Triggering germination represents a novel strategy to enhance killing of Clostridium difficile spores

• Published in: PloS one Vol. 5; no. 8; p. e12285
• Main Authors: Nerandzic, Michelle M, Donskey, Curtis J
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.08.2010; Public Library of Science (PLoS)
• Subjects: Aerobic conditions; Air; Alcohol; Alcohols; Alcohols - pharmacology; Amino acids; Anaerobic conditions; Anaerobiosis; Bacillus; Bacillus anthracis; Bacillus cereus; Bacillus subtilis; Bacteria; Biotechnology/Environmental Microbiology; Clostridium difficile; Clostridium difficile - drug effects; Clostridium difficile - growth & development; Clostridium difficile - radiation effects; Clostridium perfringens; Copper; Data processing; Decontamination; Desiccation; Developed countries; Diarrhea; Disinfectants; Disinfection - methods; Drug Resistance, Bacterial; Drying; Enterococcus - drug effects; Enterococcus - radiation effects; Ethanol; Exposure; Germination; Health care; Heat resistance; Hospitals; Hot Temperature; Humans; Hygiene; Infectious Diseases/Bacterial Infections; Infectious Diseases/Epidemiology and Control of Infectious Diseases; Keyboards; Long term health care; Methicillin-Resistant Staphylococcus aureus - radiation effects; Microbiology/Environmental Microbiology; Microbiology/Microbial Growth and Development; Microscopy; Minerals; Oxygen; Patients; Personal care products; Personal hygiene; Phase transitions; Radiation; Radiation (Physics); Radiation Dosage; Risk factors; Soaps; Solutions; Spores; Spores, Bacterial - drug effects; Spores, Bacterial - growth & development; Spores, Bacterial - radiation effects; Stimulation; Strategy; Taurocholic acid; Time Factors; Ultraviolet radiation; Ultraviolet Rays; Vancomycin - pharmacology; Veterans; Cleveland Ohio; United States > US; Ohio
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0012285

Clostridium difficile is an anaerobic, spore-forming bacterium that is the most common cause of healthcare-associated diarrhea in developed countries. Control of C. difficile is challenging because the spores are resistant to killing by alcohol-based hand hygiene products, antimicrobial soaps, and most disinfectants. Although initiation of germination has been shown to increase susceptibility of spores of other bacterial species to radiation and heat, it was not known if triggering of germination could be a useful strategy to increase susceptibility of C. difficile spores to radiation or other stressors. Here, we demonstrated that exposure of dormant C. difficile spores to a germination solution containing amino acids, minerals, and taurocholic acid resulted in initiation of germination in room air. Germination of spores in room air resulted in significantly enhanced killing by ultraviolet-C (UV-C) radiation and heat. On surfaces in hospital rooms, application of germination solution resulted in enhanced eradication of spores by UV-C administered by an automated room decontamination device. Initiation of germination under anaerobic, but not aerobic, conditions resulted in increased susceptibility to killing by ethanol, suggesting that exposure to oxygen might prevent spores from progressing fully to outgrowth. Stimulation of germination also resulted in reduced survival of spores on surfaces in room air, possibly due to increased susceptibility to stressors such as oxygen and desiccation. Taken together, these data demonstrate that stimulation of germination could represent a novel method to enhance killing of spores by UV-C, and suggest the possible application of this strategy as a means to enhance killing by other agents.