Hostname: page-component-848d4c4894-8kt4b Total loading time: 0 Render date: 2024-06-19T13:48:02.097Z Has data issue: false hasContentIssue false

Decontamination of Hospital Surfaces With Multijet Cold Plasma: A Method to Enhance Infection Prevention and Control?

Published online by Cambridge University Press:  10 August 2017

Orla J. Cahill
School of Electronic Engineering and National Centre for Plasma Science Technology, Dublin City University, Dublin, Ireland Department of Food Science and Environmental Health, Dublin Institute of Technology, Dublin, Ireland
Tânia Claro
Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
Attilio A. Cafolla
School of Physical Sciences, Dublin City University, Dublin, Ireland
Niall T. Stevens
Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
Stephen Daniels
Department of Food Science and Environmental Health, Dublin Institute of Technology, Dublin, Ireland
Hilary Humphreys*
Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland Department of Microbiology, Beaumont Hospital, Dublin, Ireland
Address correspondence to Hilary Humphreys, Department of Clinical Microbiology, RCSI Education and Research Centre, Beaumont Hospital, Dublin D09 YD60, Ireland (



To evaluate the efficacy of a multijet cold-plasma system and its efficacy in decontaminating 2 surfaces commonly found in hospitals


An in vitro study of common causes of healthcare-acquired infection


Log10 9 cultures of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended spectrum β-lactamase–producing Escherichia coli, and Acinetobacter baumannii were applied to 5-cm2 sections of stainless steel and mattress. Human serum albumin (HSA) was used as a proxy marker for organic material, and atomic force microscopy (AFM) was used to study the impact on bacterial cell structure. The inoculated surfaces were exposed to a cold-air-plasma–generating multijet prototype for 15, 20, 30, and 45 seconds.


After 45 seconds, at least 3 to 4 log reductions were achieved for all bacteria on the mattress, while 3 to 6 log reductions were observed on stainless steel. The presence of HSA had no appreciable effect on bacterial eradication. The surfaces with bacteria exposed to AFM showed significant morphological changes indicative of “etching” due to the action of highly charged ions produced by the plasma.


This multijet cold-plasma prototype has the potential to augment current environmental decontamination approaches but needs further evaluation in a clinical setting to confirm its effectiveness.

Infect Control Hosp Epidemiol 2017;38:1182–1187

Original Articles
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


PREVIOUS PRESENTATION. Preliminary data were presented at the 25th European Congress of Clinical Microbiology and Infectious Diseases in Copenhagen, Denmark, on April 26, 2015.



