title: Equal efficacy of glucoprotamin and an aldehyde product for environmental disinfection in a hematologic transplant unit: a prospective crossover trial.
abstract: BACKGROUND
  The inanimate hospital environment has emerged as an important reservoir of nosocomial pathogens. In particular, multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus, Acinetobacter species, and Clostridium difficile, play a major role in the transmission of hospital-acquired infections. In Europe, aldehydes, chlorine, and quaternary ammonium compounds have been commonly used for environmental disinfection. Glucoprotamin, a newer active compound for disinfectants, has been clinically tested for disinfection of instruments but not for environmental disinfection.
  
  
  OBJECTIVE
  This study evaluated the antimicrobial effectiveness of a glucoprotamin-containing product (Incidin) compared with that of an aldehyde-containing product (Deconex), the current standard at our institution.
  
  
  METHODS
  This prospective crossover study was conducted in our access-restricted hematologic transplant unit. A total of 3,086 samples from the environment were processed and examined for overall bacterial burden as well as selectively for S. aureus, C. difficile, and gram-negative bacteria.
  
  
  RESULTS
  There was no significant difference in residual bacteria after disinfection between the 2 products in terms of overall burden and selected pathogens. Enterococci were the predominant pathogens recovered from surfaces, but no vancomycin-resistant enterococci were recovered. Similarly, C. difficile could not be found in the patients' environment, even in rooms, despite the use of selective media.
  
  
  CONCLUSIONS
  The aldehyde-containing product (Deconex) and the glucoprotamin-containing product (Incidin) demonstrated similar efficacy against environmental contamination in a hematologic transplant unit with the application of selective media for C. difficile, S. aureus, and gram-negative bacteria in addition to standard medium.
authors.affiliation: University Hospital Basel, Basel, Switzerland.
authors.forename: Ruth
authors.initials: R
authors.lastname: Meinke
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meyer
authors.forename: Reno
authors.initials: R
authors.lastname: Frei
authors.forename: Jakob
authors.initials: J
authors.lastname: Passweg
authors.forename: Andreas F
authors.initials: AF
authors.lastname: Widmer
mesh_terms: D000447:Aldehydes / Q000494:pharmacology*; D016360:Clostridioides difficile / Q000187:drug effects / Q000302:isolation & purification; D003428:Cross Infection / Q000517:prevention & control; D018592:Cross-Over Studies; D003959:Diamines / Q000494:pharmacology*; D004202:Disinfectants / Q000494:pharmacology*; D004203:Disinfection / Q000379:methods*; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006405:Hematology; D006757:Hospital Units; D011446:Prospective Studies; D011760:Pyrrolidinones / Q000494:pharmacology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D033581:Stem Cell Transplantation; D013557:Switzerland
chemical_list: D000447:Aldehydes; D003959:Diamines; D004202:Disinfectants; D011760:Pyrrolidinones; C089578:glucoprotamine