Hydrogen Peroxide and Ultraviolet Light for Disinfecting Surfaces in Intensive Care Units: A Randomized, Controlled, Cluster, Crossover Clinical Trial

What this Trial Is About

Healthcare-associated infections (HAIs) are a significant issue in intensive care units (ICUs), often caused by environmental contamination with multidrug-resistant organisms that remain despite regular cleaning. Researchers are evaluating two advanced disinfection methods—hydrogen peroxide aerosolization and ultraviolet-C light—to reduce this contamination. This cluster-randomized, crossover trial will be conducted in 12 Brazilian ICUs to compare these methods with usual surface disinfection practices. The trial includes three sequential cleaning strategies for each ICU: usual surface disinfection alone; usual disinfection followed by hydrogen peroxide aerosolization at 7.9% concentration applied inside a protective tent during terminal cleaning of beds; and usual disinfection followed by automated ultraviolet-C irradiation applied under the same tent. The protective tent is used to prevent exposure of adjacent beds and ICU areas to the disinfecting agents. Participants will be all patients aged 18 years and older admitted to these ICUs. Researchers will measure antimicrobial use at the ICU level over three months, daily defined doses per 100 patient-days, and secondary outcomes such as rates of HAIs, contamination by multidrug-resistant organisms, specific infections like ventilator-associated pneumonia, bloodstream infections, urinary tract infections, and ICU length of stay costs. Safety and effectiveness of surface disinfection methods will be monitored throughout the study.

Hydrogen Peroxide and Ultraviolet Light for Disinfecting Surfaces in Intensive Care Units