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. 2015 Feb 2;19(1):30.
doi: 10.1186/s13054-015-0752-9.

Efficiency of hydrogen peroxide in improving disinfection of ICU rooms

Caroline Blazejewski  1 , Frédéric Wallet  2 , Anahita Rouzé  3 , Rémi Le Guern  4 , Sylvie Ponthieux  5 , Julia Salleron  6 , Saad Nseir  7   8
Affiliations

Efficiency of hydrogen peroxide in improving disinfection of ICU rooms

Caroline Blazejewski et al. Crit Care. .

Abstract

Introduction: The primary objective of this study was to determine the efficiency of hydrogen peroxide (H₂O₂) techniques in disinfection of ICU rooms contaminated with multidrug-resistant organisms (MDRO) after patient discharge. Secondary objectives included comparison of the efficiency of a vaporizator (HPV, Bioquell) and an aerosolizer using H₂O₂, and peracetic acid (aHPP, Anios) in MDRO environmental disinfection, and assessment of toxicity of these techniques.

Methods: This prospective cross-over study was conducted in five medical and surgical ICUs located in one University hospital, during a 12-week period. Routine terminal cleaning was followed by H₂O₂ disinfection. A total of 24 environmental bacteriological samplings were collected per room, from eight frequently touched surfaces, at three time-points: after patient discharge (T0), after terminal cleaning (T1) and after H₂O₂ disinfection (T2).

Results: In total 182 rooms were studied, including 89 (49%) disinfected with aHPP and 93 (51%) with HPV. At T0, 15/182 (8%) rooms were contaminated with at least 1 MDRO (extended spectrum β-lactamase-producing Gram-negative bacilli 50%, imipenem resistant Acinetobacter baumannii 29%, methicillin-resistant Staphylococcus aureus 17%, and Pseudomonas aeruginosa resistant to ceftazidime or imipenem 4%). Routine terminal cleaning reduced environmental bacterial load (P <0.001) without efficiency on MDRO (15/182 (8%) rooms at T0 versus 11/182 (6%) at T1; P = 0.371). H₂O₂ technologies were efficient for environmental MDRO decontamination (6% of rooms contaminated with MDRO at T1 versus 0.5% at T2, P = 0.004). Patient characteristics were similar in aHPP and HPV groups. No significant difference was found between aHPP and HPV regarding the rate of rooms contaminated with MDRO at T2 (P = 0.313). 42% of room occupants were MDRO carriers. The highest rate of rooms contaminated with MDRO was found in rooms where patients stayed for a longer period of time, and where a patient with MDRO was hospitalized. The residual concentration of H₂O₂ appears to be higher using aHPP, compared with HPV.

Conclusions: H₂O₂ treatment is efficient in reducing MDRO contaminated rooms in the ICU. No significant difference was found between aHPP and HPV regarding their disinfection efficiency.

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Figures

Figure 1
Figure 1
Study flowchart. HPV, hydrogen peroxide vaporization; aHPP, aersolization of hydrogen peroxide.
Figure 2
Figure 2
Classification of study rooms based on patient characteristics. LOS, length of stay; MDRO, multidrug-resistant organisms.
See this image and copyright information in PMC

Comment in

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