Proven and praised – new technology goes anywhere to kill infectious organisms
In the ongoing fight against infection many hospitals are employing technology that is coming to the end of its asset life. Hospital Times takes a look at a new, next generation solution that meets the highest standards possible in its country of manufacture. It is being trialled in UK healthcare and has already been successfully tested by the HSL, the Health and Safety Executive’s laboratory, and described as “producing some excellent results.”
Room and area decontamination continues to evolve. What is best for you and your hospital? What is truly effective in an everyday healthcare environment when there are new technologies, new methods of dispensing disinfectants?
Following a trial in both small and larger test chamber environments, the latter used as a mock ‘hospital side room’, a newly available solution to the UK demonstrated good efficacy in tests performed by the Health and Safety Laboratory (HSL). This has already surpassed the highest required standard in France – which will form the basis of the new European standard – and multiple units have proved to be easily capable of decontaminating a whole floor of a large hospital.
“This is the next generation of technology,” John Curtin, director of Decontamination Limited, the UK distributor of Phileas, tells Hospital Times. “It offers ease of use, simple maintenance, a range of compact units. It’s cost-effective, with standardisation across the range, delivers proven efficacy and has multiple disinfectant options.
“The range includes lightweight, battery operated machines that are ideal for toilets and bathrooms, and perfect for healthcare vehicles. With their ‘go-anywhere’ capability they deliver a quick turnaround for ambulances and patient transport within one hour – with no power required.”
It’s the kill rate that matters
As John explains: “People are looking for validation and efficacy. Importantly, it’s the kill rate that matters. And to achieve the proven reduction you have to operate the technology in the way in which the validation gave the reduction.
“Ours is just one of a range of solutions hospitals will employ in a multi-disciplinary approach to prevent infection. But, it’s backed up with independent validation and has achieved the highest ‘hospital’ standards in France where technology must be proven ‘in a hospital environment’.”
Well known to many in healthcare from his time with other leading infection prevention technologies currently employed in UK hospitals, John says: “I came across Phileas in 2012. The innovative system adapts spinning disc technology to airborne disinfection. It’s simple and effective. It employs Micro Drop Technology, which uses centrifugal force to project perfectly calibrated liquid droplets of 5 to 10µm into the target regions. So the Phileas range automates the disinfection of any kind of surface, even the most inaccessible.
“The system is manufactured in France and proven across Europe, the Middle and Far East and in the US. It’s also widely used in laboratories which require greater efficacy than is seen in hospitals, as well as the decontamination of difficult to reach areas, such as beyond filtration and in exhaust ducting.”
Phileas meets NF T 72281 and new European Standard
John explains: “In France Phileas easily passed the highest standard, AFNOR standard NF T 72281, which requires that equipment is proven for use in a simulated hospital room. The new European Standard for automated airborne disinfection will be developed from this French Standard.
“To prove Phileas met the NF T standard ‘for decontamination of a large volume area with proven sporicidal kill’, an independent French laboratory conducted an impressive test with multiple Phileas units. It used them to decontaminate 4,800 cubic metres – a whole floor of a large hospital. The laboratory placed biological indicators around the area and analysed the results. It was an outstanding success.
“A typical UK ward is 1,500 to 2,000 cubic metres, so the impressive test was in an area three times larger.”
John says: “When hospitals have the opportunity to decant a ward they need to know that the standard will be achieved. So it’s important to know that equipment is effective in decontaminating a large volume area. I believe this is the only formal data in which a large volume test was undertaken.”
Validation of Phileas technology ‘ticks all the boxes’
“The existing standards require that decontaminants are bactericidal, sporicidal and fungicidal,” says John. “The new European Standard will require that they also include virucidal testing – which Phileas has already proved to be.
“In the UK, proof of 6 Log reduction against spores is often required. To establish that Phileas not only achieved the imminent European Standard but had also been proven in the UK, I asked Dr Alan Beswick of the HSL to undertake his own test. These were for both microbiology safety cabinets and in HSL’s controlled atmospheric chamber, which is of similar size to a ‘hospital side room’ facility.
“Some airborne disinfectants are poor at killing spores or at penetrating soiling, so Dr Beswick used both Geobacillus stearothermophilus (a widely used commercial spore preparation) and his own preparation vegetative cell preparation of Meticillin Sensitive Staphylococcus aureus (MSSA) on steel coupons. He added protein to simulate a ‘slightly soiled environment’. This second test was very significant as manufacturers of room decontamination systems ask that you ‘first remove all visible soiling’. Any product that can still work effectively with residual soiling present is therefore advantageous for the real end user.
“On the standard sporicidal indicator, which each contained around 106 Geobacillus spores, no detectable live spores were present following the Phileas treatment of either the smaller or the larger test facilities.
“On the MSSA indicator, with slight soiling, the kill rate was again excellent for the smaller scale work, but less so for our hydrogen peroxide only disinfectant in the larger room. However, HSL tests demonstrated that in a smaller chamber setting our hydrogen peroxide and peracetic acid mix achieved the same kill rates of MSSA as our sporicidal kill. So it was effective through mild soiling.
“We also asked Dr Beswick’s team to measure the peak airborne disinfectant levels in the air during treatment. As the ‘hospital room’ is 35 cubic metres we asked Alan to undertake fumigant delivery based on 6, 8 and 10ml of disinfectant per cubic metre. This equates to 210ml, 280ml and 350ml of disinfectant respectively.
