Comparison of the Microbiological Efficacy of Disinfection Using Ultraviolet and Hydrogen Peroxide System for Carbapenemase-producing Enterobacteriaceae in a Healthcare Setting

Abstract

Background: This study aimed to compare the efficacy of microbiological disinfection between the ultraviolet-C (UV-C) device and aerosolized hydrogen peroxide (aHP) system in a healthcare setting. Methods: Four rooms were installed with two UV-C devices and two aHP systems. Thirty formica sheets contaminated with carbapenemase-producing Enterobacteriaceae (CPE) were placed in each room. After intervention, the median log10 reduction and modified decontamination rates were compared between the two methods using Rodac plates. Eight sink drains in the rooms previously occupied by a patient with CPE were sampled separately before and after the interventions. Results: The median log10 reduction was 5.52 and 5.37 after the UV-C (n=60) and aHP (n=60) interventions, respectively (P=0.86), whereas the modified decontamination rate was 50% and 45%, respectively (P=0.71). At the UV-direct sites, UV-C showed higher median log10 reduction (5.91 vs. 5.61, P=0.002) and modified decontamination rate (83% vs. 53%, P=0.03) than those of aHP. Conversely, at UV-indirect sites, aHP showed higher median log10 reduction (4.63 vs. 5.07%, P=0.02) and modified decontamination rate (17% vs. 37%, P=0.01) than those of UV-C. After the intervention, carbapenemase-resistant Gram-negative bacilli decreased further in five of the seven sink drains disinfected by sodium. Conclusion: Both UV-C and aHP reduced the bacterial contamination in the rooms. The aHP was significantly more effective than UV-C at the UV-indirect sites, and the converse was true for the UV-direct sites. Application of the intervention to disinfect the sink drains resulted in additional bacterial decontamination. Considering the features of the machines and the results of this study, healthcare facilities can choose either UV-C or aHP for decontamination.