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Tao C, Sun G, Tang X, Gan Y, Liang G, Wang J, Huang Y. Bactericidal efficacy of low concentration of vaporized hydrogen peroxide with validation in a BSL-3 laboratory. J Hosp Infect 2022; 127:51-58. [PMID: 35594986 DOI: 10.1016/j.jhin.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/26/2022] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Highly infective pathogens are cultured and studied in biosafety laboratories. It is critical to thoroughly disinfect these laboratories to prevent laboratory infection. A whole-room, non-contact, reduced corrosion disinfection strategy using hydrogen peroxide was proposed and evaluated. AIM To evaluate the bactericidal efficacy of 8% and 10% vaporized hydrogen peroxide( VHP) in a laboratory setting with spores and bacteria as bioindicators. METHODS Spores of B. atrophaeus and B. stearothermophilus, along with bacteria E. coli, S. aureus, and S. epidermidis were placed in pre-selected locations in a sealed laboratory and an OXY-PHARM NOCOSPRAY2 vaporized hydrogen peroxide generator was applied. Spore killing efficacy was qualitatively evaluated, and bactericidal efficacy was quantitatively analyzed, and the mean log10 reduction was determined. Finally, the optimized disinfection strategy was verified in a BSL-3 laboratory. FINDINGS Significant reductions in microbial load were obtained for each of the selected spores and bacteria when exposed to VHP in concentrations of 8% and 10% for 2~3 h. S. aureus was found to be more resistant than E. coli and S. epidermidis. Tests with 8% hydrogen peroxide and exposure for more than 3 h completely killed B. atrophaeus on surfaces and equipment in the BSL-3 laboratory. CONCLUSION The vaporized hydrogen peroxide generator is superior in terms of good diffusivity and low corrosiveness and is time-effective in removing the disinfectant residue. This study provides reference for the precise disinfection of air and object surfaces in biosafety laboratories under varying conditions.
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Affiliation(s)
- C Tao
- Centre for Disease Prevention and Control, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - G Sun
- Centre for Disease Prevention and Control, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
| | - X Tang
- Centre for Disease Prevention and Control, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Y Gan
- Centre for Disease Prevention and Control, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - G Liang
- School of Public Health, Guangxi Medical University. Nanning, Guangxi, China
| | - J Wang
- Centre for Disease Prevention and Control, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Y Huang
- Centre for Disease Prevention and Control, Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
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Ahmed R, Mulder R. A Systematic Review on the Efficacy of Vaporized Hydrogen Peroxide as a Non-Contact Decontamination System for Pathogens Associated with the Dental Environment. Int J Environ Res Public Health 2021; 18:4748. [PMID: 33946831 DOI: 10.3390/ijerph18094748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/30/2021] [Accepted: 04/25/2021] [Indexed: 11/22/2022]
Abstract
Aerosol generation and a wide range of pathogens originating from the oral cavity of the patient contaminate various surfaces of the dental clinic. The aim was to determine the efficacy of vaporized hydrogen peroxide fogging on pathogens related to the dental environment and its possible application in dentistry. PICOS statement (Population, Intervention, Comparison/Control, Outcome and Study design statement) was used in the review. Six electronic databases were searched for articles published from 2010 to 2020. Articles written in English reporting vaporized hydrogen peroxide on pathogens deemed to be relevant to the dental environment were assessed. The quality of the studies was assessed using the risk-of-bias assessment tool designed for the investigation of vaporized hydrogen peroxide application in dentistry. A total of 17 studies were included in the qualitative synthesis. The most commonly reported single bacterial pathogen was Methicillin-resistant Staphylococcus aureus in five studies, and the viruses Feline calicivirus, Human norovirus, and Murine norovirus were featured in three studies. The results of the studies reporting the log kill were sufficient for all authors to conclude that vaporized hydrogen peroxide generation was effective for the assessed pathogens. The studies that assessed aerosolized hydrogen peroxide found a greater log kill with the use of vaporized hydrogen peroxide generators. The overarching conclusion was that hydrogen peroxide delivered as vaporized hydrogen peroxide was an effective method to achieve large levels of log kill on the assessed pathogens. The hydrogen peroxide vapor generators can play a role in dental bio-decontamination. The parameters must be standardized and the efficacy assessed to perform bio-decontamination for the whole clinic. For vaporized hydrogen peroxide generators to be included in the dental bio-decontamination regimen, certain criteria should be met. These include the standardization and efficacy assessment of the vaporized hydrogen peroxide generators in dental clinics.
