Efficacy of Dry Mist of Hydrogen Peroxide (DMHP) against Mycobacterium tuberculosis and use of DMHP for Routine Decontamination of Biosafety Level 3 Laboratories

Abstract

Mycobacterium tuberculosis is a major cause of morbidity and mortality worldwide and is becoming a greater concern due to the development of multidrug-resistant strains. M. tuberculosis can contaminate rooms, medical equipment, and research laboratories and has the propensity to be highly resistant to decontamination. The aim of this study was to determine the efficacy of room disinfection with a dry mist of hydrogen peroxide (DMHP) in a biosafety level 3 laboratory in the event of contamination with M. tuberculosis. The biological indicators (BIs) were comprised of presterilized cotton tissues on which amounts of about 10 7 CFU/ml of M. tuberculosis H37Ra were dried. The device (Sterinis; Gloster Sante Europe) provided a DMHP of 5% hydrogen peroxide during 25 min. Three experiments were performed. The viable bacteria were reduced by values of more than 5 log 10 , and no colony grew from any BI. In conclusion, DMHP shows promise as an effective and safe alternative to the currently used formaldehyde.Tuberculosis is a major public health problem, particularly with the development of multidrug-resistant strains (22). It was declared to be a global emergency by the World Health Organization (WHO) in 1993. Mycobacterium tuberculosis bacteria are most likely transmitted by aerosols and so can easily contaminate rooms in health care facilities or research laboratories. Moreover, these bacteria present high intrinsic resistance to disinfection and fumigation processes and possess effective defense mechanisms against oxidative stress (4, 5). Their resistance to disinfectants has been considered intermediate between those of other vegetative bacteria and spores. The components of the cell wall that are responsible for this high level of resistance are unknown, but both mycolic acids and arabinogalactan appear to be involved (3,20).Chemical liquids and vapors are mainly used as decontaminating agents. Traditional room fumigation has been conducted by using formaldehyde or ethylene oxide gas. These methods have been given up due to their toxicity and carcinogenicity. In June 2004, the International Agency for Research on Cancer (IARC) classified formaldehyde as carcinogenic for humans (6,12). It has been recommended in France since September 2006 that this substance not be used for room decontamination, and its production was definitively stopped in January 2007. Thus, research laboratories and hospitals must find other solutions for decontamination; H 2 O 2 provides an alternative to formaldehyde fumigation because of its biological efficacy against various microorganisms (7,8,11,13,17) and its safety (hydrogen peroxide readily decomposes to form water and oxygen).Hydrogen peroxide has already been recommended for the disinfection of a large variety of materials, including dental instruments (18) and bronchoscopes (2). The use of H 2 O 2 vapor (VHP) for the biodecontamination of biological safety cabinets (BSCs), rooms in health care facilities (8), ambulances (1), pharmaceutical facilities, and laboratories (10, 14, 15, ...

Inactivation of Brucella Suis, Burkholderia pseudomallei, Francisella tularensis, and Yersinia pestis using Vaporous Hydrogen Peroxide

“…A common approach for decontamination and disinfection is the implementation of vaporous hydrogen peroxide, which has been used to treat pharmaceutical facilities, hospital rooms, ambulances, animal holding rooms, air ducts, mail facilities, and two office buildings (Anderson et al, 2006;Canter et al, 2005;Dryden et al, 2008;French et al, 2004;Kahnert et al, 2005;Krause et al, 2001;Verce et al, 2008). Moreover, vaporous hydrogen peroxide has been shown to be effective in inactivating a wide range of microorganisms (Boyce et al, 2008;French et al, 2004;Grare et al, 2008;Hall et al, 2007;Hall et al, 2008;Heckert et al, 1997;Johnston et al, 2005;Klapes & Vesley, 1990;Otter & Budde-Niekiel, 2009;Otter & French, 2009;Rastogi et al, 2009), including biological agents (Rogers et al, 2005;Rogers et al, 2009).…”

Inactivation ofBacillus AnthracisSpores on All-Weather Paper

“…Various methods have been used to decontaminate biocontainment rooms and laboratories, such as vaporphase hydrogen peroxide, chlorine dioxide, formaldehyde, ozone, and ultraviolet germicidal irradiation (Grare et al, 2008;Hall et al, 2007;Krishnan et al, 2006;Lowe et al, 2012;Masaoka et al, 1982;Richter et al, 2009;Sambol & Iwen, 2006). These studies demonstrate the different methods that exhibit efficacy against pathogens on non-porous surfaces and equipment.…”

Large-Scale Inactivation ofBacillus AnthracisAmes, Vollum, and Sterne Spores Using Vaporous Hydrogen Peroxide

“…Hydrogen peroxide is considered less toxic to humans than other fumigants (e.g., formaldehyde, chlorine dioxide); therefore, it has been widely used to treat laboratory and medical equipment, pharmaceutical facilities, hospital rooms, ambulances, animal holding rooms, and air ducts (Anderson et al, 2006;Dryden et al, 2008;Fichet et al, 2004;French et al, 2004;Heckert et al, 1997;Hillman, 2004;Johnston et al, 2005;Klapes & Vesley, 1990;Krause et al, 2001;;Krishna et al, 2000;Verce et al, 2008;Wagenaar & Snijders, 2004). The use of hydrogen peroxide as a fumigant, dry mist, or an aqueous solution promotes decontamination efficacy against a wide range of microorganisms, including bacterial spores, vegetative bacteria, fungi, viruses, and bacteriophages (French et al, 2004;Grare et al, 2008;Hall et al, 2007;Hall et al, 2008;Heckert et al, 1997;Hillman, 2004;Johnston et al, 2005;Klapes & Vesley, 1990;Melley et al, 2002;Otter & Dudde-Niekiel, 2009;Rastogi et al, 2009;Rogers et al, 2005;Rogers et al, 2008b;Rogers & Choi, 2008).…”