Efficiency of hydrogen peroxide in improving disinfection of ICU rooms

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• 作者：Caroline Blazejewski (1)
  Fr茅d茅ric Wallet (2)
  Anahita Rouz茅 (1)
  R茅mi Le Guern (2)
  Sylvie Ponthieux (1)
  Julia Salleron (3)
  Saad Nseir (1) (4)
  
  1. Critical Care Center ; University Hospital of Lille ; Rue E. Laine ; 59037 ; Lille Cedex ; France
  2. Microbiology Department ; University Hospital of Lille ; boulevard du Pr. Leclercq ; 59000 ; Lille Cedex ; France
  3. Statistics Department ; University Hospital of Lille ; 1 place de Verdun ; 59037 ; Lille Cedex ; France
  4. Medicine School ; Univeristy of Lille ; 1 place de Verdun ; 59037 ; Lille Cedex ; France
  
• 刊名：Critical Care
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：19
• 期：1
• 全文大小：618 KB
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• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction 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庐) and an aerosolizer using H2O2, and peracetic acid (aHPP, Anios庐) 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 尾鈥搇actamase-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 P鈥?鈥?.371). H2O2 technologies were efficient for environmental MDRO decontamination (6% of rooms contaminated with MDRO at T1 versus 0.5% at T2, P鈥?鈥?.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鈥?鈥?.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 concentration of H2O2 appears to be higher using aHPP, compared with HPV. Conclusions H2O2 treatment is efficient in reducing MDRO contaminated rooms in the ICU. No significant difference was found between aHPP and HPV regarding their disinfection efficiency.