Effectiveness of hydrogen peroxide wipes for surface disinfection in healthcare facilities

Effectiveness of hydrogen peroxide wipes for surface disinfection in healthcare facilities

Authors

  • Marco Lopuzzo
  • Maria Teresa Montagna
  • Francesco Triggiano
  • Giuseppina Caggiano

Keywords:

HAIs; healthcare facilities, surfaces disinfection; hydrogen peroxide

Abstract

 

Introduction. The correct method of surface disinfection in hospitals is an essential tool in the fight against the spread of healthcare-associated infections caused by multi-resistant microorganisms. Currently, there are many disinfectants on the market that can be used against different microorganisms. However, the effectiveness of different active molecules is controversial in the literature.

Study design. The aim of this study was to evaluate the effectiveness of wipes based on hydrogen peroxide (1.0%) and highly specific plant-based surfactants, contained in H2O2TM (Hi-speed H2O2TM) products, against some hospital-associated microorganisms.

Methods. The effectiveness of the wipes was tested against nosocomial and control strains of methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas aeruginosa, Klebsiella pneumoniae carbapenemase, Aspergillus fumigatus and Candida parapsilosis. Specifically, in vitro activity was assessed using three different techniques: stainless steel surface testing, surface diffusion testing and well diffusion test.

Results. The three different methods tested confirm the wipes’ good effectiveness against the most common multi-resistant bacteria and against fungi.

Conclusions. These data show that the tested wipes could be a valid adjunct to the disinfection process and could assist in the prevention of healthcare-associated infections.

References

1. Weber DJ, Kanamori H, Rutala WA. ‘No touch’ technologies for environmental decontamination: focus on ultraviolet devices and hydrogen peroxide systems. Curr Opin Infect Dis. 2016 Aug; 29(4): 424-31. doi: 10.1097/QCO.0000000000000284. PMID: 27257798.

2. European Centre for Disease Prevention and Control (ECDC). Available from: [https://www.ecdc.europa.eu/en/healthcare-associated-infections](https://www.ecdc.europa.eu/en/healthcare-associated-infections) [Last accessed: 2024 Mar 1].

3. Suleyman G, Alangaden G, Bardossy AC. The role of environmental contamination in the transmission of nosocomial pathogens and healthcare-associated infections. Curr Infect Dis Rep. 2018 Apr 27; 20(6): 12. doi: 10.1007/s11908-018-0620-2. PMID: 29704133.

4. Wißmann JE, Kirchhoff L, Brüggemann Y, Todt D, Steinmann J, Steinmann E. Persistence of Pathogens on Inanimate Surfaces: A Narrative Review. Microorganisms. 2021 Feb 9; 9(2): 343. doi: 10.3390/microorganisms9020343. PMID: 33572303.

5. Katzenberger RH, Rösel A, Vonberg RP. Bacterial survival on inanimate surfaces: a field study. BMC Res Notes. 2021 Mar 15; 14(1): 97. doi: 10.1186/s13104-021-05492-0. PMID: 33722269.

6. Lai Q, Spoletini G, Bianco G, Graceffa D, Agnes S, Rossi M, et al. SARS-CoV2 and immunosuppression: A double-edged sword. Transpl Infect Dis. 2020 Dec; 22(6): e13404. doi: 10.1111/tid.13404. Epub 2020 Jul 17. PMID: 32639598.

7. Vonberg RP, Weitzel-Kage D, Behnke M, Gastmeier P. Worldwide Outbreak Database: the largest collection of nosocomial outbreaks. Infection. 2011 Feb; 39(1): 29–34. doi: 10.1007/s15010-010-0064-6. Epub 2010 Dec 3. PMID: 21153042.

8. Song X, Vossebein L, Zille A. Efficacy of disinfectant-impregnated wipes used for surface disinfection in hospitals: a review. Antimicrob Resist Infect Control. 2019 Aug 19; 8: 139. doi: 10.1186/s13756-019-0595-2. PMID: 31452873.

