Efficacy and Cost Analysis of a Combined (One-Step) Detergent-Disinfectant for Environmental Decontamination Around...

Contaminated environmental surfaces contribute to the transmission of pathogens that cause healthcare-associated infections. The present study aimed to assess the efficacy and cost implications of a chlorine-based combined detergent-disinfectant used for environmental decontamination around methicillin-resistant Staphylococcus aureus (MRSA) patients.

The study was conducted over a six-month period in the inpatient wards (medical, surgical, and orthopedic) of Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, People's Republic of China. The surrounding areas of newly diagnosed MRSA patients were divided into two equal halves and decontaminated using either the conventional two-step process (cleaning with detergent followed by disinfection with a 1000 ppm hypochlorite solution) or a new one-step method using a combined detergent-disinfectant. High-touch surfaces in the patients' immediate environment were sampled before and after decontamination to detect MRSA by culture and to measure adenosine triphosphate (ATP) levels. The number of disposable wipes used and the duration of the decontamination process were recorded for the cost analysis.

Both the conventional and the new methods significantly reduced the MRSA detection rate from 68.7% to 12.7% and to 15.3%, respectively (p < 0.001), and significantly reduced the ATP failure rate from 78.2% to 2.7% and to 4.5%, respectively (p < 0.001). Compared with the conventional method, the new method saved an average of 5.9 minutes of decontamination time and 10.2 disposable wipes per patient, resulting in a substantial cost saving of over 6 million Hong Kong dollars per year according to current infection control recommendations for MRSA patients in public hospitals in Hong Kong.

The one-step method using a combined detergent-disinfectant effectively decontaminated high-touch hospital surfaces in the patient environment while reducing both time and costs. Its broader implementation in local inpatient settings may enhance environmental hygiene while reducing costs.