Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T08:36:36.016Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of the Microbiological Efficacy of Hydrogen Peroxide Vapor and Ultraviolet Light Processes for Room Decontamination

Published online by Cambridge University Press:  02 January 2015

Nancy L. Havill ,
Brent A. Moore  and
John M. Boyce
Nancy L. Havill*
Affiliation:
Hospital of Saint Raphael, New Haven, Connecticut
Brent A. Moore
Affiliation:
Yale University School of Medicine, New Haven, Connecticut
John M. Boyce
Affiliation:
Hospital of Saint Raphael, New Haven, Connecticut Yale University School of Medicine, New Haven, Connecticut
*
Hospital of Saint Raphael, 1450 Chapel Street, New Haven, CT 06511 (nhavill@srhs.org)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To compare the microbiological efficacy of hydrogen peroxide vapor (HPV) and ultraviolet radiation (UVC) for room decontamination.

Design.

Prospective observational study.

Setting.

500-bed teaching hospital.

Methods.

HPV and UVC processes were performed in 15 patient rooms. Five high-touch sites were sampled before and after the processes and aerobic colony counts (ACCs) were determined. Carrier disks with ~106Clostridium difficile (CD) spores and biological indicators (BIs) with 104 and 106Geobacillus stearothermophilus spores were placed in 5 sites before decontamination. After decontamination, CD log reductions were determined and BIs were recorded as growth or no growth.

Results.

93% of ACC samples that had growth before HPV did not have growth after HPV, whereas 52% of sites that had growth before UVC did not have growth after UVC (P < .0001). The mean CD log reduction was >6 for HPV and ~2 for UVC. After HPV 100% of the 104 BIs did not grow, and 22% did not grow after UVC, with a range of 7%–53% for the 5 sites. For the 106 BIs, 99% did not grow after HPV and 0% did not grow after UVC. Sites out of direct line of sight were significantly more likely to show growth after UVC than after HPV. Mean cycle time was 153 (range, 140–177) min for HPV and 73 (range, 39–100) min for UVC (P < .0001).

Conclusion.

