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Ayub A, Cheong YK, Castro JC, Cumberlege O, Chrysanthou A. Use of Hydrogen Peroxide Vapour for Microbiological Disinfection in Hospital Environments: A Review. Bioengineering (Basel) 2024; 11:205. [PMID: 38534479 DOI: 10.3390/bioengineering11030205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 03/28/2024] Open
Abstract
Disinfection of nosocomial pathogens in hospitals is crucial to combat healthcare-acquired infections, which can be acquired by patients, visitors and healthcare workers. However, the presence of a wide range of pathogens and biofilms, combined with the indiscriminate use of antibiotics, presents infection control teams in healthcare facilities with ongoing challenges in the selection of biocides and application methods. This necessitates the development of biocides and innovative disinfection methods that overcome the shortcomings of conventional methods. This comprehensive review finds the use of hydrogen peroxide vapour to be a superior alternative to conventional methods. Motivated by observations in previous studies, herein, we provide a comprehensive overview on the utilisation of hydrogen peroxide vapour as a superior high-level disinfection alternative in hospital settings. This review finds hydrogen peroxide vapour to be very close to an ideal disinfectant due to its proven efficacy against a wide range of microorganisms, safety to use, lack of toxicity concerns and good material compatibility. The superiority of hydrogen peroxide vapour was recently demonstrated in the case of decontamination of N95/FFP2 masks for reuse to address the critical shortage caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the COVID-19 pandemic. Despite the significant number of studies demonstrating antimicrobial activity, there remains a need to critically understand the mechanism of action by performing studies that simultaneously measure damage to all bacterial cell components and assess the correlation of this damage with a reduction in viable cell count. This can lead to improvement in antimicrobial efficacy and foster the development of superior approaches.
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Affiliation(s)
- Aaqib Ayub
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Yuen Ki Cheong
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Jesus Calvo Castro
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | | | - Andreas Chrysanthou
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield AL10 9AB, UK
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van der Starre CM, Cremers-Pijpers SAJ, van Rossum C, Bowles EC, Tostmann A. The in situ efficacy of whole room disinfection devices: a literature review with practical recommendations for implementation. Antimicrob Resist Infect Control 2022; 11:149. [PMID: 36471395 PMCID: PMC9724435 DOI: 10.1186/s13756-022-01183-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Terminal cleaning and disinfection of hospital patient rooms must be performed after discharge of a patient with a multidrug resistant micro-organism to eliminate pathogens from the environment. Terminal disinfection is often performed manually, which is prone to human errors and therefore poses an increased infection risk for the next patients. Automated whole room disinfection (WRD) replaces or adds on to the manual process of disinfection and can contribute to the quality of terminal disinfection. While the in vitro efficacy of WRD devices has been extensively investigated and reviewed, little is known about the in situ efficacy in a real-life hospital setting. In this review, we summarize available literature on the in situ efficacy of WRD devices in a hospital setting and compare findings to the in vitro efficacy of WRD devices. Moreover, we offer practical recommendations for the implementation of WRD devices. METHODS The in situ efficacy was summarized for four commonly used types of WRD devices: aerosolized hydrogen peroxide, H2O2 vapour, ultraviolet C and pulsed xenon ultraviolet. The in situ efficacy was based on environmental and clinical outcome measures. A systematic literature search was performed in PubMed in September 2021 to identify available literature. For each disinfection system, we summarized the available devices, practical information, in vitro efficacy and in situ efficacy. RESULTS In total, 54 articles were included. Articles reporting environmental outcomes of WRD devices had large variation in methodology, reported outcome measures, preparation of the patient room prior to environmental sampling, the location of sampling within the room and the moment of sampling. For the clinical outcome measures, all included articles reported the infection rate. Overall, these studies consistently showed that automated disinfection using any of the four types of WRD is effective in reducing environmental and clinical outcomes. CONCLUSION Despite the large variation in the included studies, the four automated WRD systems are effective in reducing the amount of pathogens present in a hospital environment, which was also in line with conclusions from in vitro studies. Therefore, the assessment of what WRD device would be most suitable in a specific healthcare setting mostly depends on practical considerations.