9. Facciolà A, Pellicanò GF, Visalli G, Paolucci IA, Venanzi Rullo E, Ceccarelli M, et al. The role of the hospital environment in the healthcare-associated infections: a general review of the literature. Eur Rev Med Pharmacol Sci. 2019 Feb; 23(3): 1266-1278. doi: 10.26355/eurrev_201902_17020. PMID: 30779096.

10. Squeri R, Genovese C, Palamara MA, Trimarchi G, La Fauci V. “Clean care is safer care”: correct handwashing in the prevention of healthcare associated infections. Ann Ig. 2016 Nov-Dec; 28(6): 409-415. doi: 10.7416/ai.2016.2123. PMID: 27845475.

11. Paleckyte A, Dissanayake O, Mpagama S, Lipman MC, McHugh TD. Reducing the risk of tuberculosis transmission for HCWs in high incidence settings. Antimicrob Resist Infect Control. 2021 Jul 19; 10(1): 106. doi: 10.1186/s13756-021-00975-y. PMID: 34281623.

12. Boyce JM. Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals. Antimicrob Resist Infect Control. 2016 Apr 11; 5(10): 10. doi: 10.1186/s13756-016-0111-x. PMID: 27069623.

13. Diella G, Caggiano G, Apollonio F, Triggiano F, Stefanizzi P, Fasano F, et al. SARS-CoV-2 RNA viability on high-touch surfaces and evaluation of a continuous-flow ozonation treatment. Ann Ig. 2023 Jan-Feb; 35(1): 112-120. doi: 10.7416/ai.2022.2547. Epub 2022 Oct 12. PMID: 36222607.

14. Triggiano F, Caggiano G, Lopuzzo M, Diella G, Apollonio F, Fasano F, et al. No-Touch Automated Disinfection System Based on Hydrogen Peroxide and Ethyl Alcohol Aerosols for Use in Healthcare Environments. Int J Environ Res Public Health. 2022 Apr 17; 19(8): 4868. doi: 10.3390/ijerph19084868. PMID: 35457735.

15. Caggiano G, Apollonio F, Triggiano F, Diella G, Stefanizzi P, Lopuzzo M, D’Ambrosio M, Bartolomeo N, Barbuti G, Sorrenti GT, et al. SARS-CoV-2 and Public Transport in Italy. Int J Environ Res Public Health. 2021 Oct 29; 18(21): 11415. doi: 10.3390/ijerph18179404. PMID: 34769932.

16. Caggiano G, Triggiano F, Apollonio F, Diella G, Lopuzzo M, D’Ambrosio M, et al. SARS-CoV-2 RNA and Supermarket Surfaces: A Real or Presumed Threat? Int J Environ Res Public Health. 2021 Sep 6; 18(17): 9404. doi: 10.3390/ijerph18179404. PMID: 34501993.

17. Gidari A, Sabbatini S, Bastianelli S, Pierucci S, Busti C, Bartolini D, et al. SARS-CoV-2 Survival on Surfaces and the Effect of UV-C Light. Viruses. 2021 Mar 5; 13(3): 408. doi: 10.3390/v13030408. PMID: 33807521.

18. Zhou X, Fu H, Du G, Wei X, Zhang B, Zhao T. SARS-CoV-2 RNA detection on environmental surfaces in COVID-19 wards. PLoS One. 2023 May 25; 18(5): e0286121. doi: 10.1371/journal.pone.0286121. PMID: 37228102.

19. Marcenac P, Park GW, Duca LM, Lewis NM, Dietrich EA, Barclay L, et al. Detection of SARS-CoV-2 on Surfaces in Households of Persons with COVID-19. Int J Environ Res Public Health. 2021 Aug 2; 18(15): 8184. doi: 10.3390/ijerph18158184. PMID: 34360477.

20. Cherrie JW, Cherrie MPC, Smith A, Holmes D, Semple S, Steinle S, et al. Contamination of Air and Surfaces in Workplaces with SARS-CoV-2 Virus: A Systematic Review. Ann Work Expo Health. 2021 Oct 9; 65(8): 879-892. doi: 10.1093/annweh/wxab026. PMID: 34329379.

