Effectiveness of ultraviolet-C vs aerosolized hydrogen peroxide in ICU terminal disinfection

S Kelly; D Schnugh; T Thomas

doi:10.1016/j.jhin.2021.12.004

Effectiveness of ultraviolet-C vs aerosolized hydrogen peroxide in ICU terminal disinfection

J Hosp Infect. 2022 Mar:121:114-119. doi: 10.1016/j.jhin.2021.12.004. Epub 2021 Dec 13.

Authors

S Kelly¹, D Schnugh², T Thomas³

Affiliations

¹ Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Witwatersrand University, Johannesburg, South Africa. Electronic address: seankelly0124@gmail.com.
² Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Witwatersrand University, Johannesburg, South Africa.
³ Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Witwatersrand University, Johannesburg, South Africa; Infection Control Services Laboratory, National Health Laboratory Services, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.

PMID: 34915051
DOI: 10.1016/j.jhin.2021.12.004

Abstract

Background: According to the Centers for Disease Control and Prevention, 10% of patients with healthcare-acquired infections (HAIs) died during hospitalization in 2015. Thus, a reduction in the prevalence of HAIs is critical. One strategy to achieve this is the adequate disinfection of patient rooms within hospitals.

Aim: To compare the effectiveness of an ultraviolet-C (UV-C) room sanitizer with an aerosolized hydrogen peroxide (aHP) device for the elimination of selected healthcare-associated (HA) pathogens and other HA organisms in an intensive care unit (ICU) setting.

Methods: The disinfection systems were tested on the following organisms: meticillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, carbapenem-resistant K. pneumoniae, vancomycin-resistant enterococci, multi-drug-resistant Acinetobacter baumannii and Candida auris. Media plates with known densities of each organism were placed at preselected regions within an ICU room. The mean kill rate was determined for each organism. Additionally, swabs were taken from five high-touch areas from different ICU rooms prior to manual cleaning, following manual cleaning, and following each disinfection method in order to compare their effectiveness.

Findings: The UV-C device achieved a 96.75% mean microbial reduction in non-shaded areas. It was significantly less effective in shaded areas. The aHP system achieved a mean kill rate of 50.71% for all areas. The swab results revealed that 15% of manually cleaned surfaces still harboured a microbial load, which was eradicated after use of either of the no-touch disinfection systems.

Conclusion: This study found notable differences between two no-touch disinfection methods, highlights their effectiveness, and advocates for their incorporation alongside a manual cleaning regimen.

Keywords: Aerosolized hydrogen peroxide; Healthcare-acquired infections; No-touch disinfection; Ultraviolet-C.

MeSH terms

Cross Infection* / epidemiology
Cross Infection* / prevention & control
Disinfection / methods
Humans
Hydrogen Peroxide / pharmacology
Intensive Care Units
Methicillin-Resistant Staphylococcus aureus*
Ultraviolet Rays

Substances

Hydrogen Peroxide