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McEvoy B, Lynch M, Rowan NJ. Opportunities for the application of real-time bacterial cell analysis using flow cytometry for the advancement of sterilization microbiology. J Appl Microbiol 2020; 130:1794-1812. [PMID: 33155740 DOI: 10.1111/jam.14876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 01/11/2023]
Abstract
Medical devices provide critical care and diagnostic applications through patient contact. Sterility assurance level (SAL) may be defined as the probability of a single viable micro-organism occurring on an item after a sterilization process. Sterilization microbiology often relies upon using an overkill validation method where a 12-log reduction in recalcitrant bacterial endospore population occurs during the process that exploits conventional laboratory-based culture media for enumeration. This timely review explores key assumptions underpinning use of conventional culture-based methods in sterilization microbiology. Consideration is given to how such methods may limit the ability to fully appreciate the inactivation kinetics of a sterilization process such as vaporized hydrogen peroxide (VH2O2) sterilization, and consequently design efficient sterilization processes. Specific use of the real-time flow cytometry (FCM) is described by way of elucidating the practical relevance of these limitation factors with implications and opportunities for the sterilization industry discussed. Application of FCM to address these culture-based limitation factors will inform real-time kinetic inactivation modelling and unlock potential to embrace emerging opportunities for pharma, medical device and sterilization industries including potentially disruptive applications that may involve reduced usage of sterilant.
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Affiliation(s)
- B McEvoy
- STERIS Applied Sterilization Technologies, IDA Business and Technology Park, Tullamore, Ireland
| | - M Lynch
- Centre for Disinfection, Sterilization and Biosecurity, Athlone Institute of Technology, Athlone, Ireland
| | - N J Rowan
- Centre for Disinfection, Sterilization and Biosecurity, Athlone Institute of Technology, Athlone, Ireland
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Hankenson FC, Mauntel M, Willard J, Pittsley L, Degg W, Burnell N, Vierling A, Griffis S. Vaporized Hydrogen Peroxide Decontamination of N95 Respirators in a Dedicated Animal Research Facility for Reuse During a Novel Coronavirus Pandemic. Appl Biosaf 2020; 25:142-149. [PMID: 38602982 PMCID: PMC7315381 DOI: 10.1177/1535676020936381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction During the COVID-19 pandemic, health care systems and safety providers have faced an unprecedented challenge of limited access to personal protective equipment (PPE) to conduct patient and public care. In federal emergencies, reuse of PPE after disinfection can occur by processes, like vaporized hydrogen peroxide (VHP), recommended by the Centers for Disease and Control and Prevention. We identified a vacant animal holding facility at our institution to repurpose into a regional VHP decontamination center. Methods The facility is a multiroom, 20 000 ft2 building with control of HVAC to adjust to VHP conditional requirements. H2O2 was delivered to rooms using robotic HaloFoggers, dispersing H2O2 vapor and increasingly concentrated microdroplets as a fog for a timed period based on cubic footage of rooms. Results Fogging cycles eliminated 6-log Geobacillus stearothermophilus up to 7 days postcycle. Functional efficacy of treated N95s was confirmed by fit tests of institutional personnel. Signage, process flow mapping, and training materials facilitated ease of workflow and adherence to safety expectations within the building. Discussion and Conclusion Our study determined that a variety of N95 respirator types and sizes were able to be cleared of potential bacterial and viral agents using VHP in a controlled fog/dwell/exhaust cycle. This repurposed animal facility has the capacity to decontaminate up to 6700 respirators daily, which will address the predicted surge of COVID-19 cases in the state, and ultimately allow each respirator to be reused multiple times. There is no other public site in the region with our capacity to offset the continued supply chain issues for PPE needs.