21. Bae SH, Shin H, Koo HY, Lee SW, Yang JM, Yon DK. Asymptomatic transmission of SARS-CoV-2 on evacuation flight. Emerg Infect Dis. 2020 Nov; 26(11): 2705-2708. doi: 10.3201/eid2611.203353. Epub 2020 Aug 21. PMID: 32822289.

22. Cai J, Sun W, Huang J, Gamber M, Wu J, He G. Indirect virus transmission in cluster of COVID-19 cases, Wenzhou, China, 2020. Emerging Infect Dis. 2020 Jun; 26(6): 1343. doi: 10.3201/eid2606.200412. Epub 2020 Jun 17. PMID: 32163030.

23. Xie C, Zhao H, Li K, Zhang Z, Lu X, Peng H, et al. The evidence of indirect transmission of SARS-CoV-2 reported in Guangzhou, China. BMC Public Health. 2020 Aug 5; 20(1): 1202. doi: 10.1186/s12889-020-09296-y. PMID: 32758198.

24. Boyce JM. A review of wipes used to disinfect hard surfaces in health care facilities. Am J Infect Control. 2021 Jan; 49(1): 104-114. doi: 10.1016/j.ajic.2020.06.183. Epub 2020 Jun 19. PMID: 32569612.

25. Weber DJ, Anderson D, Rutala WA. The role of the surface environment in healthcare-associated infections. Curr Opin Infect Dis. 2013 Aug; 26(4): 338-344. doi: 10.1097/QCO.0b013e3283630f04. PMID: 23743816.

26. Block SS. Peroxygen compounds. In: Block SS, ed. Disinfection, sterilization, and preservation. Philadelphia: Lippincott Williams & Wilkins; 2001: 185-204. doi:10.1017/S0195941700084289.

27. Sattar SA, Springthorpe VS, Rochon M. A product based on accelerated and stabilized hydrogen peroxide: Evidence for broad-spectrum germicidal activity. Canadian J Infect Control. 1998; 33: 123-130.

28. Linley E, Denyer SP, McDonnell G, Simons C, Maillard JY. Use of hydrogen peroxide as a biocide: new consideration of its mechanisms of biocidal action. J Antimicrob Chemother. 2012 Jul; 67(7): 1589-96. doi: 10.1093/jac/dks129. Epub 2012 Apr 24. PMID: 22532463.

29. Sies H. Hydrogen peroxide as a central redox signaling molecule in physiological oxidative stress: Oxidative eustress. Redox Biol. 2017 Apr; 11: 613-619. doi: 10.1016/j.redox.2016.12.035. Epub 2017 Jan 5. PMID: 28110218.

30. Bharti B, Li H, Ren Z, Zhu R, Zhu Z. Recent advances in sterilization and disinfection technology: A review. Chemosphere. 2022 Dec; 308(Pt 3): 136404. doi: 10.1016/j.chemosphere.2022.136404. Epub 2022 Sep 19. PMID: 36165840.

31. UNI EN ISO 4833-1:2013. Horizontal Method for the Enumeration of Microorganisms. Part 1: Colony Count at 30 Degrees C by the Pour Plate Technique. International Organization for Standardization. Milan, Italy; 2013.

32. Microbiology of Food and Animal Feeding Stuffs-Enumeration of Yeasts and Moulds by Colony-Count Technique at 25 °C-Routine Method. Association Francaise de Normalisation. La Plaine Saint-Denis Cedex, France; 2013.

33. Montagna MT, Triggiano F, Barbuti G, Bartolomeo N, De Giglio O, Diella G, et al. Study on the In Vitro Activity of Five Disinfectants against Nosocomial Bacteria. Int J Environ Res Public Health. 2019 May 29; 16(11): 1895. doi: 10.3390/ijerph16111895. PMID: 31146343.

34. Saha O, Rakhi NN, Istiaq A, Islam I, Sultana M, Hossain MA, et al. Evaluation of Commercial Disinfectants against Staphylococcus lentus and Micrococcus spp. of Poultry Origin. Vet Med Int. 2020 Sep 25; 2020: 8811540. doi: 10.1155/2020/8811540. PMID: 33062244.

