title: Inactivation of Clostridium difficile spores by disinfectants.
abstract: OBJECTIVE
  The current study was designed to evaluate the activity of glutaraldehyde-based disinfectants against Clostridium difficile using the Association of Official Analytical Chemists' (AOAC) sporicidal test. This study was undertaken because gastrointestinal endoscopes that may be contaminated with C difficile spores are most commonly disinfected between patients using glutaraldehyde-based disinfectants.
  
  
  METHODS
  Using the AOAC test, the following disinfectants were tested: 2% alkaline glutaraldehyde, 2% acid glutaraldehyde, a 1:16 dilution of a 2% glutaraldehyde-7.05% phenol-1.20% sodium phenate, and a 1:20 dilution of a 10% glutaraldehyde-0.5% phenylphenol-0.1% amylphenol.
  
  
  RESULTS
  Test results of the four disinfectants against C difficile spores at exposure times of 10, 20, and 60 minutes were as follows (number of positive penicylinders per 30 replicates): 0, 0, and 0 for 2% alkaline glutaraldehyde; 6, 3, and 0 for 2% acid glutaraldehyde; 30, 29, and 30 for a 1:16 dilution of glutaraldehyde-7.05% phenol-1.20% sodium phenate; and 30, 30, and 30 for a 1:20 dilution of glutaraldehyde-0.5% phenylphenol-0.1% amylphenol.
  
  
  CONCLUSIONS
  C difficile spores are more susceptible to inactivation by glutaraldehyde-based disinfectants than the spore-forming organisms recommended in the AOAC sporicidal test (i.e., Bacillus subtilis and Clostridium sporogenes). Diluting glutaraldehyde-based disinfectants below 2% led to the inability to inactivate spores of C difficile using exposure times commonly employed to disinfect semicritical items such as gastrointestinal endoscopes.
authors.affiliation: Department of Medicine, University of North Carolina, Chapel Hill 27599-7030.
authors.forename: W A
authors.initials: WA
authors.lastname: Rutala
authors.forename: M F
authors.initials: MF
authors.lastname: Gergen
authors.forename: D J
authors.initials: DJ
authors.lastname: Weber
mesh_terms: D016360:Clostridioides difficile / Q000187:drug effects*; D004202:Disinfectants / Q000494:pharmacology*; D020776:Endoscopes, Gastrointestinal; D004866:Equipment Contamination; D005976:Glutaral / Q000737:chemistry / Q000494:pharmacology; D006801:Humans; D013171:Spores, Bacterial / Q000187:drug effects
chemical_list: D004202:Disinfectants; D005976:Glutaral