Simple Soap and water hand washing best for controlling Clostridium difficile

No 1 in a "Cut out and Keep" series on healthy living ..

Clostridium difficile, which is the new drug resistant bacterium that is killing the elderly in hospitals across the developed world, is best removed with washing with simple soap and water a recent Canadian study concludes - this was reported to the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy in Chicago this week.

Dr. Michael Libman, director of the division of infectious diseases at the McGill University Health Centre recruited 10 volunteers and contaminated their hands with Clostridium difficile, one of the most difficult bacteria to combat in hospitals settings. Its usually spread by faecal contamination - Ygh! The volunteers washed with either:

1. Regular soap and warm or cold water,
2. Antiseptic soap and warm water,
3. An alcohol-based solution,
4. And a disinfectant towel.

"The results were striking: the protocols that involved washing with water eliminated more than 98 % of the bacteria, while washing with an alcohol-based solution eliminated almost none! The protocol involving a disinfectant towel eliminated around 95 % of bacteria." Dr. Matthew Oughton, a researcher in Libman's team said.

Clostridium is a sporulating bacterium - it produces extremely resistant spores to survive in hostile environments which develop into bacteria under the right conditions for growth.
Oughton says the results reflect the view that alcohol eliminates the living bacteria but not the spores. The mechanical action of washing combined with the chemical action of soap eliminates both.

It may be of interest that the UK department of health "A simple guide to Clostridium difficile" Dated February 8th 2007 , under notes on infection control, recommends ..".- handwashing (not relying solely on alcohol gel as this does not kill the spores)"

BBC Online, in February this year , reported by the Office for National Statistics that death certiificates issued in the England & Wales (not incl. NI & Scotland) involving Clostridium difficile rose by 69% to 3,800 from 2004-05. The same report stated that .."Rigorous cleaning with warm water and detergent is the most effective means of removing spores from the contaminated environment and the hands of staff, say experts. "

In January 2004, the Health Protection Agency introduced a mandatory reporting scheme for all cases of C. difficile in persons aged 65 and over. Data from the scheme show an increase between 2004 and 2005 in the number of C. difficile reports. (Complete HAI Stats Summer 2007 here )

UPDATE Saturday 8.00 pm BST

"Writing" in the News of the World the premiere "tits'n'bums" rag in the Murdoch stable Prime Minister Gordon Brown says he has ordered a deep clean of every hospital in Britain to tackle hospital "superbugs".

Every hospital will be disinfected and scrubbed clean over the next year

"A ward at a time, walls, ceilings, fittings and ventilation shafts will be disinfected and scrubbed clean," says the Scotsman.

In a desperate attempt to make it look like action is imminent to meet NHS victims complaints -"I've learned from what people have told me and I've heard the need for change," - he also announces some changes / face lifts / improvements ( no timetable provided) -

1. Patients to see GPs out of hours and at weekends. Ho.Ho.Ho. Not in this neck of the woods you won't - you are lucky to seem them between 9.30 and 3.00 with an hours lunch Monday - Thursday

2. He said access would also be improved, whether it be NHS walk-in centres or GP surgeries in high-street stores like Boots or Tesco.

3. Breast and colon cancer screening to include more people.

4. Cervical smear test results will be issued within 14 days, Brown said, without specifying when the changes would take place.

So if you see a nurse / doctor or the rare and stray administrator spraying / misting / their hands with alcohol gels,sprays / misters - (even Chanel No 5) just ask them to wash their hands in nice warm soapy water.