35. Athanassiadis B, Abbott PV, George N, Walsh LJ. An in vitro study of the antimicrobial activity of some endodontic medicaments and their bases using an agar well diffusion assay. Aust Dent J. 2009 Jun; 54(2): 141-146. doi: 10.1111/j.1834-7819.2009.01107.x. PMID: 19473156.

36. Dancer SJ. Hospital cleaning in the 21st century. Euro J Clin Microbiol Infect Dis. 2011 Dec; 30(12): 1473-1481. doi: 10.1007/s10096-011-1250-x. Epub 2011 Apr 17. PMID: 21499954.

37. Dettenkofer M, Wenzler S, Amthor S, Antes G, Motschall E, Daschner FD. Does disinfection of environmental surfaces influence nosocomial infection rates? A systematic review. Am J Infect Control. 2004 Apr; 32(2): 84-89. doi: 10.1016/j.ajic.2003.07.006. PMID: 15057199.

38. Warren BG, Barrett A, Graves A, King C, Turner NA, Anderson DJ. An Enhanced Strategy for Daily Disinfection in Acute Care Hospital Rooms: A Randomized Clinical Trial. JAMA Netw Open. 2022 Nov 1; 5(11): e2242131. doi: 10.1001/jamanetworkopen.2022.42131. PMID: 36378308.

39. Protano C, Cammalleri V, Romano Spica V, Valeriani F, Vitali M. Hospital environment as a reservoir for cross transmission: cleaning and disinfection procedures. Ann Ig. 2019 Sep-Oct; 31(5): 436-448. doi: 10.7416/ai.2019.2305. PMID: 31304524.

40. Rutala WA, Weber DJ. Surface disinfection: should we do it? J Hosp Infect 2001 Aug; 48 (Suppl A): S64-S68. doi: 10.1016/s0195-6701(01)90017-9. PMID: 11759030.

41. Wu YL, Yang XY, Ding XX, Li RJ, Pan MS, Zhao X, et al. Exposure to infected/colonized roommates and prior room occupants increases the risks of healthcare-associated infections with the same organism. J Hosp Infect. 2019 Feb; 101(2): 231-239. doi: 10.1016/j.jhin.2018.10.014. Epub 2018 Oct 22. PMID: 30359649.

42. Cohen B, Cohen CC, Løyland B, Larson EL. Transmission of health care-associated infections from roommates and prior room occupants: A systematic review. Clin Epidemiol. 2017 May 23; 9: 297-310. doi: 10.2147/CLEP.S124382. PMID: 28579835.

43. Christenson EC, Cronk R, Atkinson H, Bhatt A, Berdiel E, Cawley M, et al. Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities. Int J Environ Res Public Health. 2021 Oct; 18(21): 11100. doi: 10.3390/ijerph182111100.

44. Nseir S, Blazejewski C, Lubret R, Wallet F, Courcol R, Durocher A. Risk of acquiring multidrug-resistant Gram-negative bacilli from prior room occupants in the intensive care unit. Clin Microbiol Infect. 2011 Aug; 17(8): 1201-1208. doi: 10.1111/j.1469-0691.2010.03420.x. Epub 2010 Dec 3.

45. Torabi S, Zahra F. Disinfectants. 2022. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.

46. Rutala WA, Kanamori H, Gergen MF, Knelson LP, Sickbert-Bennett EE, Chen LF, et al; CDC Prevention Epicenters Program. Enhanced disinfection leads to reduction of microbial contamination and a decrease in patient colonization and infection. Infect Control Hosp Epidemiol. 2018 Sep; 39(9): 1118-1121. doi: 10.1017/ice.2018.165. Epub 2018 Jul 31. PMID: 30060770.

47. Qiu Y, Zhou Y, Chang Y, Liang X, Zhang H, Lin X, et al. The Effects of Ventilation, Humidity, and Temperature on Bacterial Growth and Bacterial Genera Distribution. Int J Environ Res Public Health. 2022 Nov 20; 19(22): 15345. doi: 10.3390/ijerph192215345. PMID: 36430064.

