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Burns units combat superbug outbreaks with hydrogen peroxide vapor (HPV) disinfection bundle
One of Europe's leading burns units has significantly reduced the incidence of noscomial MRSA and Acinetobacter baumannii using a bundle of infection control measures using the latest hydrogen peroxide vapor (HPV) disinfection technology.
Work conducted at Saint-Antoine Hospital in Paris, France by Frédéric Barbut and his team has recently been published in Burns, a leading scientific journal, demonstrating the effectiveness of regular HPV disinfection of rooms following discharge of patients known to be affected by multidrug-resistant bacteria. The Saint-Antoine Hospital burns unit is one of two major reference burns centers in Paris. It had an ongoing problem with Acinetobacter infections when it experienced a major MRSA outbreak in 2007. This lead to the closure of the unit in July 2008.
As a result, the entire unit was decontaminated using Bioquell’s HPV technology and an infection control bundle (ICB) was implemented when the unit was reopened in September 2008. The ICB comprised regular HPV disinfection of the rooms following discharge of patients colonized or infected by multidrug-resistant organisms (MDRO), pre-emptive cohort isolation of newly admitted patients before being proven culture negative and cohorting of colonized or infected patients. Additionally two air disinfection systems were installed in the corridors of the unit and improvements made to material storage.
Frequent HPV disinfection was show to be effective at significantly reducing environmental contamination (bacterial and fungal) from surfaces and the air on the unit and eliminating pathogens from the environment. The infection control bundle stopped the MRSA outbreak, resulting in a significant reduction in the incidence of nosocomial MRSA (89.3%) and A. baumannii (88.8%). It also prevented further outbreaks of these organisms in the burns unit.
Commenting on this research, James Salkeld head of healthcare at Bioquell said, “Interestingly, results showed that surfaces were still contaminated with pathogens including Acinetobacter, E. coli and S. aureus in addition to MRSA, after standard terminal cleaning and before HPV treatment. Aspergillus was also isolated from the air before HPV.”
After the implementation of the ICB, the incidence of nosocomial MDRO infection/colonization reduced significantly by 84.9%. There was a 36% reduction in the rate of nosocomial ESBL-producing Enterobacteriaceae cases but the reduction was not statistically significant. Evidence of at least two A. baumannii outbreaks and one MRSA outbreak in the unit was seen in the pre-intervention period. No outbreak of Acinetobacter or MRSA has occurred since the implementation of the ICB.
The latest research will been published in the next Burns journal (September) but is already available online at http://www.burnsjournal.com/