effect of 6% glutaraldehyde was stronger (mean: 2.05; range: 0.96-4.29; reproducibility: 0.86). PAA revealed similar results. An exemplary biocidal formulation based on 5% PAA was used at 0.5% (non-effective concentration) and 4% (effective concentration) to determine the sporicidal efficacy (4-field test) under clean conditions in triplicate with a contact time of 15 min. When used at 0.5% it demonstrated an overall log₁₀ reduction of 2.68 (range: 2.35-3.57) and at 4% of 4.61 (range: 3.82-5.71). The residual contamination on the three primarily uncontaminated test fields was <50 cfu/25 cm² in one out of nine laboratories (0.5%) and in seven out of nine laboratories (4%).

CONCLUSION

The interlaboratory reproducibility seems to be robust.

Disinfectants: The role of standardised testing to aid selection. Part 2

Choosing which disinfectant(s) to use in any particular healthcare environment is a far from trivial task and one that is undertaken by Infection Prevention and Control (IPC) professionals on a regular basis. The recent proliferation in the number and type of products designed to disinfect healthcare surfaces makes for a seemingly bewildering range of options. The primary factor to consider is whether the disinfectant is capable of killing the likely (but unknown) microbial challenge. For reusable non-invasive care equipment, standardised testing provides objective evidence for IPC teams. This second paper seeks to explain these tests and the conditions under which they are performed to aid in the IPC teams’ disinfection selection.

Vulnerability of long-term care facility residents to Clostridium difficile infection due to microbiome disruptions

Aging presents a significant risk factor for Clostridium difficile infection (CDI). A disproportionate number of CDIs affect individuals in long-term care facilities compared with the general population, likely due to the vulnerable nature of the residents and shared environment. Review of the literature cites a number of underlying medical conditions such as the use of antibiotics, proton pump inhibitors, chemotherapy, renal disease and feeding tubes as risk factors. These conditions alter the intestinal environment through direct bacterial killing, changes to pH that influence bacterial stabilities or growth, or influence nutrient availability that direct population profiles. In this review, we examine some of the contributing risk factors for elderly associated CDI and the toll they take on the microbiome.

Impact of test protocols and material binding on the efficacy of antimicrobial wipes

BACKGROUND

The use of effective cleaning/disinfectant products is important to control pathogens on healthcare surfaces. With the increasing number of wipe products available, there is a concern that combination of a formulation with the wrong material will decrease the efficacy of the product. This study aimed to use a range of efficacy test protocols to determine the efficacy of four formulations before and after binding to three commonly used wiping materials.

METHODS

Two quaternary ammonium (QAC)-based products, one hydrogen-peroxide-based product and one neutral cleaner were combined with microfibre, cotton or non-woven materials and tested for efficacy against Pseudomonas aeruginosa and Staphylococcus aureus with two surface tests (ASTM E2197-17 and EN13697-15) and two 'product' tests (ASTM E2967-15 and EN16615-15).

FINDINGS

Overall, the impact of using different materials on formulation efficacy was limited, except for an alkyl(C_12-16)dimethylbenzylammonium chloride-based product used at 0.5% v/v. The hydrogen peroxide product was the most efficacious regardless of the material used. The results from wipe test ASTM E2967-15 were consistent with those from the surface tests, but not with EN16615-15 which was far less stringent.

CONCLUSIONS

The use of different wiping cloth materials may not impact severely on the efficacy of potent disinfectants, despite the absorption of different volumes of formulation by the materials. QAC-based formulations may be at higher risk when a low concentration is used. There were large differences in efficacy depending on the standard test performed, highlighting the need for more stringency in choosing the test to make a product claim on label.

Evaluating the Sporicidal Activity of Disinfectants against Clostridium difficile and Bacillus amyloliquefaciens Spores by Using the Improved Methods Based on ASTM E2197-11

Spore-forming pathogenic bacteria, such as Clostridium difficile, are associated with nosocomial infection, leading to the increased use of sporicidal disinfectants, which impacts socioeconomic costs. However, C. difficile can be prevented using microorganisms such as Bacillus amyloliquefaciens, a prophylactic agent that has been proven to be effective against it in recent tests or it can be controlled by sporicidal disinfectants. These disinfectants against spores should be evaluated according to a known and recommended standard. Unfortunately, some newly manufactured disinfectants like Bioxy products have not yet been tested. ASTM E2197-11 is a standard test that uses stainless steel disks (1 cm in diameter) as carriers, and the performance of the test formulation is calculated by comparing the number of viable test organisms to that on the control carriers. Surface tests are preferable for evaluating disinfectants with sporicidal effects on hard surfaces. This study applies improved methods, based on the ASTM E2197-11 standard, for evaluating and comparing the sporicidal efficacies of several disinfectants against spores of C. difficile and B. amyloliquefaciens, which are used as the test organisms. With the improved method, all spores were recovered through vortexing and membrane filtration. The results show that chlorine-based products are effective in 5 min and Bioxy products at 5% w/v are effective in 10 min. Although Bioxy products may take longer to prove their effectiveness, their non-harmful effects to hospital surfaces and people have been well established in the literature.

Sporicidal efficacy of thermal-sprayed copper alloy coating

Approximately 200 000 Canadians acquire healthcare-associated bacterial infections each year and several-fold more acquire food-borne bacterial illnesses. Bacterial spores are particularly problematic because they can survive on surfaces for several months. Owing to its sporicidal activity, copper alloy sheet metal is sometimes used in hospital settings, but its widespread use is limited by cost and incompatibility with complex furniture and instrument designs and topographies. A potential alternative is the use of thermal spray technology to coat surfaces with copper alloys. We compared the sporicidal activity of thermally sprayed copper alloy on stainless steel with that of copper alloy sheet metal against Bacillus subtilis spores. Spores remained intact for at least 1 week on uncoated stainless steel, whereas spore fragmentation was initiated within 2 h of exposure to either copper surface. Less than 15% of spores were viable 2 h after exposure to either copper surface, as compared with stainless steel. By day 7, only degraded spores and petal-like nanoflowers were present on the copper surfaces. Nanoflowers, which are laminar arrangements of thin crystal sheets composed of carbon - copper phosphate, appeared to be derived from the degraded spores. Altogether, these results indicate that a thermal-sprayed copper alloy coating on stainless steel provides sporicidal activity similar to that afforded by copper alloy sheet metal.