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

NCT07233837 | Recruiting DMC

• 1 other identifier: CAAE 71265723.0.1001.0071
• Study Type: interventional
• Target: 5,000
• Locations: 1 country
• Sites: 12

Brief 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

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

Keywords

Healthcare associated infections; Antimicrobial use; Intensive care units; pneumonia, ventilator-associated; Catheter-related infections; Urinary tract infections; Hydrogen Peroxide; Ultraviolet light

Outcome Measures

Primary Outcomes (1)

• Antimicrobial utilization at the ICU level

  Antimicrobial utilization, measured as daily defined doses (DDD) of antimicrobials at the ICU level per 100 patient-days

  3 months

Secondary Outcomes (6)

• Healthcare-associated infections

  3 months

• Contamination of environmental surfaces by multi-resistant microorganisms

  3 months

• Incidence density of ventilator-associated pneumonia

  3 months

• Incidence density of central line-associated bloodstream infections

  3 months

• Incidence density of catheter-associated urinary tract infection

  3 months

Study Arms (3)

Surface disinfection with aerosolized hydrogen peroxide

EXPERIMENTAL

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.

Other: Aerosol of hydrogen peroxide

Surface disinfection with irradiation of ultraviolet light

EXPERIMENTAL

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.

Other: Irradiation of ultraviolet light

Usual disinfection

NO INTERVENTION

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

Interventions

Aerosol of hydrogen peroxide OTHER

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

Also known as: Hydrogen Peroxide

Surface disinfection with aerosolized hydrogen peroxide

Irradiation of ultraviolet light OTHER

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

Also known as: Ultraviolet light

Surface disinfection with irradiation of ultraviolet light

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

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

You may not qualify if:

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

Sponsors & Collaborators

• Hospital Israelita Albert Einstein: lead
• Hospital do Coracao: collaborator
• Hospital Sirio-Libanes: collaborator
• Beneficência Portuguesa de São Paulo: collaborator

Study Sites (12)

Hospital Maternidade Sao Vicente De Paulo

Barbalha, Ceará, Brazil

RECRUITING

Instituto Hospital de Base

Brasília, Federal District, Brazil

RECRUITING

Hospital Estadual de Aparecida de Goiânia

Aparecida de Goiânia, Goiás, Brazil

RECRUITING

Santa Casa de Misericórdia de Passos

Passos, Minas Gerais, Brazil

RECRUITING

Fundo Municipal de Saúde de Maringá

Maringá, Paraná, Brazil

RECRUITING

Hospital da Restauração

Recife, Pernambuco, Brazil

RECRUITING

Hospital Universitário da Universidade Federal do Piauí

Teresina, Piauí, Brazil

RECRUITING

Hospital Universitário Onofre Lopes

Natal, Rio Grande do Norte, Brazil

RECRUITING

Hospital Geral de Caxias do Sul

Caxias do Sul, Rio Grande do Sul, Brazil

RECRUITING

Hospital de Pronto Socorro de Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

RECRUITING

Hospital Dr Leo Orsi Bernardes

Itapetininga, São Paulo, Brazil

RECRUITING

Hospital Pelópidas Silveira

Recife, Brazil

RECRUITING

MeSH Terms

Conditions

Cross Infection; Urinary Tract Infections; Pneumonia, Ventilator-Associated; Catheter-Related Infections

Interventions

Hydrogen Peroxide; Ultraviolet Rays

Condition Hierarchy (Ancestors)

Infections; Iatrogenic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Healthcare-Associated Pneumonia; Pneumonia; Respiratory Tract Infections; Lung Diseases; Respiratory Tract Diseases

Intervention Hierarchy (Ancestors)

Peroxides; Oxides; Anions; Ions; Electrolytes; Inorganic Chemicals; Reactive Oxygen Species; Free Radicals; Oxygen Compounds; Organic Chemicals; Light; Electromagnetic Radiation; Electromagnetic Phenomena; Magnetic Phenomena; Physical Phenomena; Optical Phenomena; Radiation; Radiation, Ionizing; Radiation, Nonionizing; Sunlight; Weather; Atmosphere; Environment; Ecological and Environmental Phenomena; Biological Phenomena; Meteorological Concepts; Environment and Public Health

Study Officials

• Antonio P Nassar Jr, PhD

  Hospital Israelita Albert Einstein

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Antonio P Nassar Jr, PhD

CONTACT

551121519617; antonio.nassar@einstein.br

Adriano J Pereira, PhD

CONTACT

551121519617; Adriano.Pereira2@einstein.br

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Randomized, controlled, cluster, crossover, trial

Study Record Dates

• First Submitted: November 14, 2025
• First Posted: November 18, 2025
• Study Start: January 5, 2026
• Primary Completion (Estimated): February 26, 2027
• Study Completion (Estimated): March 1, 2027
• Last Updated: April 15, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

BR (12)