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Affiliation(s)
- Caroline M. van der Starre
- grid.10417.330000 0004 0444 9382Unit of Hygiene and Infection Prevention, Department of Medical Microbiology, Radboud Center for Infectious Diseases (RCI), Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Suzan A. J. Cremers-Pijpers
- grid.10417.330000 0004 0444 9382Unit of Hygiene and Infection Prevention, Department of Medical Microbiology, Radboud Center for Infectious Diseases (RCI), Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Carsten van Rossum
- grid.10417.330000 0004 0444 9382Unit of Hygiene and Infection Prevention, Department of Medical Microbiology, Radboud Center for Infectious Diseases (RCI), Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Edmée C. Bowles
- grid.10417.330000 0004 0444 9382Unit of Hygiene and Infection Prevention, Department of Medical Microbiology, Radboud Center for Infectious Diseases (RCI), Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Alma Tostmann
- grid.10417.330000 0004 0444 9382Unit of Hygiene and Infection Prevention, Department of Medical Microbiology, Radboud Center for Infectious Diseases (RCI), Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
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Keyhan SO, Fallahi HR, Motamedi A, Khoshkam V, Mehryar P, Moghaddas O, Cheshmi B, Firoozi P, Yousefi P, Houshmand B. Reopening of dental clinics during SARS-CoV-2 pandemic: an evidence-based review of literature for clinical interventions. Maxillofac Plast Reconstr Surg 2020; 42:25. [PMID: 32793519 PMCID: PMC7396263 DOI: 10.1186/s40902-020-00268-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/29/2020] [Indexed: 12/19/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes serious acute respiratory diseases including pneumonia and bronchitis with approximately 2.3% fatality occurrence. Main body This study argues the main concepts that need to be considered for the gradual reopening of dental offices include treatment planning approaches, fundamental elements needed to prevent transmission of SARS-CoV-2 virus in dental healthcare settings, personal protection equipment (PPE) for dental health care providers, environmental measures, adjunctive measures, and rapid point of care tests in dental offices. Conclusion This article seeks to provide an overview of existing scientific evidence to suggest a guideline for reopening dental offices.
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Affiliation(s)
- Seied Omid Keyhan
- CMFRC, National Advance Center for Craniomaxillofacial Reconstruction, Tehran, Iran.,Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Fallahi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | | - Omid Moghaddas
- Department of Periodontology, Islamic Azad University, Tehran, Iran
| | - Behzad Cheshmi
- Faculty of Dentistry, Boroujerd Islamic Azad University, Boroujerd, P.O 6915136111 Iran
| | - Parsa Firoozi
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Parisa Yousefi
- Resident of prosthodontics, Isfahan University of Medical Sciences, College of Dentistry, Isfahan, Iran
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Role of Hydrogen Peroxide Vapor (HPV) for the Disinfection of Hospital Surfaces Contaminated by Multiresistant Bacteria. Pathogens 2020; 9:pathogens9050408. [PMID: 32456303 PMCID: PMC7281489 DOI: 10.3390/pathogens9050408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 12/14/2022] Open
Abstract
The emergence of multiresistant bacterial strains as agents of healthcare-related infection in hospitals has prompted a review of the control techniques, with an added emphasis on preventive measures, namely good clinical practices, antimicrobial stewardship, and appropriate environmental cleaning. The latter item is about the choice of an appropriate disinfectant as a critical role due to the difficulties often encountered in obtaining a complete eradication of environmental contaminations and reservoirs of pathogens. The present review is focused on the effectiveness of hydrogen peroxide vapor, among the new environmental disinfectants that have been adopted. The method is based on a critical review of the available literature on this topic.
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Otter J, Yezli S, Barbut F, Perl T. An overview of automated room disinfection systems: When to use them and how to choose them. DECONTAMINATION IN HOSPITALS AND HEALTHCARE 2020. [PMCID: PMC7153347 DOI: 10.1016/b978-0-08-102565-9.00015-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Conventional disinfection methods are limited by reliance on the operator to ensure appropriate selection, formulation, distribution, and contact time of the agent. Automated room disinfection (ARD) systems remove or reduce reliance on operators and so they have the potential to improve the efficacy of terminal disinfection. The most commonly used systems are hydrogen peroxide vapor (H2O2 vapor), aerosolized hydrogen peroxide (aHP), and ultraviolet (UV) light. These systems have important differences in their active agent, delivery mechanism, efficacy, process time, and ease of use. The choice of ARD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation, and cost considerations.
