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Toilet plume aerosol generation rate and environmental contamination following bowl water inoculation with Clostridium difficile spores.
Am J Infect Control 2019; 47(5):515-520AJ

Abstract

INTRODUCTION

Clostridium difficile is the leading cause of health care-associated gastric illness. Environmental contamination with C difficile spores is a risk factor for contact transmission, and toilet flushing causes such contamination. This work explores toilet contamination persistence and environmental contamination produced over a series of flushes after contamination.

METHODS

A flushometer toilet was seeded with C difficile spores in a sealed chamber. The toilet was flushed 24times, with postflush bowl water samples and settle plates periodically collected for culturing and counting. Air samples were collected after each of 12 flushes using rotating plate impactors.

RESULTS

Spores were present in bowl water even after 24 flushes. Large droplet spore deposition accumulated over the 24-flush period. Droplet nuclei spore bioaerosol was produced over at least 12 flushes.

CONCLUSIONS

Toilets contaminated with C difficile spores are a persistent source of environmental contamination over an extended number of flushes.

Authors+Show Affiliations

Department of Occupational and Environmental Health, University of Oklahoma College of Public Health, Oklahoma City, OK, USA. Electronic address: Kathleen-Aithinne@ouhsc.edu.Department of Occupational and Environmental Health, University of Oklahoma College of Public Health, Oklahoma City, OK, USA.Xi'an Jiaotong-Liverpool University, Jiangsu Province, China.Department of Occupational and Environmental Health, University of Oklahoma College of Public Health, Oklahoma City, OK, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30554881

Citation

Aithinne, Kathleen A N., et al. "Toilet Plume Aerosol Generation Rate and Environmental Contamination Following Bowl Water Inoculation With Clostridium Difficile Spores." American Journal of Infection Control, vol. 47, no. 5, 2019, pp. 515-520.
Aithinne KAN, Cooper CW, Lynch RA, et al. Toilet plume aerosol generation rate and environmental contamination following bowl water inoculation with Clostridium difficile spores. Am J Infect Control. 2019;47(5):515-520.
Aithinne, K. A. N., Cooper, C. W., Lynch, R. A., & Johnson, D. L. (2019). Toilet plume aerosol generation rate and environmental contamination following bowl water inoculation with Clostridium difficile spores. American Journal of Infection Control, 47(5), pp. 515-520. doi:10.1016/j.ajic.2018.11.009.
Aithinne KAN, et al. Toilet Plume Aerosol Generation Rate and Environmental Contamination Following Bowl Water Inoculation With Clostridium Difficile Spores. Am J Infect Control. 2019;47(5):515-520. PubMed PMID: 30554881.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Toilet plume aerosol generation rate and environmental contamination following bowl water inoculation with Clostridium difficile spores. AU - Aithinne,Kathleen A N, AU - Cooper,Casey W, AU - Lynch,Robert A, AU - Johnson,David L, Y1 - 2018/12/14/ PY - 2018/07/23/received PY - 2018/11/10/revised PY - 2018/11/11/accepted PY - 2018/12/18/pubmed PY - 2018/12/18/medline PY - 2018/12/18/entrez KW - Aerosol KW - Clostridium difficile KW - Infection control KW - Microbial contamination KW - Plume KW - Toilet SP - 515 EP - 520 JF - American journal of infection control JO - Am J Infect Control VL - 47 IS - 5 N2 - INTRODUCTION: Clostridium difficile is the leading cause of health care-associated gastric illness. Environmental contamination with C difficile spores is a risk factor for contact transmission, and toilet flushing causes such contamination. This work explores toilet contamination persistence and environmental contamination produced over a series of flushes after contamination. METHODS: A flushometer toilet was seeded with C difficile spores in a sealed chamber. The toilet was flushed 24times, with postflush bowl water samples and settle plates periodically collected for culturing and counting. Air samples were collected after each of 12 flushes using rotating plate impactors. RESULTS: Spores were present in bowl water even after 24 flushes. Large droplet spore deposition accumulated over the 24-flush period. Droplet nuclei spore bioaerosol was produced over at least 12 flushes. CONCLUSIONS: Toilets contaminated with C difficile spores are a persistent source of environmental contamination over an extended number of flushes. SN - 1527-3296 UR - https://www.unboundmedicine.com/medline/citation/30554881/Toilet_plume_aerosol_generation_rate_and_environmental_contamination_following_bowl_water_inoculation_with_Clostridium_difficile_spores_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-6553(18)31098-8 DB - PRIME DP - Unbound Medicine ER -