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

Summary

Healthcare-associated infections (HAIs) remain a major problem in intensive care units (ICUs), driven by environmental contamination with multidrug-resistant organisms that persist despite routine manual cleaning. While hydrogen peroxide aerosolization and ultraviolet-C light devices have shown promise in reducing surface contamination, current evidence is inconsistent, mostly derived from single-center studies, and rarely linked to patient-centered outcomes.

The investigators will conduct this cluster-randomized, crossover trial in 12 Brazilian ICUs. Each ICU will sequentially implement three strategies: (1) usual surface disinfection; (2) usual surface disinfection followed by hydrogen peroxide aerosolization at 7.9% concentration, applied through a dedicated device inside a protective tent during terminal cleaning of patient beds; and (3) usual surface disinfection followed by automated ultraviolet-C irradiation, also applied under the same tent to shield adjacent occupied beds.

The primary outcome will be the antimicrobial utilization, measured as daily defined doses (DDD) of antimicrobials at the ICU level per 100 patient-days, with secondary outcomes including HAI incidence rate, environmental contamination with multidrug-resistant organisms, specific HAIs incidence rate (associated-ventilator pneumonia, central-line associated bloodstream infection, and catheter-associated urinary tract infection), and ICU length of stay costs.

Conditions

• Infection, Hospital
• Antimicrobial
• Pneumonia Associated With Mechanical Ventilation
• Urinary Tract Infection(UTI)
• Catheter Related Blood Stream Infections

Interventions

OTHER

Aerosol of hydrogen peroxide

Spray of aerosolized peroxide hydrogen using a specific device when performing terminal cleaning of the ICU bed after the patient's discharge.

OTHER

Irradiation of ultraviolet light

Irradiation of UV light for the purpose of disinfecting beds and surfaces near beds during terminal cleaning.

Sponsors & Collaborators

• Hospital Sirio-Libanes

  collaborator OTHER

• Hospital do Coracao

  collaborator OTHER

• Beneficência Portuguesa de São Paulo

  collaborator OTHER

• Hospital Israelita Albert Einstein

  lead OTHER

Principal Investigators

• Antonio P Nassar Jr, PhD · Hospital Israelita Albert Einstein

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-05

Primary Completion

2027-02-26

Completion

2027-03-01

Countries

• Brazil

Study Locations