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Affiliation(s)
- J.A. Otter
- NIHR Health Protection Research Unit (HPRU) in HCAIs and AMR at Imperial College London, and Imperial College Healthcare NHS Trust, Infection Prevention and Control, London, United Kingdom
| | - S. Yezli
- Global Centre for Mass Gatherings Medicine, WHO Collaborating Centre for Mass Gatherings Medicine, Ministry of Health-Public Health Directorate, Riyadh, Kingdom of Saudi Arabia
| | - F. Barbut
- National Reference Laboratory for C. difficile, Infection Control Unit, Hôpital Saint Antoine, Paris, France,INSERM S-1139, Faculté de Pharmacie de Paris, Université de Paris, Paris, France
| | - T.M. Perl
- Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, TX, United States
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Figueroa Castro CE, Munoz-Price LS. Advances in Infection Control for Clostridioides (Formerly Clostridium) difficile Infection. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2019. [DOI: 10.1007/s40506-019-0179-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Malik DJ, Shaw CM, Shama G, Clokie MRJ, Rielly CD. An Investigation into the Inactivation Kinetics of Hydrogen Peroxide Vapor Against Clostridium difficile Endospores. CHEM ENG COMMUN 2016. [DOI: 10.1080/00986445.2016.1223058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- D. J. Malik
- Department of Chemical Engineering, Loughborough University, Loughborough, Leicester, LE11 3TU, UK
| | - C. M. Shaw
- Department of Chemical Engineering, Loughborough University, Loughborough, Leicester, LE11 3TU, UK
| | - G. Shama
- Department of Chemical Engineering, Loughborough University, Loughborough, Leicester, LE11 3TU, UK
| | - M. R. J. Clokie
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, LE1 9HN, UK
| | - C. D. Rielly
- Department of Chemical Engineering, Loughborough University, Loughborough, Leicester, LE11 3TU, UK
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Touchless Technologies for Decontamination in the Hospital: a Review of Hydrogen Peroxide and UV Devices. Curr Infect Dis Rep 2015; 17:498. [DOI: 10.1007/s11908-015-0498-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Barbut F. How to eradicate Clostridium difficile from the environment. J Hosp Infect 2015; 89:287-95. [PMID: 25638358 DOI: 10.1016/j.jhin.2014.12.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 12/02/2014] [Indexed: 01/06/2023]
Abstract
During the last decade, Clostridium difficile has emerged as a major cause of healthcare-associated diarrhoea and death. Transmission of this spore-forming bacterium is thought to occur via the hands of healthcare providers or via the contaminated environment. Therefore, enhanced environmental cleaning/disinfection of the rooms housing C. difficile-infected patients is warranted. Guidelines from various scientific bodies have been published. They recommend performing environmental decontamination of rooms of patients with C. difficile infection (CDI) using hypochlorite (diluted 1/10) or a sporicidal product. Compliance with cleaning and disinfection is a critical point and is often suboptimal. Novel 'no-touch' methods for room disinfection have recently been introduced. Ultraviolet (UV) light or hydrogen peroxide systems are most widely used. In-vitro studies suggest that hydrogen peroxide vapour (from 30% hydrogen peroxide) methods achieve a >6 log10 reduction in C. difficile spores placed on carriers, and that aerosolized hydrogen peroxide systems (from 5% to 6% hydrogen peroxide) achieve ∼4 log10 reduction, whereas UV-based methods achieve ∼2 log10 reduction. Very few studies have assessed the impact of these devices on the transmission of C. difficile. Major limitations of these devices include the fact that they can only be used after the patient's discharge, because patients and staff must be removed from the room. The new no-touch methods for room disinfection supplement, but do not replace, daily cleaning.
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Affiliation(s)
- F Barbut
- National Reference Laboratory for C. difficile and Clinical Research Group EPIDIFF, University Pierre et Marie Curie, Paris, France; Infection Control Unit, Hôpital Saint-Antoine, Paris, France.
