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Clostridium difficile - from harmless germ to deadly hazard

Clostridium difficileClostridium difficile is an anaerobic, rod-shaped bacterium with high environmental persistence. It ranks fifth among the most common hospital infections and was long classified as relatively harmless. For more than 30 years, this bacterium has been known to be the pathogen responsible for causing Clostridium difficile-associated diarrhea (CDAD). Usually, the intestine of healthy persons is colonised with relatively small numbers of the inactive (spore-forming) bacterium. If a significant part of the natural intestinal flora is destroyed, for example by the use of a broad spectrum antibiotic, Clostridium difficile can multiply without difficulty because of its special resistance properties and the absence of competition from other bacteria.

Spores are an extremely resistant dormant form of certain bacterial species and are formed under unfavourable viability conditions. Bacterial spores are highly dehydrated, show no metabolic activity and are surrounded by a coat giving them effective protection against radiation, chemicals and heat. Bacterial spores are capable of surviving in a germinable state for many months on the surfaces of floors, equipment, instruments and furniture; when viability conditions improve, they can germinate again and multiply. Contaminated hands are one major source of infection: direct contact between physicians, nurses, patients and equipment inevitably becomes a risk without hand washing. Particularly at risk are people with a severely weakened immune system, elderly people or patients requiring chemotherapy, antibiotic therapy or tube feeding. The pathogens are transmitted by the fecal-oral route by direct or indirect contact. The consistent and rapid implementation of hygiene measures by trained personnel is therefore of paramount importance to interrupt the chain of infection. The risks of transmission associated with Clostridium difficile can be virtually eliminated by correct and targeted disinfection measures using effective products and methods. Due to their concentration and when used with the specified exposure time, disinfectants listed by the VAH (Association for Applied Hygiene) have the properties required to kill the vegetative form of the bacterium. Spores of Clostridium difficile can be combated by using sporicidal products, e.g. based on aldehydes, oxygen splitters or certain per-compounds.

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