Effectiveness of Microfiber Cloths in Reducing Clostridium difficile (CD) from the Patient Environment

Background:

Clostridium difficile infection (CDI) is a common cause of antibiotic-associated diarrhea. The prevalence and severity of Clostridium difficile infection (CDI) in hospitalized patients has significantly increased in U.S. healthcare facilities. The risk for CDI transmission from patient to patient is multifaceted and includes the patient’s environment. Currently, experts recommend using hospital-grade disinfectants for routine cleaning and to consider using bleach during periods of sustained transmission or outbreaks. Cleaning and disinfecting with bleach poses multiple challenges for hospital environmental managers. Microfiber cleaning cloths are cloths made of specialized split fibers designed to provide superior removal of dust, dirt and microorganisms.

Objective:

A study was conducted to determine the ability of microfiber cloths in reducing CD from the patient environment.

Methods:

The study design included surface testing of bedrails and inside bathroom door knobs; before and after cleaning with a microfiber cloth. Microfiber cloths with hospital-grade disinfectant were used in place of existing cotton wipes with disinfectant. Measurements were conducted in rooms of patients with active CDI disease. Each surface was cultured on CD selective media and then measured using Adenosine 5’-triphospate bioluminescent (ATP) technology ATP technology detects the presence of organic matter (dirt, dust and microorganisms), which is measured in Relative Light Units (RLUs). Bedrails and bathroom door knobs were selected based on previous study findings, which identified the two surfaces as the most contaminated, in terms of RLUs, in occupied rooms. The surfaces were then wiped once with the microfiber and disinfectant cloth to mimic poor cleaning performance. After the surface dried; a final culture and ATP test was obtained. Each culture and ATP swab test was performed on separate, but adjacent and equal sized sections of the surface.  

Results:

118 cultures and 118 ATP measures were taken in 29 CDI patient rooms. Culture results demonstrated a reduction of CD. CD positive sites were reduced from 20% to 1% after microfiber cleaning. ATP bioluminescent testing, measured in Relative Light Units (RLUs) demonstrated a reduction of organic matter (dirt, dust and microorganisms) from the environment. Accounting for both surfaces, mean ATP values went down from 402 RLUs to 115 RLUs.

Conclusions: Microfiber cloths were effective in reducing the bioload of CD in the patient’s environment. Reducing CD bioload in the environment may reduce the risk of CD transmission. Microfiber cleaning cloths demonstrated a reduction in organic matter, as measured in ATP and offers an alternate method for removal of CD without impacting routine cleaning procedures.