A nurse finishes caring for a patient with Clostridioides difficile colitis and then uses an alcohol-based hand rub before moving to the next bed. The infection control officer flags this practice. Why is alcohol-based hand rub inadequate in this situation?
- A C. difficile spores are resistant to alcohol and require mechanical removal by soap and water washing ✓
- B Alcohol cannot penetrate the gloves worn during patient care
- C Alcohol denatures proteins too slowly to act within the recommended contact time
- D Alcohol selects for alcohol-tolerant hospital strains of C. difficile
Correct answer: A. C. difficile spores are resistant to alcohol and require mechanical removal by soap and water washing
Explanation
A. difficile spores lack metabolic water content and resist the protein-denaturing action of alcohols, so alcohol-based rubs leave viable spores on hands. Washing with soap and water physically removes spores and is mandatory after contact with a CDI patient or their environment. Alcohol rubs act rapidly enough for other pathogens, glove use is unrelated to post-removal hand hygiene, and selection pressure is not the mechanism of failure.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.