Hydrogen Peroxide Vapor Helps Disinfect Hospitals

Researchers at The Johns Hopkins Hospital (JHH; Baltimore, MD, USA) placed hydrogen peroxide vapor (HPV) dispersion devices in 180 single hospital rooms (after routine cleaning) to scatter a thin film of H2O2 across all exposed hospital equipment surfaces, as well as on room floors and walls. In all, 6,350 patient admissions to JHH were closely tracked as part of the two-and-a-half-year analysis, with half the rooms received enhanced cleaning with HPV in between patients, while the rest did not. The researchers routinely tested patients and their surroundings for vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and lesser-known bacteria such as Clostridium difficile and Acinetobacter baumannii.

The results showed that HPV cleaning reduced by 64% the number of patients who later became contaminated with any of the most common drug-resistant organisms. Of special note was that HPV reduced by 80% a patient's chances of becoming colonized by the particularly aggressive and hard-to-treat bacterium VRE. Moreover, the researchers found that protection from infection was conferred on patients regardless of whether the previous room occupant was infected with drug-resistant bacteria or not. The study was published in the January 1, 2012, issue of Clinical Infectious Diseases.

“Technological solutions, when combined with standard cleaning, can effectively and systematically decontaminate patients' rooms and augment other behavioral practices, such as strict hospital staff compliance with hand-washing and bathing patients in disinfecting chlorhexidine when they are first admitted to the hospital,” said senior author epidemiologist Trish Perl, MD, MSc. “Our goal is to improve all hospital infection control practices, including cleaning and disinfection, as well as behavioral and environmental practices, to the point where preventing the spread of these multiple-drug-resistant organisms also minimizes the chances of patients becoming infected and improves their chances of recovery.”

The researchers used the Bioquell (Horsham, PA, USA) paired decontaminating units, each about the size of a washing machine. To use the devices, after the room has been cleaned, the vents are covered and the two devices are placed inside. Once the room is sealed, the larger of the two devices disperses H2O2 into the room, leaving a 2–6 micrometer layer on all exposed surfaces, including keyboards and monitors. Because H2O2 is toxic to humans if ingested or corrosive if left on the skin for too long, the second, smaller device is activated to break down the bleach into its component water and oxygen parts. The combined operation takes the devices about an hour and a half to complete.

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Johns Hopkins Hospital
Bioquell