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Efficiency of hydrogen peroxide in improving disinfection of icu rooms

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Název: Efficiency of hydrogen peroxide in improving disinfection of icu rooms
Autoři: Blazejewski, Caroline, Wallet, Frederic, Rouze, Anahita, Le Guern, Rémi, Ponthieux, Sylvie, Salleron, Julia, Nseir, Saad
Přispěvatelé: CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, Université de Lille, Lille Inflammation Research International Center (LIRIC) - U995, Centre Hospitalier Régional Universitaire Lille CHRU Lille, Recherche translationnelle : relations hôte-pathogènes - EA 7366, Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 CIIL, Lille Inflammation Research International Center - U 995 LIRIC, Recherche translationelle relations hôte-pathogènes
Rok vydání: 2020
Sbírka: LillOA (Lille Open Archive - Université de Lille)
Témata: Mesh:Peracetic Acid/pharmacology, Mesh:Patients'' Rooms/standards, Mesh:Peracetic Acid/therapeutic use, Mesh:Prospective Studies, Mesh:Volatilization, Mesh:Hydrogen Peroxide/pharmacology, Mesh:Efficiency, Mesh:Disinfection/methods, Mesh:Drug Resistance, Mesh:Multiple, Mesh:Bacterial/drug effects, Mesh:Disinfection/instrumentation, Mesh:Disinfectants/therapeutic use, Mesh:Hydrogen Peroxide/therapeutic use, Mesh:Disinfectants/pharmacology, Mesh:Cross-Over Studies, Mesh:Cross Infection/prevention & control, Mesh:Intensive Care Units/standards
Popis: BACKGROUND: The primary objective of this study was to determine the efficiency of hydrogen peroxide (H₂O₂) techniques in disinfection of ICU rooms contaminated with multidrug-resistant organisms (MDRO) after patient discharge. Secondary objectives included comparison of the efficiency of a vaporizator (HPV, Bioquell) and an aerosolizer using H₂O₂, and peracetic acid (aHPP, Anios) in MDRO environmental disinfection, and assessment of toxicity of these techniques. METHODS: This prospective cross-over study was conducted in five medical and surgical ICUs located in one University hospital, during a 12-week period. Routine terminal cleaning was followed by H₂O₂ disinfection. A total of 24 environmental bacteriological samplings were collected per room, from eight frequently touched surfaces, at three time-points: after patient discharge (T0), after terminal cleaning (T1) and after H₂O₂ disinfection (T2). RESULTS: In total 182 rooms were studied, including 89 (49%) disinfected with aHPP and 93 (51%) with HPV. At T0, 15/182 (8%) rooms were contaminated with at least 1 MDRO (extended spectrum β-lactamase-producing Gram-negative bacilli 50%, imipenem resistant Acinetobacter baumannii 29%, methicillin-resistant Staphylococcus aureus 17%, and Pseudomonas aeruginosa resistant to ceftazidime or imipenem 4%). Routine terminal cleaning reduced environmental bacterial load (P <0.001) without efficiency on MDRO (15/182 (8%) rooms at T0 versus 11/182 (6%) at T1; P = 0.371). H₂O₂ technologies were efficient for environmental MDRO decontamination (6% of rooms contaminated with MDRO at T1 versus 0.5% at T2, P = 0.004). Patient characteristics were similar in aHPP and HPV groups. No significant difference was found between aHPP and HPV regarding the rate of rooms contaminated with MDRO at T2 (P = 0.313). 42% of room occupants were MDRO carriers. The highest rate of rooms contaminated with MDRO was found in rooms where patients stayed for a longer period of time, and where a patient with MDRO was hospitalized. The residual ...
Druh dokumentu: article in journal/newspaper
Popis souboru: application/octet-stream; application/rdf+xml; charset=utf-8
Jazyk: English
Relation: Critical care (London, England); Crit. Care; http://hdl.handle.net/20.500.12210/16925
Dostupnost: https://hdl.handle.net/20.500.12210/16925
Rights: Attribution-NonCommercial 3.0 United States ; info:eu-repo/semantics/openAccess
Přístupové číslo: edsbas.E262882E
Databáze: BASE
Popis
Abstrakt:BACKGROUND: The primary objective of this study was to determine the efficiency of hydrogen peroxide (H₂O₂) techniques in disinfection of ICU rooms contaminated with multidrug-resistant organisms (MDRO) after patient discharge. Secondary objectives included comparison of the efficiency of a vaporizator (HPV, Bioquell) and an aerosolizer using H₂O₂, and peracetic acid (aHPP, Anios) in MDRO environmental disinfection, and assessment of toxicity of these techniques. METHODS: This prospective cross-over study was conducted in five medical and surgical ICUs located in one University hospital, during a 12-week period. Routine terminal cleaning was followed by H₂O₂ disinfection. A total of 24 environmental bacteriological samplings were collected per room, from eight frequently touched surfaces, at three time-points: after patient discharge (T0), after terminal cleaning (T1) and after H₂O₂ disinfection (T2). RESULTS: In total 182 rooms were studied, including 89 (49%) disinfected with aHPP and 93 (51%) with HPV. At T0, 15/182 (8%) rooms were contaminated with at least 1 MDRO (extended spectrum β-lactamase-producing Gram-negative bacilli 50%, imipenem resistant Acinetobacter baumannii 29%, methicillin-resistant Staphylococcus aureus 17%, and Pseudomonas aeruginosa resistant to ceftazidime or imipenem 4%). Routine terminal cleaning reduced environmental bacterial load (P <0.001) without efficiency on MDRO (15/182 (8%) rooms at T0 versus 11/182 (6%) at T1; P = 0.371). H₂O₂ technologies were efficient for environmental MDRO decontamination (6% of rooms contaminated with MDRO at T1 versus 0.5% at T2, P = 0.004). Patient characteristics were similar in aHPP and HPV groups. No significant difference was found between aHPP and HPV regarding the rate of rooms contaminated with MDRO at T2 (P = 0.313). 42% of room occupants were MDRO carriers. The highest rate of rooms contaminated with MDRO was found in rooms where patients stayed for a longer period of time, and where a patient with MDRO was hospitalized. The residual ...