Effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: Focus on clinical trials

Abstract

Over the last decade, substantial scientific evidence has accumulated that indicates contamination of environmental surfaces in hospital rooms plays an important role in the transmission of key health care-associated pathogens (eg, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, Acinetobacter spp). For example, a patient admitted to a room previously occupied by a patient colonized or infected with one of these pathogens has a higher risk for acquiring one of these pathogens than a patient admitted to a room whose previous occupant was not colonized or infected. This risk is not surprising because multiple studies have demonstrated that surfaces in hospital rooms are poorly cleaned during terminal cleaning. To reduce surface contamination after terminal cleaning, no touch methods of room disinfection have been developed. This article will review the no touch methods, ultraviolet light devices, and hydrogen peroxide systems, with a focus on clinical trials which have used patient colonization or infection as an outcome. Multiple studies have demonstrated that ultraviolet light devices and hydrogen peroxide systems have been shown to inactivate microbes experimentally plated on carrier materials and placed in hospital rooms and to decontaminate surfaces in hospital rooms naturally contaminated with multidrug-resistant pathogens. A growing number of clinical studies have demonstrated that ultraviolet devices and hydrogen peroxide systems when used for terminal disinfection can reduce colonization or health care-associated infections in patients admitted to these hospital rooms.

Preventing Transmission of Multidrug-Resistant Pathogens in the Intensive Care Unit

“…59 Both methods reduce the burden of bacterial pathogens, including spores, in the environment. Hydrogen peroxide vapor is highly effective for eliminating pathogens that are on surfaces out of the line of sight, but takes hours and requires sealing of a patient room, including temporary closure of air supply and return.…”

Implementation of Recent Infection Prevention Procedures Published by Centers for Disease Control and Prevention: Difficulties and Problems in Orthodontic Offices

“…Oosthuysen has indicated how frequently such covers should be replaced on the basis of the high turnover of orthodontic patients, cost and environmental impact (2) but, in our view, the decision depends on the degree of risk posed by environmental contamination during the various dental procedures (the removal of fixed appliances vs the replacement of orthodontic elastomeric chains) and, particularly, the frequent poor oral hygiene of orthodontic patients. Terminal disinfection using a hydrogen peroxidebased, no-touch procedure based is very convenient and safe for use in an OF (34). Modifying removable orthodontic appliances, using rotary instruments, at the side of the dental chair should be avoided because acrylic baseplates are always contaminated by mutant Streptococci colonies/biofilms after one week's use by children (3,35,36).…”

Implementation Lessons Learned From the Benefits of Enhanced Terminal Room (BETR) Disinfection Study: Process and Perceptions of Enhanced Disinfection with Ultraviolet Disinfection Devices

“…4–6 Enhanced terminal room disinfection using ultraviolet (UV) light in addition to standard cleaning is an evidence-based strategy that decreases the risk of MDRO acquisition from the environment. 7,8 However, more data are needed to guide hospitals in identifying and overcoming challenges to successful implementation of enhanced disinfection strategies.…”