Barbalha

Healthcare-associated infections (HAIs) are a major issue in intensive care units (ICUs), often caused by contamination with multidrug-resistant organisms that remain despite routine cleaning. This trial evaluates different surface disinfection methods to reduce such contamination and improve patient outcomes. It is a cluster-randomized, crossover study conducted in 12 Brazilian ICUs, comparing usual cleaning methods with additional disinfection technologies. The trial involves three sequential strategies in each ICU: usual surface disinfection alone; usual disinfection followed by aerosolized hydrogen peroxide sprayed at 7.9% concentration inside a protective tent during terminal cleaning of patient beds; and usual disinfection followed by automated ultraviolet-C light irradiation applied under the same protective tent to disinfect beds and nearby surfaces. These methods are compared to assess their impact on infection control. Participants admitted to the ICUs will be monitored for antimicrobial use, which is the primary outcome measured as daily defined doses per 100 patient-days over three months. Secondary outcomes include rates of HAIs, environmental contamination by resistant organisms, specific infection types like ventilator-associated pneumonia, bloodstream infections, urinary tract infections, and ICU length of stay and costs. The study includes assessments of contamination and infection rates during each intervention period to evaluate effectiveness and safety.