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Lemmen S, Scheithauer S, Häfner H, Yezli S, Mohr M, Otter JA. Evaluation of hydrogen peroxide vapor for the inactivation of nosocomial pathogens on porous and nonporous surfaces. Am J Infect Control 2015; 43:82-5. [PMID: 25564129 DOI: 10.1016/j.ajic.2014.10.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/10/2014] [Accepted: 10/13/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Clostridium difficile spores and multidrug-resistant (MDR) organisms, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and MDR Acinetobacter baumannii, are important nosocomial pathogens that are difficult to eliminate from the hospital environment. We evaluated the efficacy of hydrogen peroxide vapor (HPV), a no-touch automated room decontamination system, for the inactivation of a range of pathogens dried onto hard nonporous and porous surfaces in an operating room (OR). METHODS Stainless steel and cotton carriers containing >4 log10 viable MRSA, VRE, or MDR A baumannii were placed at 4 locations in the OR along with 7 pouched 6 log10Geobacillus stearothermophilus spore biologic indicators (BIs). HPV was then used to decontaminate the OR. The experiment was repeated 3 times. RESULTS HPV inactivated all spore BIs (>6 log10 reduction), and no MRSA, VRE, or MDR A baumannii were recovered from the stainless steel and cotton carriers (>4-5 log10 reduction, depending on the starting inoculum). HPV was equally effective at all carrier locations. We did not identify any difference in efficacy for microbes dried onto stainless steel or cotton surfaces, indicating that HPV may have a role in the decontamination of both porous and nonporous surfaces. CONCLUSION HPV is an effective way to decontaminate clinical areas where contamination with bacterial spores and MDR organisms is suspected.
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Affiliation(s)
- Sebastian Lemmen
- Department of Infection Control and Infectious Diseases, University Hospital Aachen, Aachen, Germany.
| | - Simone Scheithauer
- Department of Infection Control and Infectious Diseases, University Hospital Aachen, Aachen, Germany
| | - Helga Häfner
- Department of Infection Control and Infectious Diseases, University Hospital Aachen, Aachen, Germany
| | | | | | - Jonathan A Otter
- Bioquell UK Ltd, Andover, Hampshire, UK; Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, King's College London and Guy's and St. Thomas' National Health Service (NHS) Foundation Trust, London, UK
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Steindl G, Fiedler A, Huhulescu S, Wewalka G, Allerberger F. Effect of airborne hydrogen peroxide on spores of Clostridium difficile. Wien Klin Wochenschr 2014; 127:421-6. [PMID: 25527140 DOI: 10.1007/s00508-014-0682-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 11/20/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Contamination of surfaces by spores of Clostridium difficile is a major factor influencing the spread of healthcare-associated C. difficile infection. The aim of this study was to test the effect of an automated room disinfection system that provides an aerosol of 7.5 % hydrogen peroxide (H2O2) disinfectant, on spores of two different strains of C. difficile, and to evaluate the impact of biological soiling on the efficacy of H2O2 disinfection. MATERIAL AND METHOD The strains used were a C. difficile PCR ribotype 027 and a C. difficile ATCC 9689. Spore suspensions of each strain were applied to ceramic tiles and exposed to aerosolized H2O2 at different locations in a test room. Biological soiling was simulated by bovine serum albumin and sheep erythrocytes. At set time points spores were recovered, plated onto Columbia 5 % sheep blood agar, and surviving bacteria were counted as colony-forming units (cfu). RESULTS No viable spores of either strain were recovered after a 3 h exposure to gaseous H2O2. Spores located inside a drawer showed recovery of approximately 1E5 cfu/ml for C. difficile ribotype 027 after 1 h. In the presence of organic matter, a more than fivefold log reduction compared with not exposed controls could be observed for spores of either strain tested. CONCLUSION Appropriate decontamination of surfaces exposed to spores of C. difficile is challenging for conventional cleaning methods. Aerosolized H2O2 delivered by automated room disinfection systems could possibly improve surface decontamination and thereby reduce transmission of healthcare-associated C. difficile infection. Also in the presence of organic matter H2O2 disinfection appears to be an effective adjunct for decontamination of environmental surfaces.
