Pathogenicity and virulence of Clostridium botulinum.

Clostridium botulinum, a polyphyletic Gram-positive taxon of bacteria, is classified purely by their ability to produce botulinum neurotoxin (BoNT). BoNT is the primary virulence factor and the causative agent of botulism. A potentially fatal disease, botulism is classically characterized by a symmetrical descending flaccid paralysis, which is left untreated can lead to respiratory failure and death. Botulism cases are classified into three main forms dependent on the nature of intoxication; foodborne, wound and infant. The BoNT, regarded as the most potent biological substance known, is a zinc metalloprotease that specifically cleaves SNARE proteins at neuromuscular junctions, preventing exocytosis of neurotransmitters, leading to muscle paralysis. The BoNT is now used to treat numerous medical conditions caused by overactive or spastic muscles and is extensively used in the cosmetic industry due to its high specificity and the exceedingly small doses needed to exert long-lasting pharmacological effects. Additionally, the ability to form endospores is critical to the pathogenicity of the bacteria. Disease transmission is often facilitated via the metabolically dormant spores that are highly resistant to environment stresses, allowing persistence in the environment in unfavourable conditions. Infant and wound botulism infections are initiated upon germination of the spores into neurotoxin producing vegetative cells, whereas foodborne botulism is attributed to ingestion of preformed BoNT. C. botulinum is a saprophytic bacterium, thought to have evolved its potent neurotoxin to establish a source of nutrients by killing its host.

Chlorhexidine to Maintain Cleanliness of Restroom Door Handles.

Restroom internal door handles have the potential to become contaminated by pathogenic bacteria, particularly because frequent breakdowns occur in hand hygiene. Cleaning these door handles periodically could reduce this cross-contamination risk. The sustained effect following cleaning with chlorhexidine could be beneficial in restroom facilities as cleaning episodes are of necessity at time intervals. The cleaning efficacies and residual effects of Sani Cloth CHG 2% wipes were investigated in a double-blinded randomized crossover controlled trial in a school setting. No significant difference occurred in initial cleaning efficacy; however, following a six-hour period of use by pupils of the restroom facilities, the internal door handles wiped with Sani-Cloth CHG 2% wipes were significantly less contaminated than those with the control wipe (14% v. 32%, p = .02). Cleaning with Sani-Cloth CHG 2% wipes demonstrated significant improvements in the continuous cleanliness of restroom door handles during use with this simple and inexpensive technique.