1. Bradbury, SL, Mack, D, Crofts, T, Ellison Iii, RT. Potential bloodborne pathogen exposure from occult mattress damage. Am J Infect Control 2014;42:421422.CrossRefGoogle ScholarPubMed
2. Creamer, E, Shore, AC, Deasy, EC, et al. Air and surface contamination patterns of meticillin-resistant Staphylococcus aureus on eight acute hospital wards. J Hosp Infect 2014;86:201208.CrossRefGoogle ScholarPubMed
3. Gardner, P, Muller, MP, Prior, B, So, K, Tooze, J, Eum, L, Kachur, O. Wheelchair cleaning and disinfection in Canadian health care facilities: “That’s wheelie gross!” Am J Infect Control 2014;42:11731177.CrossRefGoogle Scholar
4. Hooker, EA, Allen, SD, Gray, LD. Terminal cleaning of hospital bed mattresses and bedecks does not eliminate bacterial contamination. Am J Infect Control 2011;39:E23E24.CrossRefGoogle Scholar
5. Livshiz-Riven, I, Borer, A, Nativ, R, Eskira, S, Larson, E. Relationship between shared patient care items and healthcare-associated infections: A systematic review. Inter J Nurs Stud 2015;52:380392.CrossRefGoogle ScholarPubMed
6. O’Connor, N, Cahill, O, Galvin, S, et al. Handheld cold atmospheric air plasma pen and in vitro studies of MRSA, C. difficile, and A. baumannii decontamination. Paper presented at the 39th International Conference on Plasma Sciences; July 2102; Edinburgh, Scotland.Google Scholar
7. Barbut, F. How to eradicate Clostridium difficile from the environment. J Hosp Infect 2015;89:287295.CrossRefGoogle ScholarPubMed
8. Doll, M, Morgan, DJ, Anderson, D, Bearman, G. Touchless technologies for decontamination in the hospital: a review of hydrogen peroxide and UV devices. Curr Infect Dis Rep 2015;17:44.CrossRefGoogle ScholarPubMed
9. Galvin, S, Boyle, M, Russell, RJ, et al. Evaluation of vaporized hydrogen peroxide, Citrox and pH neutral Ecasol for decontamination of an enclosed area: a pilot study. J Hosp Infect 2012;80:6770.CrossRefGoogle ScholarPubMed
10. Galvin, S, Cahill, O, O’Connor, N, Cafolla, AA, Daniels, S, Humphreys, H. The antimicrobial effects of helium and helium–air plasma on Staphylococcus aureus and Clostridium difficile . Lett Appl Microbiol 2013;57:8390.CrossRefGoogle ScholarPubMed
11. Speight, S, Moy, A, Macken, S, et al. Evaluation of the sporicidal activity of different chemical disinfectants used in hospital against Clostridium difficile . J Hosp Infect 2011;79:1822.CrossRefGoogle ScholarPubMed
12. Horcas, I, Fernandez, R, Gomez-Rodriguez, JM, Colchero, J, Gomez-Herrero, J, Baro, AM. WSXM: a software for scanning probe microscopy and a tool for nanotechnology. Rev Scient Instrum 2007;78:013705013708.CrossRefGoogle Scholar
13. Otter, JA. How do we tackle contaminated hospital surfaces? Healthcare Infect 2013;18:4244.CrossRefGoogle Scholar
14. Manian, FA, Griesenauer, S, Senkel, D, et al. Isolation of Acinetobacter baumannii complex and methicillin-resistant Staphylococcus aureus from hospital rooms following terminal cleaning and disinfection: Can we do better? Infect Control Hosp Epidemiol 2011;32:667672.CrossRefGoogle ScholarPubMed
15. Rutala, WA, Weber, DJ. 2014. Selection of the ideal disinfectant. Infect Control Hosp Epidemiol 2014;35:855865.CrossRefGoogle ScholarPubMed
16. O’Gorman, J, Humphreys, H. Application of copper to prevent and control infection. Where are we now? J Hosp Infect 2012;81:217223.CrossRefGoogle ScholarPubMed
17. Stoffels, E, Sakiyama, Y, Graves, DB. 2008. Cold atmospheric plasma: charged species and their interactions with cells and tissues. Plasma Sci IEEE Trans 2008;36:14411457.CrossRefGoogle Scholar
18. O’Connor, N, Cahill, O, Daniels, S, Galvin, S, Humphreys, H. Cold atmospheric pressure plasma and decontamination. Can it contribute to preventing hospital-acquired infections? J Hosp Infect 2014;88:5965.CrossRefGoogle ScholarPubMed
19. Fridman, G, Brooks, AD, Balasubramanian, M, et al. Comparison of direct and indirect effects of non-thermal atmospheric-pressure plasma on bacteria. Plasma Proc Polymer 2007;4:370375.CrossRefGoogle Scholar
20. Alkawareek, MY, Algwari, QT, Gorman, SP, Graham, WG, O’Connell, D, Gilmore, BF. 2012. Application of atmospheric pressure nonthermal plasma for the in vitro eradication of bacterial biofilms. FEMS Immunol Med Microbiol 2012;65:381384.CrossRefGoogle ScholarPubMed
21. Weber, DJ, Rutala, WA, Anderson, DJ, Chen, LFC, Sickbert-Bennett, EE, Boyce, JM. Effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: focus on clinical trials. Am J Infect Control 2016;44:e77e84.CrossRefGoogle ScholarPubMed
22. Mai-Prochnow, A, Murphy, AB, McLean, KM, Kong, MG, Ostrikov, K. Atmospheric pressure plasmas: infection control and bacterial responses. Int J Antimicrob Ag 2014;43:508517.CrossRefGoogle ScholarPubMed
23. Wolkewitz, M, Barnett, AG, Palomar Martinez, M, Frank, U, Schumacher, M. Interventions to control nosocomial infections: study designs and statistical issues. J Hosp Infect 2014;86:7782.CrossRefGoogle ScholarPubMed