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Affiliation(s)
- Georg Steindl
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Beethovenstraße 6, 8010, Graz, Austria,
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Barra-Carrasco J, Paredes-Sabja D. Clostridium difficile spores: a major threat to the hospital environment. Future Microbiol 2014; 9:475-86. [PMID: 24810347 DOI: 10.2217/fmb.14.2] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Clostridium difficile is a Gram-positive, anaerobic spore former and is an important nosocomial and community-acquired pathogenic bacterium. C. difficile infections (CDI) are a leading cause of infections worldwide with elevated rates of morbidity. Despite the fact that two major virulence factors, the enterotoxin TcdA and the cytotoxin TcdB, are essential in the development of CDI, C. difficile spores are the main vehicle of infection, and persistence and transmission of CDI and are thought to play an essential role in episodes of CDI recurrence and horizontal transmission. Recent research has unmasked several properties of C. difficile's unique strategy to form highly transmissible spores and to persist in the colonic environment. Therefore, the aim of this article is to summarize recent advances in the biological properties of C. difficile spores, which might be clinically relevant to improve the management of CDI in hospital environments.
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Affiliation(s)
- Jonathan Barra-Carrasco
- Laboratorio de Mecanismos de Patogénesis Bacteriana, Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andrés Bello, República 217, Santiago, Chile
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Quoi de neuf dans les techniques de désinfection des chambres de réanimation ? MEDECINE INTENSIVE REANIMATION 2014. [DOI: 10.1007/s13546-014-0884-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Goyal SM, Chander Y, Yezli S, Otter JA. Evaluating the virucidal efficacy of hydrogen peroxide vapour. J Hosp Infect 2014; 86:255-9. [PMID: 24656442 PMCID: PMC7132520 DOI: 10.1016/j.jhin.2014.02.003] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 02/11/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Surface contamination has been implicated in the transmission of certain viruses, and surface disinfection can be an effective measure to interrupt the spread of these agents. AIM To evaluate the in-vitro efficacy of hydrogen peroxide vapour (HPV), a vapour-phase disinfection method, for the inactivation of a number of structurally distinct viruses of importance in the healthcare, veterinary and public sectors. The viruses studied were: feline calicivirus (FCV, a norovirus surrogate); human adenovirus type 1; transmissible gastroenteritis coronavirus of pigs (TGEV, a severe acute respiratory syndrome coronavirus [SARS-CoV] surrogate); avian influenza virus (AIV); and swine influenza virus (SwIV). METHODS The viruses were dried on stainless steel discs in 20- or 40-μL aliquots and exposed to HPV produced by a Clarus L generator (Bioquell, Horsham, PA, USA) in a 0.2-m(3) environmental chamber. Three vaporized volumes of hydrogen peroxide were tested in triplicate for each virus: 25, 27 and 33 mL. FINDINGS No viable viruses were identified after HPV exposure at any of the vaporized volumes tested. HPV was virucidal (>4-log reduction) against FCV, adenovirus, TGEV and AIV at the lowest vaporized volume tested (25 mL). For SwIV, due to low virus titre on the control discs, >3.8-log reduction was shown for the 25-mL vaporized volume and >4-log reduction was shown for the 27-mL and 33-mL vaporized volumes. CONCLUSION HPV was virucidal for structurally distinct viruses dried on surfaces, suggesting that HPV can be considered for the disinfection of virus-contaminated surfaces.
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Affiliation(s)
- S M Goyal
- Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, MN, USA.
| | - Y Chander
- Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, MN, USA
| | - S Yezli
- Bioquell UK Ltd, Andover, UK
| | - J A Otter
- Bioquell UK Ltd, Andover, UK; Centre for Clinical Infection and Diagnostics Research (CIDR), Department of Infectious Diseases, King's College London School of Medicine and Guy's and St Thomas' NHS Foundation Trust, UK
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Abstract
Conventional disinfection methods are limited by reliance on the operator to ensure appropriate selection, formulation, distribution and contact time of the agent. ‘No-touch’ automated room disinfection (NTD) systems remove or reduce reliance on operators and so they have the potential to improve the efficacy of terminal disinfection. The most commonly used systems are hydrogen peroxide vapour (H2O2 vapour), aerosolised hydrogen peroxide (aHP) and ultraviolet (UV) radiation. These systems have important differences in their active agent, delivery mechanism, efficacy, process time and ease of use. The choice of NTD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation and cost constraints.
