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Impact of Hydrogen Peroxide Vapor Room Decontamination on Clostridium difficile Environmental Contamination and Transmission in a Healthcare Setting

Published online by Cambridge University Press:  02 January 2015

John M. Boyce*
Affiliation:
Hospital of St. Raphael, New Haven, Connecticut Yale University School of Medicine, New Haven, Connecticut
Nancy L. Havill
Affiliation:
Hospital of St. Raphael, New Haven, Connecticut
Jonathan A. Otter
Affiliation:
Bioquell, Andover, United Kingdom
L. Clifford McDonald
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Nicholas M. T. Adams
Affiliation:
Bioquell, Andover, United Kingdom
Timothea Cooper
Affiliation:
Hospital of St. Raphael, New Haven, Connecticut
Angela Thompson
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Lois Wiggs
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
George Killgore
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Allison Tauman
Affiliation:
Hospital of St. Raphael, New Haven, Connecticut
Judith Noble-Wang
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
*
Infectious Diseases Section, Hospital of Saint Raphael, 1450 Chapel Street, New Haven, CT 06511 (JBoyce@srhs.org)

Abstract

Objective.

To determine whether hydrogen peroxide vapor (HPV) decontamination can reduce environmental contamination with and nosocomial transmission of Clostridium difficile.

Design.

A prospective before-after intervention study.

Setting.

A hospital affected by an epidemic strain of C. difficile.

Intervention.

Intensive HPV decontamination of 5 high-incidence wards followed by hospital-wide decontamination of rooms vacated by patients with C. difficile-associated disease (CDAD). The preintervention period was June 2004 through March 2005, and the intervention period was June 2005 through March 2006.

Results.

Eleven (25.6%) of 43 cultures of samples collected by sponge from surfaces before HPV decontamination yielded C. difficile, compared with 0 of 37 cultures of samples obtained after HPV decontamination (P < .001). On 5 high-incidence wards, the incidence of nosocomial CDAD was significantly lower during the intervention period than during the preintervention period (1.28 vs 2.28 cases per 1,000 patient-days; P = .047). The hospital-wide CDAD incidence was lower during the intervention period than during the preintervention period (0.84 vs 1.36 cases per 1,000 patient-days; P = .26). In an analysis limited to months in which the epidemic strain was present during both the preintervention and the intervention periods, CDAD incidence was significandy lower during the intervention period than during the preintervention period (0.88 vs 1.89 cases per 1,000 patient-days; P = .047).

Conclusions.

HPV decontamination was efficacious in eradicating C. difficile from contaminated surfaces. Further studies of the impact of HPV decontamination on nosocomial transmission of C. difficile are warranted.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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