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Background  Removing spores of   Clostridium difficile   and   Bacillus anthracis   from skin is challenging because they are resistant to commonly used antimicrobials and soap and water washing provides only modest efficacy. We hypothesized that hygiene interventions incorporating a sporicidal electrochemically generated hypochlorous acid solution (Vashe ® ) would reduce the burden of spores on skin.    Methods  Hands of volunteers were inoculated with non-toxigenic   C. difficile   spores or   B. anthracis   spore surrogates to assess the effectiveness of Vashe solution for reducing spores on skin. Reduction in spores was compared for Vashe hygiene interventions versus soap and water (control). To determine the effectiveness of Vashe solution for removal of   C. difficile   spores from the skin of patients with   C. difficile   infection (CDI), reductions in levels of spores on skin were compared for soap and water versus Vashe bed baths.    Results  Spore removal from hands was enhanced with Vashe soak (>2.5 log 10  reduction) versus soap and water wash or soak (~2.0 log 10  reduction;  P   < 0.05) and Vashe wipes versus alcohol wipes ( P   < 0.01). A combined approach of soap and water wash followed by soaking in Vashe removed >3.5 log 10  spores from hands ( P   < 0.01 compared to washing or soaking alone). Bed baths using soap and water (N =26 patients) did not reduce the percentage of positive skin cultures for CDI patients (64% before versus 57% after bathing;  P  =0.5), whereas bathing with Vashe solution (N =21 patients) significantly reduced skin contamination (54% before versus 8% after bathing;  P  =0.0001). Vashe was well-tolerated with no evidence of adverse effects on skin.    Conclusions  Vashe was safe and effective for reducing the burden of   B. anthracis   surrogates and   C. difficile   spores on hands. Bed baths with Vashe were effective for reducing   C. difficile   on skin. These findings suggest a novel strategy to reduce the burden of spores on skin.

Novel Strategies for Enhanced Removal of Persistent Bacillus anthracis Surrogates and Clostridium difficile Spores from Skin