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Polyhexamethylene as Successful as Chlorine in Disinfecting During Clostridium difficile Outbreak: Presented at ICAAC

By Ed Susman

SAN FRANCISCO -- September 16, 2009 -- Polyhexamethylene guanidine hydrochloride-based products were able to disinfect surfaces in patient hospital rooms during a Clostridium difficile outbreak better than chlorine-based disinfectants, according to researchers presenting at the 49th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC).

"The total number of positive environmental swabs was significantly lower [P < .05] in wards using polyhexamethylene than in wards using chlorine," said Laura Lindholm, MSc, Turku University Hospital, Turku, Finland, speaking at a poster presentation here on September 15.

"As part of the infection-control measures used to combat the C difficile outbreak, the isolation rooms were disinfected daily with 1,000 ppm chlorine," Lindholm explained. "However, the corrosive nature of chlorine creates a need for a new effective, environmental and user-friendly sporicidal disinfectant."

In the study, either chlorine-based or polyhexamethylene-based products were used to disinfect wards where 20 patients had been placed during an epidemic outbreak of C difficile. Environmental swabs were taken from 15 different sites in the isolation rooms housing symptomatic patients. Swabs were also taken from control rooms. The rooms were sampled 3 times -- at day 1, day 3-5, and day 7-9.

During the initial swab-collection process, about 8% of the samples from the polyhexamethylene-disinfected rooms and 11% of the samples from the chlorine-disinfected rooms were positive for C difficile. The positive samples decreased during the second time period and further decreased for both sample groups in the third time period.

Overall, the researchers collected 1,226 environmental swabs, and found that 32 of 630 (5.1%) of the polyhexamethylene samples from the study wards and 48 of 596 (8.1%) of the chlorine samples from the control rooms were positive for C difficile.

"Polyhexamethylene guanidine hydrochloride-based disinfectant is a promising new sporicidal hospital-cleaning agent," Lindholm concluded. "While we consider this agent at least as good in disinfecting surfaces as chlorine in the wards where there is a C difficile outbreak, this new disinfectant also has other advantages: It is odourless, it does not have the distinctive chlorine smell, and it is not corrosive."

Lindholm said that polyhexamethylene is available for use in hospitals in Canada, the United Kingdom, and in the Nordic countries in Europe. It is not available yet in the United States.

[Presentation title: Comparison of the Polyhexamethylene Guanidine Hydrochloride (PHMG)-Based and Chlorine-Based Disinfectant in a C difficile Outbreak Setting. Abstract K-2091]

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