Efficiency of hydrogen peroxide vapors in reducing multidrug-resistant organisms: a meta-analysis_West China Medical Journal

Authors：

PENG Yalan , LIN Ji , HUANG Wenzhi ,  QIAO Fu

Department of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

QIAO Fu, Email: 114558366@qq.com

Keywords：

Hydrogen peroxide vapor; Multidrug-resistant organisms; Efficiency of disinfection; Meta-analysis

DOI：

10.7507/1002-0179.202102043

Video：

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Objective To evaluate the efficiency of hydrogen peroxide vapor (HPV) in disinfecting multidrug-resistant organisms (MDROs).Methods We searched Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database for before-after studies or case-control studies or cohort studies evaluating efficiency of HPV and published from January 2010 to December 2020 (the time range was from January 2000 to December 2020 in the snowball searching). RevMan 5.4 and R 4.0.2 softwares were used for meta-analysis.Results A total of 9 studies were included, consisting of 8 before-after studies and 1 cohort study. Six studies evaluated positive rate of environmental samplings, meta-analysis revealed that HPV combined with manual cleaning disinfected the environment efficiently [relative risk (RR)=0.03, 95% confidence interval (CI) (0.01, 0.08), P< 0.000 01] and HPV was more efficient than manual cleaning [RR=0.04, 95%CI (0.02, 0.10), P< 0.000 01]. Three studies evaluated the hospital-acquired MDROs colonization/infection rates, and the results of the 3 studies were consistent, revealing that HPV could reduce hospital-acquired MDROs colonization/infection rates.Conclusion HPV is efficient in reducing MDROs contaminated surfaces and hospital-acquired infection rate.

Citation： PENG Yalan, LIN Ji, HUANG Wenzhi, QIAO Fu. Efficiency of hydrogen peroxide vapors in reducing multidrug-resistant organisms: a meta-analysis. West China Medical Journal, 2021, 36(3): 341-347. doi: 10.7507/1002-0179.202102043 Copy

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16.	Hardy KJ, Gossain S, Henderson N, et al. Rapid recontamination with MRSA of the environment of an intensive care unit after decontamination with hydrogen peroxide vapour. J Hosp Infect, 2007, 66(4): 360-368.
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18.	Jeanes A, Rao G, Osman M, et al. Eradication of persistent environmental MRSA. J Hosp Infect, 2005, 61(1): 85-86.
19.	Mitchell BG, Digney W, Locket P, et al. Controlling methicillin-resistant Staphylococcus aureus (MRSA) in a hospital and the role of hydrogen peroxide decontamination: an interrupted time series analysis. BMJ Open, 2014, 4(4): e004522.
20.	Otter JA, Cummins M, Ahmad F, et al. Assessing the biological efficacy and rate of recontamination following hydrogen peroxide vapour decontamination. J Hosp Infect, 2007, 67(2): 182-188.
21.	Otter JA, Yezli S, Schouten M, et al. Hydrogen peroxide vapor decontamination of an intensive care unit to remove environmental reservoirs of multidrug-resistant gram-negative rods during an outbreak. Am J Infect Control, 2010, 38(9): 754-756.
22.	Passaretti CL, Otter JA, Reich NG, et al. An evaluation of environmental decontamination with hydrogen peroxide vapor for reducing the risk of patient acquisition of multidrug-resistant organisms. Clin Infect Dis, 2013, 56(1): 27-35.

