Intensive care unit (ICU)-acquired infection is a common adverse event in critically ill patients. No significant difference was found between aHPP and HPV regarding their disinfection efficiency. H 2O 2 treatment is efficient in reducing MDRO contaminated rooms in the ICU. The residual concentration of H 2O 2 appears to be higher using aHPP, compared with HPV. The highest rate of rooms contaminated with MDRO was found in rooms where patients stayed for a longer period of time, and where a patient with MDRO was hospitalized. 42% of room occupants were MDRO carriers. No significant difference was found between aHPP and HPV regarding the rate of rooms contaminated with MDRO at T2 ( P = 0.313). Patient characteristics were similar in aHPP and HPV groups. H 2O 2 technologies were efficient for environmental MDRO decontamination (6% of rooms contaminated with MDRO at T1 versus 0.5% at T2, P = 0.004). Routine terminal cleaning reduced environmental bacterial load ( P <0.001) without efficiency on MDRO (15/182 (8%) rooms at T0 versus 11/182 (6%) at T1 P = 0.371). At T0, 15/182 (8%) rooms were contaminated with at least 1 MDRO (extended spectrum β–lactamase-producing Gram-negative bacilli 50%, imipenem resistant Acinetobacter baumannii 29%, methicillin-resistant Staphylococcus aureus 17%, and Pseudomonas aeruginosa resistant to ceftazidime or imipenem 4%). In total 182 rooms were studied, including 89 (49%) disinfected with aHPP and 93 (51%) with HPV. A total of 24 environmental bacteriological samplings were collected per room, from eight frequently touched surfaces, at three time-points: after patient discharge (T0), after terminal cleaning (T1) and after H 2O 2 disinfection (T2). Routine terminal cleaning was followed by H 2O 2 disinfection.
This prospective cross-over study was conducted in five medical and surgical ICUs located in one University hospital, during a 12-week period. Secondary objectives included comparison of the efficiency of a vaporizator (HPV, Bioquell®) and an aerosolizer using H 2O 2, and peracetic acid (aHPP, Anios®) in MDRO environmental disinfection, and assessment of toxicity of these techniques. The primary objective of this study was to determine the efficiency of hydrogen peroxide (H 2O 2) techniques in disinfection of ICU rooms contaminated with multidrug-resistant organisms (MDRO) after patient discharge.
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