infection control & hospital epidemiology october 2017, vol. 38, no. 10 original article
Decontamination of Hospital Surfaces With Multijet Cold Plasma: A Method to Enhance Infection Prevention and Control?
Orla J. Cahill, PhD;1,2 Tânia Claro, PhD;3 Attilio A. Cafolla, PhD;4 Niall T. Stevens, PhD;3 Stephen Daniels, PhD;2 Hilary Humphreys, MD, FRCPI, FRCPath, FFPath(RCPI), DipHIC3,5
objective. To evaluate the efficacy of a multijet cold-plasma system and its efficacy in decontaminating 2 surfaces commonly found in hospitals
design. An in vitro study of common causes of healthcare-acquired infection
methods. Log10 9 cultures of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended spectrum β-lacta- mase–producing Escherichia coli, and Acinetobacter baumannii were applied to 5-cm2 sections of stainless steel and mattress. Human serum albumin (HSA) was used as a proxy marker for organic material, and atomic force microscopy (AFM) was used to study the impact on bacterial cell structure. The inoculated surfaces were exposed to a cold-air-plasma–generating multijet prototype for 15, 20, 30, and 45 seconds.
results. After 45 seconds, at least 3 to 4 log reductions were achieved for all bacteria on the mattress, while 3 to 6 log reductions were observed on stainless steel. The presence of HSA had no appreciable effect on bacterial eradication. The surfaces with bacteria exposed to AFM showed significant morphological changes indicative of “etching” due to the action of highly charged ions produced by the plasma.
conclusion. This multijet cold-plasma prototype has the potential to augment current environmental decontamination approaches but needs further evaluation in a clinical setting to confirm its effectiveness.
Infect Control Hosp Epidemiol 2017;38:1182–1187
“High-touch” or frequently touched surfaces may become con- taminated with common pathogens of healthcare-associated infections (HCAIs) including methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, vancomycin-resistant enterococci (VRE), and gram-negative organisms such as Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. The risk of cross-contamination between patients is high due to the use of contaminated patient items: mattresses, bed frames, call buttons, over-bed tables, wheelchairs, bedside lockers, etc.1–4 Moreover, smaller objects (eg, thermometers, blood pressure cuffs, and glucometers) have also been found to have a high bioburden and may be a source of cross-infection between patients.5 The application of cold-air atmospheric pressure plasma
(CAPP) is a nontoxic process. A limited amount of heat is pro- duced (ie, <45°C) in addition to potent radicals (originally from the gas composition) that have antibacterial properties but do not seem to have a destructive impact on surfaces irrespective of
composition.6 Such an approach represents a potentially more attractive alternative to hydrogen peroxide (HP) and ultraviolet light (UVL), which have been increasingly promoted to assist in reducing HCAIs but require the area to be vacated of patients, healthcare staff, and somematerials (eg, soft furnishings).7–9 We previously documented the efficacy of a single-jet CAPP system to eradicate vegetative bacteria from a variety of surfaces.10 Here, we describe the development and evaluation of a
multijet CAPP system to reduce in number a variety of important bacterial pathogens of HCAI from 2 surfaces com- monly found in hospitals in the presence and absence of human serum albumin (HSA).
methods Bacterial Strains and Growth Conditions
We chose 2 gram-positive organisms (MRSA and VRE) and 2 gram-negative organisms (E. coli and A. baumannii)forthis study.
Affiliations: 1. School of Electronic Engineering and National Centre for Plasma Science Technology, Dublin City University, Dublin, Ireland; 2. Depart-
ment of Food Science and Environmental Health, Dublin Institute of Technology, Dublin, Ireland; 3. Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; 4. School of Physical Sciences, Dublin City University, Dublin, Ireland; 5. Department of Microbiology, Beaumont Hos- pital, Dublin, Ireland.
PREVIOUS PRESENTATION. Preliminary data were presented at the 25th European Congress of Clinical Microbiology and Infectious Diseases in Copenhagen, Denmark, on April 26, 2015.
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2017/3810-0007. DOI: 10.1017/ice.2017.168 Received March 6, 2017; accepted July 5, 2017; electronically published August 10, 2017
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