Hydrogen peroxide vapour (HPV) decontamination assessments at the Birmingham Heartlands hospital

Heartlands Hospitals, Heart of England NHS Foundation Trust

Now published in Hardy et al. J Hosp Infect 2007;66:360-368.

Case study contributors:

Katie Hardy (Clinical Scientist, Heart of England NHS Foundation Trust), Peter Hawkey (Consultant Microbiologist, Heart of England NHS Foundation Trust), Savita Gossain (Consultant Microbiologist, Heart of England NHS Foundation Trust), Beryl Oppenheim (Consultant Microbiologist, Heart of England NHS Foundation Trust), Jonathan A. Otter (BIOQUELL (UK) Ltd.)

Hydrogen peroxide vapour (HPV) has been shown to eradicate environmental contamination due to methicillin-resistant Staphylococcus aureus (MRSA) and other organisms in several clinical settings. However, the rate of recontamination following HPV decontamination is largely unknown. We conducted studies in our hospital to confirm the microbiological efficacy of the HPV process and to investigate the rate of recontamination in several different scenarios. HPV was used to decontaminate our intensive care unit (ICU), high-dependency unit (HDU) and a general ward. MRSA was identified after cleaning but before HPV decontamination in all three areas tested. No MRSA was detected immediately after HPV decontamination in all three areas, corroborating the data from other studies. No MRSA recontamination was detected until four weeks after HPV on the HDU following the first admission of MRSA-positive patients. By contrast, MRSA contamination was identified 24-hours after HPV on the ICU into which MRSA colonised patients were admitted immediately after HPV. Recontamination on the general ward had returned to pre-cleaning levels by six days after HPV; one patient MRSA-positive patient was admitted to the ward after HPV. Rapid recontamination with MRSA occurred when areas were re-populated by MRSA-positive patients but not when areas were populated by only MRSA-negative patients. These findings are important for the optimal deployment of HPV in hospitals.

Other information or references:

Bates CJ, Pearse R. Use of hydrogen peroxide vapour for environmental control during a Serratia outbreak in a neonatal intensive care unit. J Hosp Infect 2005;61:364-366.

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.

Hardy KJ, Gossain S, Henderson N, Drugan C, Oppenheim BA, Gao F, Hawket PM. Rapid recontamination with MRSA of the environment of an intensive care unit after decontamination with hydrogen peroxide vapour. J Hosp Infect 2007;66:360-368.

Jeanes A, Rao G, Osman M, Merrick P. Eradication of persistent environmental MRSA. J Hosp Infect 2005;61:85-86.

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Otter JA, Cummins M, Ahmad F, van Tonder C, Drabu Y. Assessing the biological efficacy and rate of recontamination following hydrogen peroxide vapour decontamination. J Hosp Infect 2007 in press.

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.

Rogers JV, Sabourin CL, Choi YW, Richter WR, Rudnicki DC, Riggs KB, Taylor ML, Chang J. Decontamination assessment of Bacillus anthracis, Bacillus subtilis, and Geobacillus stearothermophilus spores on indoor surfaces using a hydrogen peroxide gas generator. J Appl Microbiol 2005;99:739-748.