Hydrogen peroxide vapor kill superbugs dead

mostly in rooms that did not undergo enhanced cleaning.

Perl says that patients bringing in or picking up drug-resistant organisms while undergoing treatment in hospitals is a persistent and growing problem, and previous research has shown that patients who stay in a hospital room previously occupied by an infected patient are at greater risk of becoming infected.

“Our study results are evidence that 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,” says Perl, senior hospital epidemiologist for the Johns Hopkins Health System and a professor at the Johns Hopkins University School of Medicine.

“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,” says Perl.

The paired robot-like devices, each about the size of a washing machine and weighing nearly 60 pounds, as well as supplies used in the study, were provided by their manufacturer, Bioquell Inc. of Horsham, Pennsylvania.

After the room has been cleaned, the vents are covered and the two devices are placed inside. The sliding door is closed, and the room is sealed. Then, the larger of the two devices disperses hydrogen peroxide into the room, leaving a very tiny, almost invisible layer (only 2 microns to 6 microns in thickness) on all exposed surfaces, including keyboards and monitors, as well as tables and chairs.

Because hydrogen peroxide can be 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.

“What is so exciting about this new method of infection control is that the devices are easy to use and hospital staff embrace it very quickly,” says surgeon and study co-investigator Pamela Lipsett, M.D., M.H.P.E. Lipsett, a professor and director of surgical and critical care fellowship training at Johns Hopkins, says that during the study and before room cleanings, staff were “wheeling in” other pieces of equipment so these, too, could be decontaminated by the hydrogen peroxide vapor.

As a result of the study and the researchers’ recommendation, JHH has purchased two of the Bioquell decontaminating units, which cost more than $40,000 per pair. The devices, already in use at some twenty other hospitals across the country, will be used at Johns Hopkins to decontaminate rooms typically housing high-risk patients under strict isolation precautions because of severe infection with a multiple-drug-resistant organism.

Researchers say they next plan to study the devices’ effectiveness at decontaminating the outside packaging of unused but potentially exposed hospital supplies, which are typically discarded even though their seals remain intact. The research team also wants to coordinate study testing among other hospitals to validate their Johns Hopkins findings. Larger and longer studies may also be planned, to precisely measure and determine how well the devices work against the spread of each hospital superbug. The current study had only sufficient numbers to statistically validate the paired unit’s effectiveness against VRE.