Significant impact of terminal room cleaning with bleach on reducing nosocomial Clostridium difficile

The investigators were alerted to increased rates of Clostridium difficile-positive tests at all 3 hospitals in their healthcare system. In response, an intervention of terminal room cleaning with dilute bleach was instituted to decrease the amount of C difficile environmental spore contamination from patients with C difficile infection (CDI). The intervention consisted of replacing quaternary ammonium compound as a room cleaning agent with dilute bleach to disinfect rooms of patients with CDI upon discharge. All surfaces, floor to ceiling, were wiped with dilute bleach applied with towels to thoroughly wet the surfaces. Daily room cleaning remained unchanged. Patients remained on C difficile contact isolation precautions until discharge. The results demonstrate that there was a 48% reduction in the prevalence density of C difficile after the bleaching intervention. The implementation of a thorough, all-surface terminal bleach cleaning programme in the rooms of patients with CDI has made a sustained, significant impact on reducing the rate of nosocomial CDI in this healthcare system. Am J Infect Control. 2010;38(5):350-3. Epub 2010 Jan 31.