Efficacy, efficiency and safety aspects of hydrogen peroxide vapour and aerosolized hydrogen peroxide room disinfection systems

Published:February 06, 2012DOI:https://doi.org/10.1016/j.jhin.2011.11.019

      Summary

      Background

      This was a head-to-head comparison of two hydrogen-peroxide-based room decontamination systems.

      Aim

      To compare the efficacy, efficiency and safety of hydrogen peroxide vapour (HPV; Clarus R, Bioquell, Andover, UK) and aerosolized hydrogen peroxide (aHP; SR2, Sterinis, now supplied as Glosair, Advanced Sterilization Products (ASP), Johnson & Johnson Medical Ltd, Wokingham, UK) room disinfection systems.

      Method

      Efficacy was tested using 4- and 6-log Geobacillus stearothermophilus biological indicators (BIs) and in-house prepared test discs containing approximately 106 meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile and Acinetobacter baumannii. Safety was assessed by detecting leakage of hydrogen peroxide using a hand-held detector. Efficiency was assessed by measuring the level of hydrogen peroxide using a hand-held sensor at three locations inside the room, 2 h after the start of the cycles.

      Findings

      HPV generally achieved a 6-log reduction, whereas aHP generally achieved less than a 4-log reduction on the BIs and in-house prepared test discs. Uneven distribution was evident for the aHP system but not the HPV system. Hydrogen peroxide leakage during aHP cycles with the door unsealed, as per the manufacturer’s operating manual, exceeded the short-term exposure limit (2 ppm) for more than 2 h. When the door was sealed with tape, as per the HPV system, hydrogen peroxide leakage was <1 ppm for both systems. The mean concentration of hydrogen peroxide in the room 2 h after the cycle started was 1.3 [standard deviation (SD) 0.4] ppm and 2.8 (SD 0.8) ppm for the four HPV and aHP cycles, respectively. None of the readings were <2 ppm for the aHP cycles.

      Conclusion

      The HPV system was safer, faster and more effective for biological inactivation.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Journal of Hospital Infection
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Dancer S.J.
        The role of environmental cleaning in the control of hospital-acquired infection.
        J Hosp Infect. 2009; 73: 378-385
        • Kramer A.
        • Schwebke I.
        • Kampf G.
        How long do nosocomial pathogens persist on inanimate surfaces? A systematic review.
        BMC Infect Dis. 2006; 6: 130
        • French G.L.
        • Otter J.A.
        • Shannon K.P.
        • Adams N.M.
        • Watling D.
        • Parks M.J.
        Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination.
        J Hosp Infect. 2004; 57: 31-37
        • Jeanes A.
        • Rao G.
        • Osman M.
        • Merrick P.
        Eradication of persistent environmental MRSA.
        J Hosp Infect. 2005; 61: 85-86
        • Otter J.A.
        • French G.L.
        Survival of nosocomial bacteria and spores on surfaces and inactivation by hydrogen peroxide vapor.
        J Clin Microbiol. 2009; 47: 205-207
        • Andersen B.M.
        • Rasch M.
        • Hochlin K.
        • Jensen F.H.
        • Wismar P.
        • Fredriksen J.E.
        Decontamination of rooms, medical equipment and ambulances using an aerosol of hydrogen peroxide disinfectant.
        J Hosp Infect. 2006; 62: 149-155
        • Barbut F.
        • Menuet D.
        • Verachten M.
        • Girou E.
        Comparison of the efficacy of a hydrogen peroxide dry-mist disinfection system and sodium hypochlorite solution for eradication of Clostridium difficile spores.
        Infect Control Hosp Epidemiol. 2009; 30: 515-517
        • Boyce J.M.
        New approaches to decontamination of rooms after patients are discharged.
        Infect Control Hosp Epidemiol. 2009; 30: 515-517
        • Shapey S.
        • Machin K.
        • Levi K.
        • Boswell T.C.
        Activity of a dry mist hydrogen peroxide system against environmental Clostridium difficile contamination in elderly care wards.
        J Hosp Infect. 2008; 70: 136-141
        • Bartels M.D.
        • Kristoffersen K.
        • Slotsbjerg T.
        • Rohde S.M.
        • Lundgren B.
        • Westh H.
        Environmental meticillin-resistant Staphylococcus aureus (MRSA) disinfection using dry-mist-generated hydrogen peroxide.
        J Hosp Infect. 2008; 70: 35-41
        • Otter J.A.
        • Havill N.L.
        • Boyce J.M.
        Hydrogen peroxide vapor is not the same as aerosolized hydrogen peroxide.
        Infect Control Hosp Epidemiol. 2010; 11: 1201-1202
        • Unger-Bimczok B.
        • Kottke V.
        • Hertel C.
        • Rauschnabel J.
        The influence of humidity, hydrogen peroxide concentration, and condensationon the inactivation of Geobacillus stearothermophilus spores with hydrogen peroxide vapor.
        J Pharm Innov. 2008; 3: 123-133
        • Boyce J.M.
        • Havill N.L.
        • Otter J.A.
        • et al.
        Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile environmental contamination and transmission in a healthcare setting.
        Infect Control Hosp Epidemiol. 2008; 29: 723-729
        • Andersen B.M.
        • Rasch M.
        • Kvist J.
        • et al.
        Floor cleaning: effect on bacteria and organic materials in hospital rooms.
        J Hosp Infect. 2009; 71: 57-65
        • Bergen L.K.
        • Meyer M.
        • Hog M.
        • Rubenhagen B.
        • Andersen L.P.
        Spread of bacteria on surfaces when cleaning with microfibre cloths.
        J Hosp Infect. 2009; 71: 132-137
        • Pottage T.
        • Richardson C.
        • Parks S.
        • Walker J.T.
        • Bennett A.M.
        Evaluation of hydrogen peroxide gaseous disinfection systems to decontaminate viruses.
        J Hosp Infect. 2010; 74: 55-61
        • Bates C.J.
        • Pearse R.
        Use of hydrogen peroxide vapour for environmental control during a Serratia outbreak in a neonatal intensive care unit.
        J Hosp Infect. 2005; 61: 364-366
        • Park J.
        • Plese M.R.
        • Puskar M.A.
        Evaluation of a personal monitor employing an electrochemical sensor for assessing exposure to hydrogen peroxide in the workplace.
        AIHA J. 2003; 64: 360-367