Background
A 2015 study matching use of disposable and reusable sharps containers (DSCs, RSCs)
with Clostridium difficile infection (CDI) incidence found a decreased incidence with DSCs. We conducted microbiologic
samplings and examined the literature and disease-transmission principles to evaluate
the scientific feasibility of such an association.
Methods
(i) 197 RSCs were sampled for C. difficile at processing facilities; (ii) RSCs were challenged with high C. difficile densities to evaluate efficacy of automated decontamination; and (iii) 50 RSCs and
50 DSCs were sampled in CDI patient rooms in 7 hospitals. Results were coupled with
epidemiologic studies, clinical requirements, and chain-of-infection principles, and
tests of evidence of disease transmission were applied.
Results
C. difficile spores were found on 9 of 197 (4.6%) RSCs prior to processing. Processing completely
removed C. difficile. In CDI patient rooms, 4 of 50 RSCs (8.0%) and 8 of 50 DSCs (16.0%) had sub-infective
counts of C. difficile (P = .27). DSCs were in permanent wall cabinets; RSCs were removed and decontaminated
frequently.
Conclusion
With C. difficile bioburden being sub-infective on both DSCs and RSCs, sharps containers being no-touch,
and glove removal required after sharps disposal, we found 2 links in the chain of
infection to be broken and 5 of 7 tests of evidence to be unmet. We conclude that
sharps containers pose no risk of C. difficile transmission.
Key Words
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Article info
Publication history
Published online: May 22, 2018
Footnotes
Funding/support: Investigation was supported by Daniels Health and included costs associated with conducting the study and use of processing facilities to randomly sample reusable sharps containers and conduct challenge tests.
Conflicts of interest: C.D. declared fees received for laboratory costs associated with this study; other fees were declared outside the submitted work. R.O. declared fees outside the submitted work. T.G declared fees received for overseeing the study; other fees were declared outside the submitted work.
Disclaimer: Daniels Health had no access to, or input into, details of study design, collation, results, analysis, or the manuscript.
Identification
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© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