48. Wolkoff P. Indoor air humidity, air quality, and health—An overview. Int J Hyg Environ Health. 2018 Apr; 221(3): 376-390. doi: 10.1016/j.ijheh.2018.01.015. Epub 2018 Jan 31. PMID: 29398406.

49. Otter JA, Yezli S, French GL. The role played by contaminated surfaces in the transmission of nosocomial pathogens. Infect Control Hosp Epidemiol. 2011 Jul; 32(7): 687-699. doi: 10.1086/660363. PMID: 21666400.

50. Rutala WA, Weber DJ and Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities, 2008; last update: May 2019. Available from: [https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines-H.pdf](https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines-H.pdf) [Last accessed: 2024 Mar 1]. doi: 10.1086/650197.

51. Triggiano F, Caggiano G, Lopuzzo M, Diella G, Apollonio F, Fasano F, et al. No-Touch Automated Disinfection System Based on Hydrogen Peroxide and Ethyl Alcohol Aerosols for Use in Healthcare Environments. Int J Environ Res Public Health. 2022 Apr 17; 19(8): 4868. doi: 10.3390/ijerph19084868. PMID: 35457735.

52. Otter JA, Yezli S, Perl TM, Barbut F, French GL. The role of ‘no-touch’ automated room disinfection systems in infection prevention and control. J Hosp Infect. 2013 Jan; 83(1): 1-13. doi: 10.1016/j.jhin.2012.10.002. Epub 2012 Nov 26. PMID: 23195691.

53. Ríos-Castillo AG, González-Rivas F, Rodríguez-Jerez JJ. Bactericidal Efficacy of Hydrogen Peroxide-Based Disinfectants Against Gram-Positive and Gram-Negative Bacteria on Stainless Steel Surfaces. J Food Sci. 2017 Oct; 82(10): 2351-2356. doi: 10.1111/1750-3841.13790. Epub 2017 Aug 23. PMID: 28833105.

54. Song X, Vossebein L, Zille A. Efficacy of disinfectant-impregnated wipes used for surface disinfection in hospitals: a review. Antimicrob Resist Infect Control. 2019 Aug 19; 8: 139. doi: 10.1186/s13756-019-0595-2. PMID: 31452873.

55. Kelley AM, Voorn MG, Tembo GM, Horn CM, Li X, Teska PJ, et al. Contact time has limited impact on the efficacy of disinfectant towelettes when tested under conditions reflective of realistic use. Antimicrob Resist Infect Control. 2023 Jul 16; 12(1): 71. doi: 10.1038/s41598-023-32876-y. PMID: 37455322.

56. Edwards NWM, Best EL, Connell SD, Goswami P, Carr CM, Wilcox MH, et al. Role of surface energy and nanoroughness in the removal efficiency of bacterial contamination by nonwoven wipes from frequently touched surfaces. Sci Technol Adv Mater. 2017 Mar 14; 18(1): 197-209. doi: 10.1080/14686996.2017.1288543. PMID: 28469734.

57. Moccia G, Motta O, Pironti C, Proto A, Capunzo M, De Caro F. An alternative approach for the decontamination of hospital settings. J Infect Public Health. 2020 Dec; 13(12): 2038-2044. doi: 10.1016/j.jiph.2020.09.020. Epub 2020 Oct 21. PMID: 33289645.

58. D’Accolti M, Soffritti I, Bonfante F, Ricciardi W, Mazzacane S, Caselli E. Potential of an Eco-Sustainable Probiotic-Cleaning Formulation in Reducing Infectivity of Enveloped Viruses. Viruses. 2021 Nov 4; 13(11): 2227. doi: 10.3390/v13112227. PMID: 34835033.

Downloads

Published

2024-08-30

Issue

Section

Original research

How to Cite

1.
Lopuzzo M, Montagna MT, Triggiano F, Caggiano G. Effectiveness of hydrogen peroxide wipes for surface disinfection in healthcare facilities. Ann Ig. 2024;36(4):487-497. doi:10.7416/ai.2024.2621