Disinfecting noncritical medical equipment—Effectiveness of hydrogen peroxide dry mist as an adjunctive method

doi:10.1016/j.ajic.2020.05.016

American Journal of Infection Control

Volume 48, Issue 8, August 2020, Pages 897-902

https://doi.org/10.1016/j.ajic.2020.05.016 Get rights and content

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Highlights

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Manual disinfection of medical devices is prone to failure.
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Dry mist hydrogen peroxide (HPDM) is a nonmanual automatized disinfection technique.
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We evaluated the effectiveness of HPDM on ‘ready to use’ noncritical equipment.
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HPDM substantially reduced bacterial burden on noncritical medical devices.

Background

Manual disinfection of medical devices is prone to failure. Disinfection by aerosolized hydrogen peroxide might be a promising adjunctive method. We aimed to assess effectiveness of dry mist of hydrogen peroxide (HPDM) on noncritical medical equipment.

Methods

One cycle of HPDM was applied on a convenience sample of 16 different types of "ready to use" noncritical medical devices in a closed, but nonsealed room. Of every object, 2 adjacent areas with assumed similar bacterial burden were swabbed before and after HPDM deployment, respectively. After culturing, colony forming units (CFU) were counted, and bacterial burden per cm² calculated.

Results

Of 160 objects included in the study, 36 (23%) showed a CFU-count of zero both before and after HPDM use. A decrease from a median of 0.14 CFU/cm² (range: 0.00-125.00/cm²) to a median of 0.00 CFU/cm² (range: 0.00-4.00/cm²) (P < .001) was observed. The bacterial burden was reduced by more than 90% in 45% (95% CI: 37-53) of objects. No pathogenic bacteria were identified.

Discussion

HPDM reduced bacterial burden on noncritical medical items. Since cleanliness of the included "ready to use" objects was high and no pathogens were found before nebulization, the HPDM device did not increase patient safety in this setting.

Conclusion

HPDM nebulization can be a useful nonmanual adjunctive disinfection method in high-risk settings.

Key Words

Hydrogen peroxide nebulizer

Disinfection

Infection prevention

Infection control

Equipment contamination

Environmental contamination

Cited by (0)

: Conflicts of interest: Christian Garzoni served as external scientific advisor to 99Technologies on Healthcare Acquired Infections from 2013 to 2017. The other authors declare no conflict of interest.

: Funding: The HPDM device (HyperDRYMist, Modulator Micro Nebulizer 99mb by 99Technologies), disinfection solution, and financial support for laboratory material was provided by 99T for the duration of the study. The funding source was not involved in study design, collection and interpretation of the data, and manuscript preparation and submission. AW is supported by the academic career program “Filling the gap” of the Medical Faculty of the University of Zurich.

: Ethics approval and consent to participate: Not applicable.

: Availability of data and materials: All data generated or analysed during this study are included in this published article and its supplementary information files.

: Authors’ contributions: AW, EA, CG, AZ and HS designed the study. EA acquired the data. AW, EA and SPK performed statistical analyses. AW, EA, SPK, and HS analyzed and interpreted the data. EA and AW drafted the manuscript, and SPK, CG, AZ, and HS provided critical review of the manuscript for important intellectual content. All authors agree with the content and conclusions of this manuscript.

^#: Contributed equally.