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Ten steps to preventing infection in hospitals... Award by the NHS Purchasing and Supply Agency to BIOQUELL BIOQUELL Enhances Patient Safety DoH & PASA Publish report on Success of BIOQUELL System in Showcase Hospital Programme DOTMED Business News Article BIOQUELL assist with clean up BIOQUELL Launch new Clarus L2 HPV Generator Contamination cleanup at Genzyme Briefing on the outbreak of Swine Influenza Virus BIOQUELL takes top prize at the Department of Health HCAI Technology Innovation Summit USA Today reports on patient protection and lax attitudes that spread hospital infections BBC News Films 'New Weapons Against Hospital Bugs' at Lewisham Hospital Don't Skimp on the Gym Because of MRSA BIOQUELL moves to newly renovated production facility Infection Control & Hospital Epidemiology Article - Impact of Hydrogen Peroxide Vapor Room Decontamination on Clostridium difficile... BIOQUELL technology showcased in seven NHS hospitals "Hydrogen Peroxide Vapor can control Nosocomial MRSA Outbreak" - Clinical Infectious Diseases Article Rapid Review Panel upgrades BIOQUELL technology to Level One Status Department of Health Post BIOQUELL Case Studies as "Best Practice" on website Award of Joint Material Decontamination System (US military) sub-contract |
Healthcare microbiology This pages contain scientific information regarding the principal micro-organisms that we regularly encounter in the field of modern healthcare. BIOQUELL's hydrogen peroxide vapor (HPV) technology is regularly used in this field for the bio decontamination of rooms and buildings as a significant contribution to the eradication of hospital associated infections including:
Is environmental contamination in hospitals relevant clinically? A number of organisms that are often implicated in hospital-acquired infections (HAI's) are known to contaminate the hospital environment. These include Gram-positive cocci such as methicillin-resistant Staphylococcus aureus (MRSA) (Boyce et al. 1997;French et al. 2004a) and vancomycin-resistant enterococci (VRE) (Boyce et al. 1994); spore forming Gram-positive rods such as Clostridium difficile (McFarland 2002;Verity et al. 2001); Gram-negative rods including the Enterobacteriaceae, for example Klebsiella sp. and Escherichia coli (E. coli)(Fryklund et al. 1995) and Acinetobacter sp. (Getchell-White et al. 1989); viruses such as Norovirus (Green et al. 1998) and fungi such as Aspergillus sp. (Menotti et al. 2005;Symoens et al. 2002). Is such environmental contamination a cause or effect of nosocomial infection? A number of studies in the 1980s and early 1990s suggested that contamination of the hospital environment with nosocomial pathogens does not represent a risk to patients (Maki et al. 1982;McGowan, Jr. 1981) and that vegetative (that is, non spore-forming) bacteria do not survive for extended periods on environmental surfaces (Hirai 1991). Although the link between environmental contamination and nosocomial cross infection remains controversial, there is increasing evidence that indirect transfer of nosocomial pathogens via the contaminated environment is a significant route of transmission for certain micro-organisms (Dancer 1999;Hota 2004). More recent studies have demonstrated that vegetative nosocomial bacteria can survive for many months when dried onto surfaces (French et al. 2004b;Smith et al. 1996;Wagenvoort et al. 2000). For example, MRSA and A. baumannii were found to survive in excess of 300 days on dry surfaces in one study (Wagenvoort and Joosten 2002). Although direct transmission of nosocomial pathogens via healthcare workers hands is widely considered to be the most important route of transmission (Boyce and Pittet 2002), healthcare workers hands can become contaminated indirectly through contact with the inanimate environment in clinical areas (Bhalla et al. 2004;Boyce et al. 1997;Ray et al. 2002). Indirect contamination of the hands via the inanimate environment in the absence of patient contact could represent a significant and underestimated route of transmission. Indirect transmission through environmental contamination has been shown to be a significant transmission route for C. difficile (Fawley and Wilcox 2001;Mayfield et al. 2000;McFarland 2002; Samore et al. 1996;Verity et al. 2001;Wilcox et al. 2004) and A. baumannii (Catalano et al. 1999;Denton et al. 2004). There is accumulating evidence that indirect transmission through environmental contamination is also a significant transmission route for other micro-organisms such as MRSA (Dealler 2004;Rampling et al. 2001) and VRE (Martinez et al. 2003). Pilot implementation of BIOQUELL's HPV technology, St. Thomas’ Hospital, London Given the ever-increasing rates of methicillin-resistant Staphylococcus aureus (MRSA) infection, colonisation and bacteraemia in the UK, BIOQUELL collaborated with St Thomas’ Hospital Department of Microbiology and King’s College London to investigate the level of MRSA environmental contamination at St Thomas’ (French et al. 2004a). In response to the high level of MRSA contamination discovered, the effect of conventional cleaning and bio-decontamination with BIOQUELL’s RBDS was compared. Graphical summary of St Thomas' / BIOQUELL's research Key Findings: Click here... to enlarge graph
Recent correspondence in the Journal of Hospital Infection regarding this publication has discussed some practical questions associated with the implementation of RBDS into a busy hospital (Otter et al. 2005;Taneja et al. 2005). Applications of BIOQUELL’s HPV technology A number of in-use evaluations have now been completed in clinical settings. One study investigated the use of RBDS for environmental control during a Serratia marcescens outbreak on a Neonatal Intensive Care Unit (NICU) at the Royal Hallamshire Hospital, Sheffield (Bates and Pearse 2005). This study concluded that ‘HPV provided a safe and effective means for the eradication of environmental S. marcescens from our NICU, which may otherwise have resulted in a continuation of the outbreak. This was clinically helpful in allowing beds to be re-opened more quickly, in a speciality in which the number of beds available is frequently inadequate.’ Another study described the use of RBDS for the eradication of persistent MRSA environmental contamination from a surgical ward at Lewisham Hospital, London (Jeanes et al. 2005). This study concluded that ‘Decontamination using HPV provides a rapid and cost-effective method for the eradication of environmental MRSA.’ A large study was initiated in the USA in 2005 investigating the hospital-wide effect of regular bio-decontamination in a University-affiliated teaching hospital. The study has focussed on the rate of C. difficile-associated diarrhoea (CDAD) in the hospital, but the rates of other environmentally-associated nosocomial pathogens, including MRSA and VRE, have also been studied. The encouraging preliminary results were presented at the Interscience Conference for Antimicrobial Agents and Chemotherapy (ICAAC) at Washington DC in December 2005 (see link, below). Further results will be released in 2006. Many other as yet unpublished in-use evaluations, particularly relating to eradicating nosocomial pathogens during epidemics, have also been completed in NHS clinical settings and the results have been encouraging. Further details of these trials will be posted on this site when they become available. Conclusion It seems that the importance of contamination of the hospital environment with nosocomial pathogens has been historically underestimated; evidence is accumulating rapidly that indirect transmission through contaminated environmental surfaces is an important route of transmission. BIOQUELL’s HPV technology has been shown to eradicate important environmental pathogens from environmental surfaces and in-use evaluations have demonstrated a resultant impact on rates of infection, particularly in epidemic scenarios. Further work is in progress to determine the optimal deployment of BIOQUELL’s technology to maximise the reduction of HAI. If you would like any further information regarding the application of BIOQUELL’s technology in your institution, please contact us via the link at the bottom of the page References Bates,C.J. and Pearse,R. (2005) Use of hydrogen peroxide vapour for environmental control during a Serratia outbreak in a neonatal intensive care unit. J Hosp. Infect 61, 364-366. Dancer,S.J. (1999) Mopping up hospital infection. J Hosp. Infect 43, 85-100. Hirai,Y. (1991) Survival of bacteria under dry conditions; from a viewpoint of nosocomial infection. J Hosp. Infect 19, 191-200. 
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