Validation of the Decontamination of a Specialist Transport System for Patients with High Consequence Infectious Diseases

Microorganisms. 2021 Dec 13;9(12):2575. doi: 10.3390/microorganisms9122575.


When transferring highly infective patients to specialist hospitals, safe systems of work minimise the risk to healthcare staff. The EpiShuttle is a patient transport system that was developed to fit into an air ambulance. A validated decontamination procedure is required before the system can be adopted in the UK. Hydrogen peroxide (H2O2) vapour fumigation may offer better penetration of the inaccessible parts than the liquid disinfectant wiping that is currently suggested. To validate this, an EpiShuttle was fumigated in a sealed test chamber. Commercial bacterial spore indicators (BIs), alongside organic liquid suspensions and dried surface samples of MS2 bacteriophage (a safe virus surrogate), were placed in and around the EpiShuttle, for the purpose of evaluation. The complete kill of all of the BIs in the five test runs demonstrated the efficacy of the fumigation cycle. The log reduction of the MS2 that was dried on the coupons ranged from 2.66 to 4.50, but the log reduction of the MS2 that was in the organic liquids only ranged from 0.07 to 1.90, confirming the results of previous work. Fumigation with H2O2 alone may offer insufficient inactivation of viruses in liquid droplets, therefore a combination of fumigation and disinfectant surface wiping was proposed. Initial fumigation reducing contamination with minimal intervention allows disinfectant wipe cleaning to be completed more safely, with a second fumigation step inactivating the residual pathogens.

Keywords: decontamination; hospital; hydrogen peroxide; infection; patient transport; validation.