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INFECTION PREVENTION
terial spores (such as C. difficile) fungi (such as Candida), vegetative
bacteria (such as Staphylococcus and Pseudomonas).1 There are others on the resistance spectrum, but prions are the most difficult to
kill. The good news? You can rest easy: Surfaces and the environment
don't play a role in prion transmission.2
2. A patient has explosive diarrhea upon entry to the OR. You discover from
the patient's record that an assay for Clostridium difficile is pending.
What chemical disinfectant would you ask the housekeeper to use to
clean the room after the case?
a. quaternary ammonium compound
b. a hospital-grade, EPA-approved disinfectant
c. 1:10 bleach-based product
d. 70% isopropyl alcohol
Answer: c. 1:10 bleach-based product.
C. difficile is an anaerobic, gram-positive bacterium that can persist
for extended periods on a variety of surfaces in the environment
because it is spore-forming. According to the Guide to the
Elimination of Clostridium difficile in Healthcare Settings, "The
term 'hypersporulation' has been used to denote the propensity of the
bacterium to move from the vegetative form to the spore form with
increased rapidity. The term has also been used to note that contact
with some germicides stress the bacterium, so it more readily transiJ A N U A R Y 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
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