To evaluate the ability of ClO 2 to decontaminate pathogens known to cause healthcare-associated infections in a hospital room strains of Acinetobacter baumannii, Escherichia coli, Enterococcus faecalis, Mycobacterium smegmatis, and Staphylococcus aureus were spot placed in duplicate pairs at 10 sites throughout a hospital room and then exposed to ClO 2 gas. Organisms were collected and evaluated for reduction in colony forming units following gas exposure. Six sterilization cycles with varied gas concentrations, exposure limits, and relative humidity levels were conducted. Reductions in viable organisms achieved ranged from 7 to 10-log reductions. Two sterilization cycles failed to produce complete inactivation of organisms placed in a bathroom with the door closed. Reductions of organisms in the bathroom ranged from 6-log to 10-log reductions. Gas leakage between hospital floors did not occur; however, some minor gas leakage from the door of hospital room was measured which was subsequently sealed to prevent further leakage. Novel technologies for disinfection of hospital rooms require validation and safety testing in clinical environments. Gaseous ClO 2 is effective for sterilizing environmental contamination in a hospital room. Concentrations of ClO 2 up to 385 ppm were safely maintained in a hospital room with enhanced environmental controls.
References
[1]
Klevens, R.M.; Edwards, J.R.; Richards, C.L.; Horan, T.C.; Gaynes, R.P.; Pollock, D.A.; Cardo, D.M. Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Rep. 2007, 122, 160–166.
[2]
Martinez, J.A.; Ruthazer, R.; Hansjosten, K.; Barefoot, L.; Snydman, D.R. Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci in patients treated in a medical intensive care unit. Arch. Intern. Med. 2003, 163, 1905–1912, doi:10.1001/archinte.163.16.1905.
Boyce, J.M.; Potter-Bynoe, G.; Chenevert, C.; King, T. Environmental contamination due to methicillin-resistant Staphylococcus aureus: Possible infection control implications. Infect. Control. Hosp. Epidemiol. 1997, 18, 622–627.
[5]
Hardy, K.J.; Oppenheim, B.A.; Gossain, S.; Gao, F.; Hawkey, P.M. A study of the relationship between environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and patients’ acquisition of MRSA. Infect. Control. Hosp. Epidemiol. 2006, 27, 127–132, doi:10.1086/500622.
[6]
Huang, S.S.; Datta, R.; Platt, R. Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch. Intern. Med. 2006, 166, 1945–1951, doi:10.1001/archinte.166.18.1945.
[7]
Falk, P.S.; Winnike, J.; Woodmansee, C.; Desai, M.; Mayhall, C.G. Outbreak of vancomycin-resistant enterococci in a burn unit. Infect. Control Hosp. Epidemiol. 2000, 21, 575–582.
[8]
Rampling, A.; Wiseman, S.; Davis, L.; Hyett, A.P.; Walbridge, A.N.; Payne, G.C.; Cornaby, A.J. Evidence that hospital hygiene is important in the control of methicillin-resistant Staphylococcus aureus. J. Hosp. Infect. 2001, 49, 109–116.
[9]
Aygun, G.; Demirkiran, O.; Utku, T.; Mete, B.; Urkmez, S.; Yilmaz, M.; Yasar, H.; Dikmen, Y.; Ozturk, R. Environmental contamination during a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit. J. Hosp. Infect. 2002, 52, 259–262, doi:10.1053/jhin.2002.1300.
[10]
Boyce, J.M.; Havill, N.L.; Otter, J.A.; McDonald, L.C.; Adams, N.M.; Cooper, T.; Thompson, A.; Wiggs, L.; Killgore, G.; Tauman, A.; Noble-Wang, J. Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile environmental contamination and transmission in a healthcare setting. Infect. Control Hosp. Epidemiol. 2008, 29, 723–729, doi:10.1086/589906.
[11]
French, G.L.; Otter, J.A.; Shannon, K.P.; Adams, N.M.; Watling, D.; Parks, M.J. Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): A comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination. J. Hosp. Infect. 2004, 57, 31–37, doi:10.1016/j.jhin.2004.03.006.
[12]
Andersen, B.; Rasch, M.; Hochlin, K.; Jensen, F.H.; Wismar, P.; Fredriksen, J.E. Decontamination of rooms, medical equipment and ambulances using an aerosol of hydrogen peroxide disinfectant. J. Hosp. Infect. 2006, 62, 149–155, doi:10.1016/j.jhin.2005.07.020.
[13]
Umezawa, K.; Asai, S.; Inokuchi, S.; Miyachi, H. A comparative study of the bactericidal activity and daily disinfection housekeeping surfaces by a new portable pulsed UV radiation device. Curr. Microbiol. 2012, 64, 581–587, doi:10.1007/s00284-012-0110-y.
[14]
Clark, J.; Barrett, S.P.; Rogers, M.; Stapleton, R. Efficacy of super-oxidized water fogging in environmental decontamination. J. Hosp. Infect. 2006, 64, 386–390, doi:10.1016/j.jhin.2006.07.019.
