Aerosolized hydrogen peroxide reduces C. difficile in hospitals, study finds
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Adding aerosolized hydrogen peroxide to hospital infection prevention protocols significantly reduced Clostridioides difficile infections, according to the results of a 10-year study reported in the American Journal of Infection Control.
It was the first long-term evaluation of aerosolized hydrogen peroxide to reduce C. difficile infection (CDI) in a clinical setting, according to the Association for Professionals in Infection Control and Epidemiology, which publishes the journal.
C. difficile is resistant to temperature changes, hand sanitizers and most disinfectants Christopher L. Truitt, PhD, chief scientific officer at Infection Controls Inc., and colleagues wrote in the new study. It is frequently recovered from both symptomatic and asymptomatic carriers, and patients staying in rooms where the prior occupant had a C. difficile infection are at an increased risk for getting an infection themselves, they explained.
Truitt and colleagues conducted a retrospective analysis of C. difficile rates at Pennsylvania Hospital in Philadelphia — a 475-bed acute care facility — over a 10-year period. For the initial 5 years, they analyzed the before-and-after effects of aerosolized hydrogen peroxide (aHP) added to prevention protocols. Over the next 5 years, they assessed the impact of continued use of aHP on C. difficile rates.
The period before aHP was implemented lasted 27 months, from July 2009 through September 2011. Once implementation began, the study period lasted 33 months, from April 2012 through December 2014. They excluded 6 months of the study period because aHP was not consistently used.
Throughout the study period, there were a total of 192 health care-associated C. difficile infections (HA-CDI). Of those, 120 occurred before the implementation of aHP, with a rate of 4.6 C. difficile infections per 10,000 days. After aHP implementation, there were 72 cases for a rate of 2.7 cases per 10,000 days.
“Our study showed that persistence in utilizing an aerosolized hydrogen peroxide system had a significant impact on reducing C. difficile infections hospitalwide,” Truitt said in a press release.
In the second 5-year portion of the study, the authors reported that the rate of C. difficile infections decreased annually — from 5.4 per 10,000 days in 2015 to 1.4 per 10,000 days in 2019. The standardized infection ratio dropped from 0.77 in 2015 to 0.5 in 2019.
“We report a 41% reduction in HA-CDI rates associated with aHP implementation,” the authors wrote. “To our knowledge, this is the first study showing the effectiveness of aHP in reducing CDI rates in a clinical setting.”
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