An evaluation of environmental decontamination with hydrogen peroxide vapor for reducing the risk of patient acquisition of multidrug-resistant organisms

Catherine L. Passaretti, Jonathan A. Otter, Nicholas G. Reich, Jessica Myers, John Shepard, Tracy Ross, Karen C. Carroll, Pam Lipsett, Trish M. Perl

Research output: Contribution to journalArticle

126 Scopus citations


Background. Admission to a room previously occupied by a patient with certain multidrug-resistant organisms (MDROs) increases the risk of acquisition. Traditional cleaning strategies do not remove all environmental MDROs. We evaluated the environmental and clinical impact of hydrogen peroxide vapor (HPV) room disinfection.Methods. We performed a 30-month prospective cohort intervention study on 6 high-risk units in a 994-bed tertiary care hospital. Following a 12-month preintervention phase, HPV was implemented on 3 units to decontaminate the rooms of patients known to be infected or colonized with epidemiologically important MDROs, following their discharge. Monthly environmental samples for MDROs were collected on all study units for 3 preintervention and 6 intervention months. The risk of MDRO acquisition in patients admitted to rooms decontaminated using HPV was compared with rooms disinfected using standard methods.Results. The prior room occupant was known to be infected or colonized with an MDRO in 22% of 6350 admissions. Patients admitted to rooms decontaminated using HPV were 64% less likely to acquire any MDRO (incidence rate ratio [IRR], 0.36; 95% confidence interval [CI],. 19-.70; P <. 001) and 80% less likely to acquire VRE (IRR, 0.20; 95% CI,. 08-.52; P <. 001) after adjusting for other factors. The risk of acquiring Clostridium difficile, methicillin-resistant Staphylococcus aureus, and multidrug-resistant gram-negative rods individually was reduced, but not significantly. The proportion of rooms environmentally contaminated with MDROs was reduced significantly on the HPV units (relative risk, 0.65, P =. 03), but not on non-HPV units.Conclusions. HPV decontamination reduced environmental contamination and the risk of acquiring MDROs compared with standard cleaning protocols.

Original languageEnglish (US)
Pages (from-to)27-35
Number of pages9
JournalClinical Infectious Diseases
Issue number1
Publication statusPublished - Jan 1 2013



  • decontamination
  • disinfection
  • environmental contamination
  • hydrogen peroxide vapor
  • multidrug-resistant organisms

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

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