[15]
Rastogi, V.K.; Wallace, L.; Smith, L.S. Disinfection of Acinetobacter baumannii-contaminated surfaces relevant to medical treatment facilities with ultraviolet C light. Mil. Med. 2007, 172, 1166–1169.
[16]
Canter, D.A.; Gunning, D.; Rodgers, P.; O’Connor, L.; Traunero, C.; Kempter, C.J. Remediation of Bacillus anthracis contamination in the US Department of Justice mail facility. Biosecur. Bioterror. 2005, 3, 119–127, doi:10.1089/bsp.2005.3.119.
[17]
Barth, E.; Rupert, R.; Stroud, F.; Rice, E.; Potoka, B. Environmental response to intentional dissemination of Bacillus anthracis spores in the United States—2001. Remediat. J. 2003, 13, 99–111, doi:10.1002/rem.10078.
[18]
Smith, P.W.; Anderson, A.O.; Christopher, G.W.; Cieslak, T.J.; Devreede, G.J.; Fosdick, G.A.; Greiner, C.B.; Hauser, J.M.; Hinrichs, S.H.; Huebner, K.D.; et al. Designing a biocontainment unit to care for patients with serious communicable diseases: A consensus statement. Biosecur. Bioterror. 2006, 4, 351–365, doi:10.1089/bsp.2006.4.351.
[19]
Brown, B.A.; Springer, B.; Steingrube, V.A.; Wilson, R.W.; Pfyffer, G.E.; Garcia, M.J.; Menendez, M.C.; Rodriguez-Salgado, B.; Jost, K.C., Jr.; Chiu, S.H. Mycobacterium wolinskyi sp. nov. and Mycobacterium goodii sp. nov., two new rapidly growing species related to Mycobacterium smegmatis and associated with human wound infections: A cooperative study from the International Working Group on Mycobacterial Taxonomy. Int. J. Syst. Evol. Microbiol. 1999, 49, 1493–1511.
[20]
Obee, P.; Griffith, C.; Cooper, R.; Bennion, N. An evaluation of different methods for the recovery of meticillin-resistant Staphylococcus aureus from environmental surfaces. J. Hosp. Infect. 2007, 65, 35–41, doi:10.1016/j.jhin.2006.09.010.
[21]
Wright, J.B.; Lam, K.; Burrell, R.E. Wound management in an era of increasing bacterial antibiotic resistance: A role for topical silver treatment. Am. J. Infect. Control 1998, 26, 572–577, doi:10.1053/ic.1998.v26.a93527.
Murray, P.; Baron, E.; Jorgensen, J.; Landry, M.; Pfaller, M. Manual of Clinical Microbiology; ASM Press: Washington, DC, USA, 2007.
[24]
Moat, J.; Cargill, J.; Shone, J.; Upton, M. Application of a novel decontamination process using gaseous ozone. Can. J. Microbio. 2009, 55, 928–933, doi:10.1139/W09-046.
[25]
Berrington, A.W.; Pedler, S.J. Investigation of gaseous ozone for MRSA decontamination of hospital side-rooms. J. Hosp. Infect. 1998, 40, 61–65, doi:10.1016/S0195-6701(98)90026-3.
[26]
Chan, P.C.; Huang, L.M.; Lin, H.C.; Chang, L.Y.; Chen, M.L.; Lu, C.Y.; Lee, P.I.; Chen, J.M.; Lee, C.Y.; Pan, H.J.; Wang, J.T.; Chang, S.C.; Chen, Y.C. Control of an outbreak of pandrug-resistant Acinetobacter baumannii colonization and infection in a neonatal intensive care unit. Infect. Control. Hosp. Epidemiol. 2007, 28, 423–429.
[27]
Frieden, T.R.; Munsiff, S.S.; Low, D.E.; Willey, B.M.; Williams, G.; Faur, Y.; Eisner, W.; Warren, S.; Kreiswirth, B. Emergence of vancomycin-resistant enterococci in New York City. Lancet 1993, 342, 76–79, doi:10.1016/0140-6736(93)91285-T.
[28]
Lai, K.K.; Kelley, A.L.; Melvin, Z.S.; Belliveau, P.P.; Fontecchio, S.A. Failure to eradicate vancomycin-resistant enterococci in a university hospital and the cost of barrier precautions. Infect. Control. Hosp. Epidemiol. 1998, 19, 647–652.
[29]
Noble, M.A.; Isaac-Renton, J.L.; Bryce, E.A.; Roscoe, D.L.; Roberts, F.J.; Walker, M.; Scharf, S.; Walsh, A.; Altamirano-Dimas, M.; Gribble, M. The toilet as a transmission vector of vancomycin-resistant enterococci. J. Hosp. Infect. 1998, 40, 237–241, doi:10.1016/S0195-6701(98)90141-4.
