title: Effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: Focus on clinical trials.
abstract: Over the last decade, substantial scientific evidence has accumulated that indicates contamination of environmental surfaces in hospital rooms plays an important role in the transmission of key health care-associated pathogens (eg, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, Acinetobacter spp). For example, a patient admitted to a room previously occupied by a patient colonized or infected with one of these pathogens has a higher risk for acquiring one of these pathogens than a patient admitted to a room whose previous occupant was not colonized or infected. This risk is not surprising because multiple studies have demonstrated that surfaces in hospital rooms are poorly cleaned during terminal cleaning. To reduce surface contamination after terminal cleaning, no touch methods of room disinfection have been developed. This article will review the no touch methods, ultraviolet light devices, and hydrogen peroxide systems, with a focus on clinical trials which have used patient colonization or infection as an outcome. Multiple studies have demonstrated that ultraviolet light devices and hydrogen peroxide systems have been shown to inactivate microbes experimentally plated on carrier materials and placed in hospital rooms and to decontaminate surfaces in hospital rooms naturally contaminated with multidrug-resistant pathogens. A growing number of clinical studies have demonstrated that ultraviolet devices and hydrogen peroxide systems when used for terminal disinfection can reduce colonization or health care-associated infections in patients admitted to these hospital rooms.
authors.affiliation: Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, NC; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address: dweber@unch.unc.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Weber
authors.affiliation: Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, NC; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC.
authors.forename: William A
authors.initials: WA
authors.lastname: Rutala
authors.affiliation: Division of Infectious Diseases, Duke University Medical School, Durham, NC.
authors.forename: Deverick J
authors.initials: DJ
authors.lastname: Anderson
authors.affiliation: Division of Infectious Diseases, Duke University Medical School, Durham, NC.
authors.forename: Luke F
authors.initials: LF
authors.lastname: Chen
authors.affiliation: Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, NC; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC.
authors.forename: Emily E
authors.initials: EE
authors.lastname: Sickbert-Bennett
authors.affiliation: Division of Infectious Diseases, Yale School of Medicine, New Haven, CT.
authors.forename: John M
authors.initials: JM
authors.lastname: Boyce
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D003666:Decontamination / Q000379:methods*; D004783:Environmental Microbiology; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage*; D010362:Patients' Rooms; D014466:Ultraviolet Rays
chemical_list: D000891:Anti-Infective Agents, Local; D006861:Hydrogen Peroxide
keywords: Health care–associated infections; hydrogen peroxide systems; pulsed xenon; room decontamination; surface environment; ultraviolet C; ultraviolet light