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Saving Costs through the Decontamination of the Packaging of Unused Medical Supplies Using Hydrogen Peroxide Vapor

Published online by Cambridge University Press:  02 January 2015

Jonathan A. Otter
Bioquell, Horsham, Pennsylvania
Elaine Nowakowski
Johns Hopkins Hospital, Baltimore, Maryland
James A. G. Salkeld
Bioquell, Horsham, Pennsylvania
Mike Duclos
Bioquell, Horsham, Pennsylvania
Catherine L. Passaretti
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Saber Yezli
Bioquell, Horsham, Pennsylvania
Tracy Ross
Johns Hopkins Hospital, Baltimore, Maryland Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Karen C. Carroll
Johns Hopkins Hospital, Baltimore, Maryland Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Trish M. Perl*
Johns Hopkins Hospital, Baltimore, Maryland Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Johns Hopkins Hospital, 600 North Wolfe Street, 327 A Billings, Baltimore, MD 21287 (



Individually packaged sterile supply items may become contaminated and act as vectors for nosocomial transmission of multidrug-resistant organisms (MDROs). Thus, many hospitals have a policy to dispose of these unused, packaged supply items at patient discharge from the hospital, which has considerable cost implications. We evaluated the frequency of contamination of these items, the efficacy of hydrogen peroxide vapor (HPV) in disinfecting them, and costs associated with discarded supplies.


Before-after study.


A pilot study was performed in the rooms of 20 patients known to be colonized or infected with vancomycin-resistant enterococci (VRE), and a follow-up study was performed in an additional 20 rooms of patients under precautions for various MDROs in 6 high-risk units. Five pairs of supply items were selected. One item of each pair was sampled without exposure to HPV, and the other was sampled after HPV exposure. The cost of discarded supplies was calculated by examining stock lists of supplies stored on the study units.


Seven (7%) of 100 items were contaminated with VRE in the pilot study, and 9 (9%) of 100 items were contaminated with MDROs in the follow-up study. None of the items were contaminated after exposure to HPV (P < .02 in both the pilot and the follow-up study). The annual cost of supplies discarded at patient hospital discharge was $387,055. This figure does not include the cost of waste disposal and is therefore likely to be an underestimation of the financial burden.


HPV effectively disinfected the packaging of supply items, which could generate considerable financial and environmental benefits.

Original Article
Copyright © The Society for Healthcare Epidemiology of America 2013

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