C-Diff Transmission Potential with Sharps Containers


Authors:   Grimmond T, Neelakanta A, Miller B, Saiyed A, Gill P, Cadnum J, Olmsted R, Donskey C, Pate K, Miller K

Publication:   Clostridium Difficile: Carriage & Transmission potential by single-use and reusable sharps containers. American Journal of Infection Control 46 (2018) 1154-9 



What is the study?

This article explores and challenges the idea that sharps containers could play a role in C Difficile transmission to patients or staff. Through extensive research and validation of multiple single use and reusable sharps containers, it finds that the assertion that sharps containers may be a fomite for C. Difficile transmission is unfounded. 


Design and Methods 

A multi-faceted epidemiologic, epidemiologic, microbiologic, chain-of-infection, and test-of-evidence approach was employed. 197 Sharpsmart reusable sharps containers (RSC's) were sampled for C. Difficile at processing facilities. Sharpsmart sharps containers were challenged with high C. Difficile densities to evaluate efficacy of automated decontamination through the Daniels Washsmart process. 50 Sharpsmart reusable sharps containers and 50 Disposable sharps containers (DSC's) were sampled in CDI patient rooms in 7 hospitals for C. Difficile carriage. 


What did we learn?

As a result of studying 100 reusable sharps containers and disposable sharps containers: 

  • Stage 1: C. difficile spores were found on 9 of 197 (4.6%) reusable sharps containers prior to processing
  • Stage 2: Decontamination processing completely removed C. difficile
  • Stage 3: 4 of 50 reusable sharps containers (8%) and 8 of 50 disposable sharps containers (16%) had sub-infective counts of C. difficile.
  • 2 links in the chain of infection were found to be broken
  • 5 of 7 tests of evidence for environmental sources of infection were found to be unmet.


“…neither DSCs nor RSCs play a role in C. difficile transmission to patients or staff…the assertion that sharps containers may be a fomite for C. difficile transmission is not scientifically feasible.”



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