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Malik D. The elephant in the room: on the routine use of hydrogen peroxide vapour decontamination systems in health care. J Hosp Infect 2013; 83:354-5. [DOI: 10.1016/j.jhin.2012.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 08/23/2012] [Indexed: 10/27/2022]
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Barbut F, Yezli S, Otter J. Hydrogen peroxide room disinfection: there is no elephant in the room but there's plenty of evidence in the trunk. J Hosp Infect 2013; 83:355-6. [DOI: 10.1016/j.jhin.2012.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 12/17/2012] [Indexed: 11/17/2022]
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Otter JA, Yezli S, Perl TM, Barbut F, French GL. The role of 'no-touch' automated room disinfection systems in infection prevention and control. J Hosp Infect 2012. [PMID: 23195691 DOI: 10.1016/j.jhin.2012.10.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Surface contamination in hospitals is involved in the transmission of pathogens in a proportion of healthcare-associated infections. Admission to a room previously occupied by a patient colonized or infected with certain nosocomial pathogens increases the risk of acquisition by subsequent occupants; thus, there is a need to improve terminal disinfection of these patient rooms. Conventional disinfection methods may be limited by reliance on the operator to ensure appropriate selection, formulation, distribution and contact time of the agent. These problems can be reduced by the use of 'no-touch' automated room disinfection (NTD) systems. AIM To summarize published data related to NTD systems. METHODS Pubmed searches for relevant articles. FINDINGS A number of NTD systems have emerged, which remove or reduce reliance on the operator to ensure distribution, contact time and process repeatability, and aim to improve the level of disinfection and thus mitigate the increased risk from the prior room occupant. Available NTD systems include hydrogen peroxide (H(2)O(2)) vapour systems, aerosolized hydrogen peroxide (aHP) and ultraviolet radiation. These systems have important differences in their active agent, delivery mechanism, efficacy, process time and ease of use. Typically, there is a trade-off between time and effectiveness among NTD systems. The choice of NTD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation and cost constraints. CONCLUSION NTD systems are gaining acceptance as a useful tool for infection prevention and control.
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Affiliation(s)
- J A Otter
- Centre for Clinical Infection and Diagnostics Research, CIDR, Department of Infectious Diseases, King's College London, School of Medicine and Guy's and St Thomas' NHS Foundation Trust, UK.
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Otter J, Yezli S, French G. Impact of the suspending medium on susceptibility of meticillin-resistant Staphylococcus aureus to hydrogen peroxide vapour decontamination. J Hosp Infect 2012; 82:213-5. [DOI: 10.1016/j.jhin.2012.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Accepted: 08/16/2012] [Indexed: 02/03/2023]
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Linley E, Denyer SP, McDonnell G, Simons C, Maillard JY. Use of hydrogen peroxide as a biocide: new consideration of its mechanisms of biocidal action. J Antimicrob Chemother 2012; 67:1589-96. [PMID: 22532463 DOI: 10.1093/jac/dks129] [Citation(s) in RCA: 277] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Hydrogen peroxide is extensively used as a biocide, particularly in applications where its decomposition into non-toxic by-products is important. Although increasing information on the biocidal efficacy of hydrogen peroxide is available, there is still little understanding of its biocidal mechanisms of action. This review aims to combine past and novel evidence of interactions between hydrogen peroxide and the microbial cell and its components, while reflecting on alternative applications that make use of gaseous hydrogen peroxide. It is currently believed that the Fenton reaction leading to the production of free hydroxyl radicals is the basis of hydrogen peroxide action and evidence exists for this reaction leading to oxidation of DNA, proteins and membrane lipids in vivo. Investigations of DNA oxidation suggest that the oxidizing radical is the ferryl radical formed from DNA-associated iron, not hydroxyl. Investigations of protein oxidation suggest that selective oxidation of certain proteins might occur, and that vapour-phase hydrogen peroxide is a more potent oxidizer of protein than liquid-phase hydrogen peroxide. Few studies have investigated membrane damage by hydrogen peroxide, though it is suggested that this is important for the biocidal mechanism. No studies have investigated damage to microbial cell components under conditions commonly used for sterilization. Despite extensive studies of hydrogen peroxide toxicity, the mechanism of its action as a biocide requires further investigation.
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Affiliation(s)
- Ezra Linley
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
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