文摘大家译：过氧化氢气雾消毒效果和再污染率评估

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Assessing the biological efficacy and rate of recontamination following hydrogen peroxide vapour decontamination
Journal of Hospital Infection
Volume 67, Issue 2, October 2007, Pages 182-188
J.A. Ottera, M. Cumminsb, F. Ahmadc, C. van Tonderc and Y.J. Drabud, ,  
aBIOQUELL (UK) Ltd, Andover, Hampshire, UK
bInfection Control Department, Barts and the London NHS Trust, The Royal London Hospital, London, UK
cInfection Control Department, North Middlesex University Hospital NHS Trust, London, UK
dInfection Prevention and Control Department, Barking, Havering and Redbridge Hospitals NHS Trust, Romford, Essex, UK
Received 17 January 2007;  accepted 26 July 2007.  Available online 19 September 2007.



Summary
The inanimate hospital environment can become contaminated with nosocomial pathogens. Hydrogen peroxide vapour (HPV) decontamination has proven effective for the eradication of persistent environmental contamination. We investigated the extent of meticillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and gentamicin-resistant Gram-negative rod (GNR) contamination in a ward side-room occupied by a patient with a history of MRSA, VRE and GNR infection and colonisation and investigated the impact of HPV decontamination. Fifteen standardised sites in the room were sampled using a selective broth enrichment protocol to culture MRSA, VRE and GNR. Sampling was performed before cleaning, after cleaning, after HPV decontamination and at intervals over the subsequent 19 days on two separate occasions. Environmental contamination was identified before cleaning on 60, 30 and 6.7% of sites for MRSA, GNR and VRE, respectively, and 40, 10 and 6.7% of sites after cleaning. Only one site (3.3%) was contaminated with MRSA after HPV decontamination. No recontamination with VRE was identified and no recontamination with MRSA and GNR was identified during the two days following HPV decontamination. Substantial recontamination was identified approximately one week after HPV decontamination towards post-cleaning levels for GNR and towards pre-cleaning levels for MRSA. HPV is more effective than standard terminal cleaning for the eradication of nosocomial pathogens. Recontamination was not immediate for MRSA and GNR but contamination returned within a week in a room occupied by a patient colonised with MRSA and GNR. This finding has important implications for the optimal deployment of HPV decontamination in hospitals.

Keywords: Meticillin-resistant Staphylococcus aureus; Vancomycin-resistant enterococci; Acinetobacter; Environmental contamination; HPV decontamination; Hydrogen peroxide vapour; Recontamination

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