“The high point was very similar for all three, but two hours after the end of the spray time there was no measurable level of hydrogen peroxide in the room. The hydrogen peroxide turns to water vapour and oxygen.”
The test data was described by Dr Beswick as “the excellent results we experienced with Phileas.”
With this impressive success in both France and the UK, John explains: “As far as validation of Phileas technology is concerned ‘it ticks all the boxes’. From single rooms to large volumes, it’s validated for healthcare use in the European country of origin, meets the only European efficacy standard for healthcare and shows 6 Log reduction for sporicidal kill.
“The results speak for themselves,” says John. “On the two spores required for the current French standard, which form part of the new European 2014 Standard Phileas achieved greater than 6 Log, including on C. diff spores. Similar, impressive sporicidal results were achieved in the UK with the Geobacillus testing at HSL.”
Handy, battery powered units for use in all risk areas
“In terms of the range of applications, every other manufacturer is currently providing ‘one size fits all’ – for equipment that really can’t do it all. With Phileas you have handy, mains/battery powered units for difficult to access areas, such as toilets, bathrooms, ambulances and community transport vehicles. They’re lightweight for ease of use and mobility, delivering high volume capability from a small unit and exceptionally quiet. In fact, the small, battery-powered unit with two litres of fluid weighs just 8kg.
“In terms of the range of machines, the battery operated units are ideal for side rooms. They will decontaminate up to 45 cubic metres in 2 to 2½ hours, when the area will be available for re-use. The larger machine, ideal for six-bedded bays, again takes 2 to 2 ½ hours to complete the cycle.
“The only variable is the spray time. All the operator needs to do is dial in the room size and the unit automatically calculates the necessary fumigant dosage and the required spray time.”
John says: “The range starts at under £5,000, including chemicals, remote control unit, transfer unit for disinfectant and one year’s warranty. So you could have one of each of Phileas’s battery operated and room/bay, theatre/capability machines and have large volume capability for less than half of the price of some other area decontamination equipment that’s available.
“There are volume discounts for chemicals and units, and additional warranties are available. Finance options are always available.
“We’ve a full technical support team, here in the UK, and we offer the full range of decontamination services, as required – with call-out or managed services.”
Offers choice of machine sizes and disinfectants
As John explains: “With Phileas there is a choice of disinfectants. Hydrogen peroxide is used for whole room decontamination, while the hydrogen peroxide and peracetic acid combination is used for room decontamination and cabinets.
“While the price of the chemicals is comparable with other makes, the canisters have a three-year shelf life and a one-year in-use life. So they offer distinct advantages.
“Our disinfectants meet biocidal product regulations and standards. Importantly, the new European biocide product regulations will be applicable in the UK prior to Brexit.
“The top end machines monitor the amount of disinfectant available. While the smaller machines do not have this facility, it’s very simple for the operator to check that sufficient fluid is available for the area to be decontaminated. A simple visual check allows the operator to see how much fluid is in the machine, without needing to open the chamber. All the other Health and Safety criteria apply.
“As you would expect from a company involved in this for over 10 years, we provide all the necessary Health and Safety training to ensure safe deployment to protect staff, patients and visitors.”
John says: “For all models, the software, PCB controllers and delivery units are standard and interchangeable between products. The technology is standardised across the range. Remote operation is managed from a proprietary tablet by an on-board Wi-Fi link, which does not interfere with hospital protocols.
“This allows staff to remotely start cycles from outside the room, ensures spray cycles are completed and advises when contact time is completed to begin room re-entry protocol.
“The tablet can initiate cycles on four units simultaneously and manage any number of operational units, whilst also providing full reporting on cycles, error messages and deployment data in easy to read PDF format downloadable to USB interface.”
“Phileas technology is proven and no longer a one-size-fits-all. It’s manageable, light, quiet, suitable for all at risk-areas, financially effective and proven, with efficacy meeting known standards and the imminent European Standard.”
John Curtain, director Decontamination Limited
John adds: “To ensure room fumigant levels are safe for re-entry, inexpensive hand-held monitors are available to measure hydrogen peroxide, while mobile sensors can measure the hydrogen peroxide and peractic acid mix should it be used for whole room treatment.”
How is Phileas being accepted in UK healthcare?
“It’s being reviewed by a flagship London hospital and a Care Commissioning Group in the Midlands is looking to employ it,” explains John. “The system’s also being trialled by a major FM company which manages cleaning facilities in UK hospitals. It’s also being assessed for decontaminating operating theatres in the south of England. With its ‘go-anywhere’ capability, a Scottish NHS Trust with links to ambulance services is also considering adopting the system.
“A contracting company is looking at a machine we have that fits into air conditioning ductwork in hospitals. Our Phileas Genius is put into the duct post-clean. After its spray cycles they switch on the system’s extraction and let it pull the disinfectant passed the filter.”
John adds: “The technology is proven and no longer a one-size-fits-all. It’s manageable, light, quiet, suitable for all at risk-areas, financially effective and proven, with efficacy meeting known standards and the imminent European Standard.
“You can see the success Phileas delivers in your own facility. Free demonstrations and trials are available.”
Decontamination Limited offers full technical support in the UK and a full range of decontamination services – including call-out or managed services.