Clostridioides Difficile: Environmental Cleaning
C. difficile does present a challenge given its ability to produce spores. These spores are not inactivated by many disinfectants commonly used in hospitals and can survive for up to five months in the environment. If there is evidence of an ongoing cluster of infections, an undesirably high endemic rate or outbreak of CDI, disinfection of surfaces using 1:10 dilution of sodium hypochlorite (liquid bleach) may lower contamination of the environment with C. difficile spores. Bleach, however, is not a particularly effective agent for cleaning environmental surfaces, so a detergent to remove soil before attempting disinfection is still recommended. There is some evidence that bleach and other oxidizing disinfectants can inactivate spores, however both contact time and concentration are important parameters to follow.
Cleaning with Bleach, Using Household Measurement Terms
| Bleach Solution | Dilution Exact | Chlorine (ppm) | Dilution approximate | Household (ppm) Approximate | Application |
|---|---|---|---|---|---|
| 5.25% – 6.15% | Concentrate | 52,500 – 61,500 | Concentrate | 52,500 – 61,500 | *Patient Care |
| 5.25% – 6.15% | 1:10 | 5,250 – 6,150 | 1.5 cups / 1 gallon | ~6000 | *Patient Care |
| 5.25% – 6.15% | 1:100 | 525-615 | 0.25 cup / 1 gallon | ~600 | *Patient Care |
| 5.25% | 1:200 | 263 | 1 tablespoon / 1 gallon | <200 | Dietary |
| 5.25% – 6.15% | 1:1000 | 53-62 | 1 teaspoon / 1 gallon | ~50 | Dietary |