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Affiliation(s)
- F. Claire Hankenson
- Campus Animal Resources, Michigan State University, East Lansing, MI, USA
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Mark Mauntel
- Campus Animal Resources, Michigan State University, East Lansing, MI, USA
| | - Jamie Willard
- Environmental Health and Safety, Office of Regulatory Affairs, Michigan State University, East Lansing, MI, USA
| | - Leslie Pittsley
- Campus Animal Resources, Michigan State University, East Lansing, MI, USA
| | | | | | | | - Stanley Griffis
- Department of Supply Chain Management, Eli Broad College of Business, Michigan State University, East Lansing, MI, USA
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Smith JS, Hanseler H, Welle J, Rattray R, Campbell M, Brotherton T, Moudgil T, Pack TF, Wegmann K, Jensen S, Jin J, Bifulco CB, Prahl SA, Fox BA, Stucky NL. Effect of various decontamination procedures on disposable N95 mask integrity and SARS-CoV-2 infectivity. J Clin Transl Sci 2020; 5:e10. [PMID: 34192045 PMCID: PMC7605403 DOI: 10.1017/cts.2020.494] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has created a high demand on personal protective equipment, including disposable N95 masks. Given the need for mask reuse, we tested the feasibility of vaporized hydrogen peroxide (VHP), ultraviolet light (UV), and ethanol decontamination strategies on N95 mask integrity and the ability to remove the infectious potential of SARS-CoV-2. METHODS Disposable N95 masks, including medical grade (1860, 1870+) and industrial grade (8511) masks, were treated by VHP, UV, and ethanol decontamination. Mask degradation was tested using a quantitative respirator fit testing. Pooled clinical samples of SARS-CoV-2 were applied to mask samples, treated, and then either sent immediately for real-time reverse transcriptase-polymerase chain reaction (RT-PCR) or incubated with Vero E6 cells to assess for virucidal effect. RESULTS Both ethanol and UV decontamination showed functional degradation to different degrees while VHP treatment showed no significant change after two treatments. We also report a single SARS-CoV-2 virucidal experiment using Vero E6 cell infection in which only ethanol treatment eliminated detectable SARS-CoV-2 RNA. CONCLUSIONS We hope our data will guide further research for evidenced-based decisions for disposable N95 mask reuse and help protect caregivers from SARS-CoV-2 and other pathogens.
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Affiliation(s)
- Jeffrey S. Smith
- Providence Portland Medical Center, Department of Medicine, Portland, Oregon, USA
| | | | - John Welle
- Regional Pathology, Providence St. Joseph Health, Portland, Oregon, USA
| | - Rogan Rattray
- Regional Pathology, Providence St. Joseph Health, Portland, Oregon, USA
| | - Mary Campbell
- Regional Pathology, Providence St. Joseph Health, Portland, Oregon, USA
| | - Tacy Brotherton
- Cancer Research Animal Division, Robert W. Franz Cancer Center, Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon, USA
| | - Tarsem Moudgil
- Molecular & Tumor Immunology, Robert W. Franz Cancer Center, Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon, USA
| | - Thomas F. Pack
- Axovant Gene Therapies, Ltd, Durham, North Carolina, USA
| | - Keith Wegmann
- Molecular & Tumor Immunology, Robert W. Franz Cancer Center, Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon, USA
| | - Shawn Jensen
- Molecular & Tumor Immunology, Robert W. Franz Cancer Center, Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon, USA
| | - Justin Jin
- Providence Portland Medical Center, Department of Medicine, Portland, Oregon, USA
| | - Carlo B. Bifulco
- Regional Pathology, Providence St. Joseph Health, Portland, Oregon, USA
- Translational Molecular Pathology and Molecular Genomics, Robert W. Franz Cancer Center, Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon, USA
| | - Scott A. Prahl
- Electrical Engineering and Renewable Energy, Oregon Institute of Technology, Wilsonville, Oregon, USA
| | - Bernard A. Fox
- Molecular & Tumor Immunology, Robert W. Franz Cancer Center, Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon, USA
- Department of Molecular Microbiology and Immunology, and Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Nicholas L. Stucky
- Providence Portland Medical Center, Department of Medicine, Portland, Oregon, USA
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McEvoy B, Rowan NJ. Terminal sterilization of medical devices using vaporized hydrogen peroxide: a review of current methods and emerging opportunities. J Appl Microbiol 2019; 127:1403-1420. [PMID: 31410952 DOI: 10.1111/jam.14412] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/03/2019] [Accepted: 07/25/2019] [Indexed: 01/08/2023]
Abstract
Medical devices are an important and growing aspect of healthcare provision and are increasing in complexity to meet established and emerging patient needs. Terminal sterilization plays a vital role in the provision of safe medical devices. While terminal sterilization technologies for medical devices include multiple radiation options, ethylene oxide remains the predominant nonthermal gaseous option, sterilizing c. 50% of all manufactured devices. Vaporized hydrogen peroxide (abbreviated VH2O2 by the International Organization for Standardization) is currently deployed for clinical sterilization applications, where its performance characteristics appear aligned to requirements, constituting a viable alternative low-temperature process for terminal processing of medical devices. However, VH2O2 has operational limitations that create technical challenges for industrial-scale adoption. This timely review provides a succinct overview of VH2O2 in gaseous sterilization and addresses its applicability for terminal sterilization of medical devices. It also describes underappreciated factors such as the occurrence of nonlinear microbial inactivation kinetic plots that may dictate a need to develop a new standard approach to validate VH2O2 for terminal sterilization of medical devices.
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Affiliation(s)
- B McEvoy
- STERIS Applied Sterilization Technologies, IDA Business and Technology Park, Tullamore, Ireland
| | - N J Rowan
- Bioscience Research Institute, Athlone Institute of Technology, Athlone, Ireland
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