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Evaluation of hydrogen peroxide vapor for the inactivation of nosocomial pathogens on porous and nonporous surfaces

Major article in the American Journal of Infection Control, 43 (2015) 82-5

Sebastian Lemmen MD (a), Simone Scheithauer (a), Helga Häfner (a), Saber Yezli PhD (b), Michael Mohr (c), Jonathan A. Otter PhD (b,d)

(a) Department of Infection Control and Infectious Diseases, University Hospital Aachen, Aachen, Germany
(b) Bioquell UK Ltd, Andover, Hampshire, UK
(c) Schülke & Mayr GmbH, Norderstedt, Germany
(d) 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

Background:
Clostridium difficile spores and multidrug-resistant (MDR) organisms, such as methicillinresistant 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 log10 Geobacillus 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.