An evaluation of nebulised hydrogen peroxide post routine cleaning for environmental surface disinfection

Abstract number: R2581

Kok J., Thomas L., Tallon J., Dempsey K., Gilbert G.

Objectives: Environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) establishes reservoirs of infection and facilitates transmission. Routine cleaning methods may be inadequate for environmental disinfection and hypochlorite disinfection is time-consuming, potentially toxic and therefore no longer widely used. This study evaluated the efficacy of nebulised hydrogen peroxide (6% H2O2; Nocospray, OXY'PHARM) following routine cleaning, for surface disinfection.

Methods: Environmental surfaces (bed, bedside rail, bedside table, blood pressure cuff, intravenous pump, call button, dresser, door handle, toilet seat, toilet rail and curtain rail) in a closed room measuring 80m3 artificially contaminated with MRSA and/or VRE were sampled with sterile swabs (Copan) prior to and after routine cleaning (using neutral detergent and quaternary ammonium compound [Viraclean, Whiteley]); and after further disinfection with Nocospray (delivered from a portable aerosoliser over 18 minutes). Swabs were plated onto MRSA (Oxoid) and VRE (bioMérieux) chromogenic agars and placed into enrichment broth. After 48 hours incubation at 37°C, the presence of MRSA and/or VRE was noted; if absent, enrichment broth fluid was plated onto chromogenic agar and read after 48 hours incubation. RODAC plates (BD Diagnostics) were applied to five surfaces (bed, bedside rail, blood pressure cuff, toilet seat and toilet rail) prior to and after Viraclean and Nocospray, and bacterial colonies counted.

Results: MRSA was detected in 22 (100%), 9 (40%), 11 (50%), 7 (32%) and 7 (32%) and VRE in 22 (100%), 13 (59%), 17 (77%), 4 (18%) and 5 (23%) of 22 surfaces tested: pre-cleaning, post Viraclean with direct plating, post Viraclean with enrichment, post Nocospray with direct plating and post Nocospray with enrichment, respectively. Blood pressure cuffs were least likely to be adequately cleaned; MRSA and VRE were recovered after both Viraclean and Nocospray. The table below shows the number of bacterial colonies detected on RODAC plates at each stage.

Conclusion: Nocospray further reduced environmental contamination with MRSA and VRE following Viraclean. The process is quick, convenient, safe and allows rapid turnaround of rooms after disinfection. Reducing environmental reservoirs should reduce transmission of MRSA and VRE.

Session Details

Date: 07/05/2011
Time: 00:00-00:00
Session name: Abstracts of 21st ECCMID / 27th ICC
Location: Milan, Italy, 7 - 10 May 2011
Presentation type:
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