Both HPV and UVC reduce bacterial contamination, including spores, in patient rooms, but HPV is significantly more effective. UVC is significantly less effective for sites that are out of direct line of sight.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 5 , May 2012 , pp. 507 - 512
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Otter, JA, Yezli, S, French, GL. The role played by contaminated surfaces in the transmission of nosocomial pathogens. Infect Control Hosp Epidemiol 2011;32:687–699.Google Scholar
2.Datta, R, Platt, R, Yokoe, DS, Huang, SS. Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants. Arch Intern Med 2011;171:491–494.Google Scholar
3.Nseir, S, Blazejewski, C, Lubret, R, Wallet, F, Courcol, R, Durocher, A. Risk of acquiring multidrug-resistant gram-negative bacilli from prior room occupants in the ICU. Clin Microbiol Infect 2011;17:1201–1208.Google Scholar
4.Drees, M, Snydman, D, Schmid, C, et al. Prior environmental contamination increases the risk of acquisition of vancomycin-resistant enterococci. Clin Infect Dis 2008;46:678–685.Google Scholar
5.Shaughnessy, MK, Micielli, RL, DePestel, DD, et al. Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol 2011;32:201–206.Google Scholar
6.Huang, SS, Datta, R, Platt, R. Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch Intern Med 2006;166: 1945–1951.Google Scholar
7.Boyce, JM, Havill, NL, Lipka, A, Havill, H, Rizvani, R. Variations in hospital daily cleaning practices. Infect Control Hosp Epidemiol 2010;31:99–101.CrossRefGoogle ScholarPubMed
8.Carling, PC, Parry, MM, Rupp, ME, Po, JL, Dick, B, Von Beheren, S. Improving cleaning of the environment surrounding patients in 36 acute care hospitals. Infect Control Hosp Epidemiol 2008; 29:1035–1041.Google Scholar
9.Rutala, WA, Weber, DJ. Are room decontamination units needed to prevent transmission of environmental pathogens? Infect Control Hosp Epidemiol 2011;32:743–747.Google Scholar
10.Boyce, JM. New approaches to decontamination of rooms after patients are discharged. Infect Control Hosp Epidemiol 2009;30: 515–517.Google Scholar
11.Otter, JA, Cummins, M, Ahmad, F, van Tonder, C, Drabu, YJ. Assessing the biological efficacy and rate of recontamination following hydrogen peroxide vapour decontamination. J Hosp Infect 2007;67:182–188.Google Scholar
12.Otter, JA, French, GL. Survival of nosocomial bacteria and spores on surfaces and inactivation by hydrogen peroxide vapor. J Clin Microbiol 2009;47:205–207.Google Scholar
13.Jeanes, A, Rao, G, Osman, M, Merrick, P. Eradication of persistent environmental MRSA. J Hosp Infect 2005;61:85–86.Google Scholar
14.Otter, JA, Yezli, S, Schouten, MA, van Zanten, AR, Houmes-Zielman, G, Nohlmans-Paulssen, MK. Hydrogen peroxide vapor decontamination of an intensive care unit to remove environmental reservoirs of multidrug-resistant gram-negative rods during an outbreak. Am J Infect Control 2010;38:754–756.Google Scholar
15.Manian, FA, Griesenauer, S, Senkel, D. Impact of an intensive terminal cleaning and disinfection (C/D) protocol involving selected hospital rooms on endemic nosocomial infection (N1) rates of common pathogens at a tertiary care medical center. In: 5th Decennial Meeting of the Society for Healthcare Epidemiology of America (SHEA). Atlanta, GA, 2010. Abstract LB6.Google Scholar
16.Passaretti, CL, Otter, JA, Lipsett, P, et al. Adherence to hydrogen peroxide vapor (HPV) decontamination reduces VRE acquisition in high-risk units. In: 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and the Infectious Diseases Society of America (IDSA). Washington, DC, 2008. Abstract K4124b.Google Scholar
17.Boyce, JM, Havill, NL, Otter, JA, et al. Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile en vironmental contamination and transmission in a healthcare setting. Infect Control Hosp Epidemiol 2008;29:723–729.CrossRefGoogle Scholar
18.Portala, WA, Gergen, MF, Weber, DJ. Room decontamination with UV radiation. Infect Control Hosp Epidemiol 2010;31:1025–1029.Google Scholar
19.Nerandzic, MM, Cadnum, JL, Pultz, MJ, Donskey, CJ. Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms. BMC Infect Dis 2010;10:197.Google Scholar
20.Boyce, JM, Havill, NL, Moore, BA. Terminal decontamination of patient rooms using an automated mobile UV light unit. Infect Control Hosp Epidemiol 2011;32:737–742.Google Scholar
21.French, GL, Otter, JA, Shannon, KP, Adams, NM, Watling, D, Parks, MJ. Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination. J Hosp Infect 2004;57:31–37.Google Scholar
22.McDonnell, G, Russell, AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12:147–179.Google Scholar
23.Hall, L, Otter, JA, Chewins, J, Wengenack, NL. Use of hydrogen peroxide vapor for deactivation of Mycobacterium tuberculosis in a biological safety cabinet and a room. Journal of Clinical Microbiology 2007;45:810–815.Google Scholar
24.Hayden, MK, Bonten, MJ, Blom, DW, Lyle, EA, van de Vijver, DA, Weinstein, RA. Reduction in acquisition of vancomycin-resistant Enterococcus after enforcement of routine environmental cleaning measures. Clin Infect Dis 2006;42:1552–1560.Google Scholar
25.Holmdahl, T, Lanbeck, P, Wullt, M, Walder, MH. A head-to-head comparison of hydrogen peroxide vapor and aerosol room decontamination systems. Infect Control Hosp Epidemiol 2011;32: 831–836.Google Scholar
26.Dumigan, DG, Boyce, JM, Havill, NL, Golebiewski, M, Balougun, O, Rizvani, R. Who is caring for your environment of care? developing standardized cleaning procedures and effective monitoring techniques. Am J Infect Control 2010:38(5):387–389.Google Scholar
27.Boyce, JM, Havill, NL, Dumigan, DG, Golebiewski, M, Balogun, O, Rizvani, R. Monitoring the effectiveness of hospital cleaning practices by use of an adenosine triphosphate bioluminescence assay. Infect Control Hosp Epidemiol 2009;30:678–684.Google Scholar
28.Lawley, TD, Clare, S, Deakin, LJ, et al. Use of purified Clostridium difficile spores to facilitate evaluation of health care disinfection regimens. Appl Environ Microbiol 2010;76:6895–6900.Google Scholar