How to eradicate Pseudomonas (bacteria) in operating theatre walls?

From the Guidelines

To eradicate Pseudomonas bacteria from operating theater walls, implement a comprehensive cleaning protocol using a combination of quaternary ammonium compounds and hydrogen peroxide-based disinfectants, as recommended by guidelines for environmental infection control in health-care facilities 1.

Key Steps for Eradication

• Thoroughly clean all surfaces with a detergent to remove organic matter
• Apply a hospital-grade disinfectant such as 0.5% accelerated hydrogen peroxide or 0.1% sodium hypochlorite (bleach) solution, ensuring adequate contact time of 5-10 minutes as specified by the manufacturer
• For persistent contamination, consider using peracetic acid-based products at 0.2-0.35% concentration
• Implement a regular cleaning schedule with daily disinfection of all surfaces and deep cleaning weekly

Importance of Ventilation and Monitoring

• Proper ventilation with HEPA filtration and maintaining negative pressure in the operating room are crucial for preventing airborne Pseudomonas, as emphasized in guidelines for environmental infection control in health-care facilities 1
• Environmental monitoring through surface sampling should be conducted regularly to verify effectiveness, with consideration of monthly monitoring of air quality with a laser counter equipped with an isokinetic probe 1

Staff Training and Precautions

• Staff should wear appropriate PPE during cleaning and be trained on proper disinfection techniques to ensure thoroughness and prevent cross-contamination, as recommended by guidelines for infection control in anaesthesia 1
• Use appropriate hand hygiene, PPE, and isolation precautions during cleaning and disinfecting procedures, as emphasized in guidelines for environmental infection control in health-care facilities 1

From the Research

Eradication Methods

To eradicate Pseudomonas in operating theatre walls, the following methods can be considered:

• Using hydrogen peroxide and sodium hypochlorite disinfectants, which have been shown to be more effective against Pseudomonas aeruginosa biofilms than quaternary ammonium compounds 2
• Utilizing hydrogen peroxide-based disinfectants, which have demonstrated bactericidal efficacy against Pseudomonas aeruginosa on stainless steel surfaces 3
• Employing sodium dichloro-s-triazinetriones and quaternary alcohols, which have been found to significantly inactivate dry-surface biofilms of Pseudomonas aeruginosa 4

Disinfectant Efficacy

The efficacy of disinfectants against Pseudomonas aeruginosa biofilms can vary depending on the active ingredient and product type. Studies have shown that:

• Hydrogen peroxide and sodium hypochlorite disinfectants are more effective than quaternary ammonium compounds against Pseudomonas aeruginosa biofilms 2
• Quaternary ammonium plus alcohol, sodium dichloro-s-triazinetrione, and hydrogen peroxide products are more efficacious against dry-surface biofilms of Pseudomonas aeruginosa than quaternary ammoniums 4
• The use of hydrogen peroxide with other antimicrobial products can increase its bactericidal efficacy against Pseudomonas aeruginosa 3

Infection Control

Infection control measures in operating theatres are crucial to prevent the spread of pathogens, including Pseudomonas. Recommendations include:

• Routine cleaning of environmental surfaces to reestablish a clean environment after each operation 5
• Using hospital disinfectant to decontaminate affected areas when visible soiling occurs during an operation 5
• Considering the use of antimicrobial prophylaxis and avoiding unnecessary traumatic tissue dissection to reduce the risk of surgical site infections 5