1. 胡付品. 251135株临床分离菌株主要菌种分布（CHINET 2020）中国细菌耐药监测网. (2020-09-01)[2021-01-03]. http://www.chinets.com/Data/AntibioticDrugFast.
2. Huang W, Qiao F, Zhang Y, et al. In-hospital medical costs of infections caused by carbapenem-resistant Klebsiella pneumoniae. Clin Infect Dis, 2018, 67(Suppl_2): S225-S230.
3. Chen Z, Xu Z, Wu H, et al. The impact of carbapenem-resistant Pseudomonas aeruginosa on clinical and economic outcomes in a Chinese tertiary care hospital: a propensity score-matched analysis. Am J Infect Control, 2019, 47(6): 677-682.
4. Lemos EV, De La Hoz FP, Alvis N, et al. Impact of carbapenem resistance on clinical and economic outcomes among patients with Acinetobacter baumannii infection in Colombia. Clin Microbiol Infect, 2014, 20(2): 174-180.
5. 白艳玲, 杜明梅, 刘伯伟, 等. 感染/定植耐碳青霉烯类肺炎克雷伯菌住院患者周围环境中分离CRKP菌株的流行特征. 中华医院感染学杂志, 2018, 28(8): 1131-1134.
6. 杨宝财, 苗勤, 刘海涛, 等. 我院ICU多重耐药鲍曼不动杆菌聚集性病例与环境污染调查分析. 河北医科大学学报, 2019, 40(11): 1317-1321.
7. Blazejewski C, Wallet F, Rouzé A, et al. Efficiency of hydrogen peroxide in improving disinfection of ICU rooms. Crit Care, 2015, 19(1): 30.
8. 朱越献, 干铁儿, 徐虹, 等. 环境清洁措施对ICU高频接触物体表面多重耐药菌检出的影响. 中国消毒学杂志, 2016, 33(8): 735-738.
9. French GL, Otter JA, Shannon KP, et al. 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(1): 31-37.
10. Boyce JM. Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals. Antimicrob Resist Infect Control, 2016, 5: 10.
11. Doll M, Morgan DJ, Anderson D, et al. Touchless technologies for decontamination in the hospital: a review of hydrogen peroxide and UV devices. Curr Infect Dis Rep, 2015, 17: 44.
12. Weber DJ, Kanamori H, Rutala W. “No touch” technologies for environmental decontamination: focus on ultraviolet devices and hydrogen peroxide systems. Curr Opin Infect Dis, 2016, 29(4): 424-431.
13. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions Version 5.1.0. The Cochrane Collaboration, 2011. (2012-03-30)[2021-02-25]. http://www.cochrane-handbook.org.
14. Slim K, Nini E, Forestier D, et al. Methodological Index for Non-randomized Studies (MINORS): development and validation of a new instrument. ANZ J Surg, 2003, 73(9): 712-716.
15. 曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
16. Hardy KJ, Gossain S, Henderson N, et al. Rapid recontamination with MRSA of the environment of an intensive care unit after decontamination with hydrogen peroxide vapour. J Hosp Infect, 2007, 66(4): 360-368.
17. Horn K, Otter JA. Hydrogen peroxide vapor room disinfection and hand hygiene improvements reduce Clostridium difficile infection, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, and extended-spectrum β-lactamase. Am J Infect Control, 2015, 43(12): 1354-1356.
18. Jeanes A, Rao G, Osman M, et al. Eradication of persistent environmental MRSA. J Hosp Infect, 2005, 61(1): 85-86.
19. Mitchell BG, Digney W, Locket P, et al. Controlling methicillin-resistant Staphylococcus aureus (MRSA) in a hospital and the role of hydrogen peroxide decontamination: an interrupted time series analysis. BMJ Open, 2014, 4(4): e004522.
20. Otter JA, Cummins M, Ahmad F, et al. Assessing the biological efficacy and rate of recontamination following hydrogen peroxide vapour decontamination. J Hosp Infect, 2007, 67(2): 182-188.
21. Otter JA, Yezli S, Schouten M, et al. Hydrogen peroxide vapor decontamination of an intensive care unit to remove environmental reservoirs of multidrug-resistant gram-negative rods during an outbreak. Am J Infect Control, 2010, 38(9): 754-756.
22. Passaretti CL, Otter JA, Reich NG, et al. An evaluation of environmental decontamination with hydrogen peroxide vapor for reducing the risk of patient acquisition of multidrug-resistant organisms. Clin Infect Dis, 2013, 56(1): 27-35.

West China Medical Journal

Efficiency of hydrogen peroxide vapors in reducing multidrug-resistant organisms: a meta-analysis

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