Evaluation of a Continuous Decontamination Technology in an Intensive Care Unit

Abstract

Background: The scientific literature increasingly indicates the need for the development of continuous disinfection to address the persistent contamination and recontamination that occurs in the patient rooms despite routine cleaning and disinfection. Methods: To determine a baseline microbial burden level on patient room surfaces in the intensive care unit (ICU) of a large urban hospital, 50 locations were swabbed for total colony-forming units (CFU) and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA). Once the baseline in ICU patient rooms was established, 5 novel decontamination devices were installed in the HVAC ducts near these patient rooms. The devices provide a continuous low-level application of oxidizing molecules, predominately hydrogen peroxide. These molecules exit the duct and circulate in the patient room through normal convection, landing on all surfaces. After activation, environmental sampling was conducted every 4 weeks for 4 months. The effect from continuous low levels of oxidizing molecules on the intrinsic microbial burden and the prevalence of MRSA were analyzed. In addition to external laboratory reports, the facility tracked healthcare-associated infections (HAIs) in the unit. HAI data were averaged by month and were compared to the preactivation average in the same unit. Results: The preactivation average microbial burden found on the 50 locations were 179,000 CFU per 100 in². The prevalence of MRSA was 71% with an average of 81 CFU per 100 in². After activation of the devices, levels of microbial burden, prevalence of MRSA, and average monthly HAI rates were all significantly lower on average: 95% reduction in average microbial burden (8,206 CFU per 100 in²); 81% reduction in the prevalence of MRSA (13% vs 71%); 54% reduction in the average of healthcare-onset HAIs. All data were obtained from the averages of sampling data for 4 weeks during the 4-month trial period. Conclusions: The continuous application of low levels of oxidizing molecules throughout the patient rooms of an ICU demonstrated 3 outcomes: reduced overall surface microbial burden, lowered the incidence of MRSA, and significantly decreased the monthly average HAI rate. Please note, the ICU ran other infection prevention interventions at this time, including standard cleaning, as well as and their standard disinfecting techniques.

Funding: This study was supported by the CASPR Group.

Disclosures: None