title: Evaluation of hydrogen peroxide vapor for the inactivation of nosocomial pathogens on porous and nonporous surfaces.
abstract: BACKGROUND
  Clostridium difficile spores and multidrug-resistant (MDR) organisms, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and MDR Acinetobacter baumannii, are important nosocomial pathogens that are difficult to eliminate from the hospital environment. We evaluated the efficacy of hydrogen peroxide vapor (HPV), a no-touch automated room decontamination system, for the inactivation of a range of pathogens dried onto hard nonporous and porous surfaces in an operating room (OR).
  
  
  METHODS
  Stainless steel and cotton carriers containing >4 log10 viable MRSA, VRE, or MDR A baumannii were placed at 4 locations in the OR along with 7 pouched 6 log10Geobacillus stearothermophilus spore biologic indicators (BIs). HPV was then used to decontaminate the OR. The experiment was repeated 3 times.
  
  
  RESULTS
  HPV inactivated all spore BIs (>6 log10 reduction), and no MRSA, VRE, or MDR A baumannii were recovered from the stainless steel and cotton carriers (>4-5 log10 reduction, depending on the starting inoculum). HPV was equally effective at all carrier locations. We did not identify any difference in efficacy for microbes dried onto stainless steel or cotton surfaces, indicating that HPV may have a role in the decontamination of both porous and nonporous surfaces.
  
  
  CONCLUSIONS
  HPV is an effective way to decontaminate clinical areas where contamination with bacterial spores and MDR organisms is suspected.
authors.affiliation: Department of Infection Control and Infectious Diseases, University Hospital Aachen, Aachen, Germany. Electronic address: slemmen@ukaachen.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Lemmen
authors.affiliation: Department of Infection Control and Infectious Diseases, University Hospital Aachen, Aachen, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Scheithauer
authors.affiliation: Department of Infection Control and Infectious Diseases, University Hospital Aachen, Aachen, Germany.
authors.forename: Helga
authors.initials: H
authors.lastname: Häfner
authors.affiliation: Bioquell UK Ltd, Andover, Hampshire, UK.
authors.forename: Saber
authors.initials: S
authors.lastname: Yezli
authors.affiliation: Schülke & Mayr GmbH, Norderstedt, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Mohr
authors.affiliation: Bioquell UK Ltd, Andover, Hampshire, UK; Centre for Clinical Infection and Diagnostics Research, Department of Infectious Diseases, King's College London and Guy's and St. Thomas' National Health Service (NHS) Foundation Trust, London, UK.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Otter
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects*; D004202:Disinfectants / Q000494:pharmacology*; D004203:Disinfection / Q000379:methods*; D004783:Environmental Microbiology; D006861:Hydrogen Peroxide / Q000494:pharmacology*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D013499:Surface Properties; D065507:Vancomycin-Resistant Enterococci / Q000187:drug effects*; D014835:Volatilization
chemical_list: D004202:Disinfectants; D006861:Hydrogen Peroxide
keywords: Cleaning; Clostridium difficile; Decontamination; Disinfection; Hydrogen peroxide vapor; Vancomycin-resistant Enterococcus