Application of hydrogen peroxide vapour (HPV) for the decontamination of mobile medical equipment

North Middlesex University NHS Trust

Case study contributors:

Yasmin J. Drabu (previously Medical Director, North Middlesex University NHS Trust), Martina Cummins (previously Lead Nurse, Infection Control, North Middlesex University NHS Trust), Fareeduddin Ahmed (Consultant Microbiologist, North Middlesex University NHS Trust), Carina van Tonder (Infection Control Nurse, Consultant Microbiologist, North Middlesex University NHS Trust), Jonathan A. Otter (BIOQUELL (UK) Ltd).

Medical equipment can become contaminated with nosocomial pathogens and can be a source for indirect transmission. To overcome some of the practical constrains associated with HPV decontamination, including the need to vacate clinical areas and relatively long cycle times compared with conventional terminal cleaning, we trialled a programme of decontamination of mobile medical equipment in dedicated decontamination rooms in our hospital. 192 items of medical equipment and fixtures were sampled after cleaning but before HPV and again immediately after HPV decontamination. 21% of the 192 sites were contaminated with nosocomial pathogens after standard cleaning (including 6% with methicillin-resistant Staphylococcus aureus (MRSA) and 5% with Acinetobacter spp.) compared with 4% of the 192 sites after HPV (p < 0.0001), including 1 with MRSA and 2 with Acinetobacter spp. Some of the items were noted to be visibly dirty after cleaning, which explains the low level of contamination on the equipment after exposure to HPV, because biological soiling reduces the efficacy of HPV. During the project, the HPV equipment and BIOQUELL personnel stationed on-site were deployed to tackle contamination elsewhere in the hospital, including C. difficile, which proved to be a useful resource. HPV was an effective method for the decontamination of mobile medical equipment and the application of HPV in a dedicated medical equipment room alleviated some of the practical constraints of the system in our busy hospital.

Other information or references:

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French GL, Otter JA, Shannon KP, Adams NM, Watling D, Parks MJ. Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination. J Hosp Infect 2004;57:31-37.

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Otter JA, French GL, Adams NM, Watling D, Parks MJ. Hydrogen peroxide vapour decontamination in an overcrowded tertiary care referral centre: some practical answers. J Hosp Infect 2006;62:384-385.

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