The current study was designed to evaluate the activity of glutaraldehyde-based disinfectants against Clostridium difficile using the Association of Official Analytical Chemists' (AOAC) sporicidal test. This study was undertaken because gastrointestinal endoscopes that may be contaminated with C difficile spores are most commonly disinfected between patients using glutaraldehyde-based disinfectants.

Using the AOAC test, the following disinfectants were tested: 2% alkaline glutaraldehyde, 2% acid glutaraldehyde, a 1: 16 dilution of a 2% glutaraldehyde-7.05% phenol- 1.20% sodium phenate, and a 1:20 dilution of a 10% glutaraldehyde-0.5% phenylphenol-0.1% amylphenol.

Test results of the four disinfectants against C difficile spores at exposure times of 10, 20, and 60 minutes were as follows (number of positive penicylinders per 30 replicates): 0, 0, and 0 for 2% alkaline glutaraldehyde; 6, 3, and 0 for 2% acid glutaraldehyde; 30, 29, and 30 for a 1:16 dilution of glutaraldehyde- 7.05% phenol-1.20% sodium phenate; and 30, 30, and 30 for a 1:20 dilution of glutaraldehyde- 0.5% phenylphenol-0.1% amylphenol.

C difficile spores are more susceptible to inactivation by glutaraldehyde-based disinfectants than the spore-forming organisms recommended in the AOAC sporicidal test (i.e., Bacillus subtilis and Clostridium sporogenes). Diluting glutaraldehyde-based disinfectants below 2% led to the inability to inactivate spores of C difficle using exposure times commonly employed to disinfect semicritical items such as gastrointestinal endoscopes.

To evaluate the utility of patient telephone surveys in further improving the detection of surgical wound infections (SWIs) postdischarge in the setting of ongoing traditional surveillance system and monthly physician surveys.

Prospective surveillance study of randomly selected patients undergoing surgery in inpatient or outpatient settings.

Tertiary care suburban hospital.

Five hundred one patients were randomly selected for telephone contact, of whom 189 (38%) were successfully contacted after three attempts. Eighteen (9.5%) patients reported one or more signs or symptoms of possible SWI. However, none of these patients required antibiotic therapy, was hospitalized with an SWI, or reported by his or her physician (based on the monthly questionnaire) to have had an SWI. Total time spent contacting patients was 47 hours and 48 minutes, or 15 minutes per each successful telephone contact.

Patient telephone surveys as conducted in this study were inefficient and failed to substantially improve the rate of detection of over traditional surveillance system and monthly physician questionnaires.