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

Hospital Israelita Albert Einstein

Status: Enrolling

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

Treatments: Other: Aerosol of hydrogen peroxide; Other: Irradiation of ultraviolet light

Study type: Interventional

Funder types: Other

Identifiers

NCT07233837

CAAE 71265723.0.1001.0071

Details and patient eligibility

About

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 average duration of antimicrobial therapy, with secondary outcomes including HAI incidence, environmental contamination with multidrug-resistant organisms, specific HAIs (associated-ventilator pneumonia, central-line associated bloodstream infection, and catheter-associated urinary tract infection), and ICU length of stay costs.

Enrollment: 4,800 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients aged 18 years and older who will be admitted to the participating ICUs

Exclusion criteria

• Patients under 18 years
• ICUs that use peroxide hydrogen or ultraviolet light for surface disinfection as part of their protocol

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Double Blind

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4,800 participants in 3 patient groups

Surface disinfection with aerosolized hydrogen peroxide

Experimental group

Description:

The hygiene team of each participating ICU will spray aerosolized peroxide hydrogen using a specific device when performing terminal cleaning of the ICU bed after the patient's discharge. As peroxide hydrogen aerosol can be irritating to people nearby, we will use a tent designed to cover the bed and nearby equipment during peroxide hydrogen disinfection, thus preventing aerosols from spreading to other beds and other areas of ICUs where beds are not in closed rooms.

Treatment:

Other: Aerosol of hydrogen peroxide

Surface disinfection with irradiation of ultraviolet light

Experimental group

Description:

The hygiene team of each participating ICU will use a specific device, requiring no manipulation, for irradiating UV light for the purpose of disinfecting beds and surfaces near beds during terminal cleaning. To prevent UV irradiation from reaching occupied beds and other areas of the ICU, the same tent described in the "peroxide hydrogen" arm.

Treatment:

Other: Irradiation of ultraviolet light

Usual disinfection

No Intervention group

Description:

The control group will perform standard cleaning and disinfection of the beds and the environment according to their previous protocols, using the usual products.