Comparison of cleaning efficacy between in-use disinfectant and electrolysed water in an English residential care home

Published:December 23, 2011DOI:



      Infection control in hospitals and care homes remains a key issue. They are regularly inspected regarding standards of hygiene, but visual assessment does not necessarily correlate with microbial cleanliness. Pathogens can persist in the inanimate environment for extended periods of time.


      This prospective study compared the effectiveness of a novel sanitizer containing electrolysed water, in which the active ingredient is stabilized hypochlorous acid (Aqualution™), with the effectiveness of the quaternary ammonium disinfectant in current use for microbial removal from hand-touch surfaces in a care home. The study had a two-period crossover design.


      Five surfaces were cleaned daily over a four-week period, with screening swabs taken before and after cleaning. Swabs were cultured in order to compare levels of surface microbial contamination [colony-forming units (cfu)/cm2] before and after cleaning with each product.


      Cleaning with electrolysed water reduced the mean surface bacterial load from 2.6 [interquartile range (IQR) 0.30–30.40] cfu/cm2 to 0.10 (IQR 0.10–1.40) cfu/cm2 [mean log10 reduction factor 1.042, 95% confidence interval (CI) 0.79–1.30]. Cleaning with the in-use quaternary ammonium disinfectant increased the bacterial load from 0.90 (IQR 0.10–8.50) cfu/cm2 to 93.30 (IQR 9.85–363.65) cfu/cm2 (mean log10 reduction −1.499, 95% CI −1.87 to −1.12) (P < 0.0001). Using two proposed benchmark standards for surface microbial levels in hospitals, electrolysed water resulted in a higher ‘pass rate’ than the in-use quaternary ammonium disinfectant (80–86% vs 15–21%, P < 0.0001).


      Electrolysed water exerts a more effective bacterial kill than the in-use quaternary ammonium disinfectant, which suggests that it may be useful as a surface sanitizer in environments such as care homes.


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        • Ryan M.J.
        • Wall P.G.
        • Adak G.K.
        • Evans H.S.
        • Cowden J.M.
        Outbreaks of infectious intestinal disease in residential institutions in England and Wales 1992–4.
        J Infect. 1997; 34: 49-54
        • Garibaldi R.A.
        Residential care and the elderly: the burden of infection.
        J Hosp Infect. 1999; 43: S9-S18
        • Dancer S.J.
        Mopping up hospital infection.
        J Hosp Infect. 1999; 43: 85-100
        • Griffith C.J.
        • Cooper R.A.
        • Gilmore J.
        • Davies C.
        • Lewis M.
        An evaluation of hospital cleaning regimes and standards.
        J Hosp Infect. 2000; 45: 19-28
        • Dancer S.J.
        How do we assess hospital cleaning? A proposal for microbiological standards for surface hygiene in hospitals.
        J Hosp Infect. 2004; 56: 10-15
        • Bhalla A.
        • Pultz N.J.
        • Gries D.M.
        • et al.
        Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalised patients.
        Infect Control Hosp Epidemiol. 2004; 25: 164-167
        • Carling P.C.
        • Briggs J.L.
        • Perkins J.
        • Highlander D.
        Improved cleaning of patient rooms using a new targeting method.
        Clin Infect Dis. 2006; 42: 385-388
        • Wu H.M.
        • Fornek M.
        • Schwab K.J.
        • et al.
        A norovirus outbreak at a long-term-care facility: the role of environmental surface contamination.
        Infect Control Hosp Epidemiol. 2005; 26: 802-810
        • Hill R.L.R.
        Half-life of antiseptics is the key: evidence from theory experimentation and practice.
        in: Hill R.L.R. Infection Control Round Table Series 85. Royal Society of Medicine Press, London2007: 1-21
        • Huang Y.R.
        • Hung Y.C.
        • Hsu S.Y.
        • Huang Y.W.
        • Hwang D.F.
        Application of electrolyzed water in the food industry.
        Food Control. 2008; 19: 329-345
      1. BSEN 1276 Compliance Study, Hospital Infection Research Laboratory, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.

      2. BSEN 1040 Compliance Study, Huntingdon Life Sciences, Alconbury, UK.

      3. BSEN 1040: 1997.

      4. BSEN 1276: 1997.

        • Venkitanarayanan K.S.
        • Ezeike G.O.
        • Hung Y.C.
        • Doyle M.P.
        Efficacy of electrolyzed oxidising water for inactivating E. coli O157:H7, Salmonella enteritidis and Listeria monocytogenes.
        Appl Environ Microbiol. 1999; 65: 4276-4279
        • Dharan S.
        • Mourouga P.
        • Copin P.
        • Bessmer G.
        • Tschanz B.
        • Pittet D.
        Routine disinfection of patients’ environmental surfaces: myth or reality?.
        J Hosp Infect. 1999; 42: 113-117
        • Moore G.
        • Griffith C.
        A laboratory evaluation of the decontamination properties of microfibre cloths.
        J Hosp Infect. 2006; 64: 379-385
        • Clark J.
        • Barrett S.P.
        • Rogers M.
        • Stapleton R.
        Efficacy of super-oxidized water fogging in environmental decontamination.
        J Hosp Infect. 2006; 64: 386-390