Evaluation of hydrogen peroxide-based foam disinfection for reducing gram-negative bacterial contamination in...

Hospital sink drains are recognized reservoirs for gram-negative bacteria (GNB). This study evaluates the efficacy of a sink drain disinfection strategy using hydrogen peroxide-based foam, mechanical cleaning, and drain cover replacement in reducing GNB bioburden in a neonatal intensive care unit (NICU).

We conducted a prospective cohort study of 30 NICU room sinks comparing three interventions: (1) foam disinfection alone (n = 5), (2) foam with mechanical cleaning (n = 5), and (3) foam with drain cover replacement (n = 5), and (4) foam, mechanical cleaning, and drain cover replacement (n = 5), to controls (no intervention, n = 10). Samples from sink drains, faucets, counters, basins, and drain covers were collected at baseline (Day 0) and post-intervention (Days 1, 3, 5, and 7). Bacterial colony counts were analyzed using linear regression models.

At baseline, sink drains and drain covers had the highest bioburden (total GNB mean ln-CFU: 15.4 and 16.4), with Pseudomonas aeruginosa (33%) and Stenotrophomonas maltophilia (39%) as predominant isolates. The intervention combining foam, mechanical cleaning, and drain cover replacement achieved the greatest bioburden reduction on Day 1 in drains (mean ln-CFU reduction = 11.0, 95% CI: 6.4, 16.0, p < 0.001) and covers (mean reduction = 14.0, 95% CI: 8.7, 19.0, p < 0.001), with sustained effects through Day 7. Recolonization to ∼50% of baseline was evident by Day 5 in both sites.

Physical bioburden removal improved the effect of a foaming disinfectant in reducing GNB. However, recolonization occurred by day 5.