Real-World Effectiveness of a Disinfectant Wipe on Healthcare Surfaces: A Multi-Center Study in Five University-Affiliated Hospitals

초록

Background: Healthcare-associated infections (HAIs) pose a significant threat to patient safety, particularly for vulnerable populations such as critically ill patients, the elderly, and individuals with multiple comorbidities. Hospital surfaces often act as reservoirs for pathogens, including multidrug-resistant strains, yet conventional disinfectants frequently lack sustained activity. We evaluated the real-world effectiveness of a novel disinfectant wipe combining low-concentration didecyldimethylammonium chloride (DDAC) and organosilane quaternary ammonium compound (Si-QAC) for its immediate and persistent antimicrobial properties across multiple hospitals. Materials and Methods: A multi-center, paired-design study was conducted at five university-affiliated hospitals between March and April 2025. Eight high-touch surfaces were categorized into dry zones (e.g., bed rails, nurse station desks) and wet zones (e.g., ward sinks, toilet lids). We compared the disinfection effectiveness of DDAC+SiQAC wipes (experimental group) against each hospital's standard disinfection protocol (control group). Microbial samples were collected at baseline and at 1, 6, and 24 hours post-disinfection. Effectiveness was measured by the change in microbial load (Delta colony-forming unit/mL) from baseline. Results: A total of 640 specimens were analyzed from 160 surfaces. To ensure rigorous analysis, pairs containing "zero-point" baseline surfaces were excluded, resulting in 39 pairs (78 surfaces) for final evaluation. The experimental group showed significant reductions from baseline at 1, 6, and 24 hours (P<0.001), whereas the control group failed to exhibit significant changes. In comparative analysis, the experimental group demonstrated superior effectiveness over the control group at 1 hour (P=0.041) and 6 hours (P=0.042). Although the difference at 24 hours (P=0.276) was not statistically significant, the experimental group maintained a lower median microbial load. Sub-group analysis revealed that the experimental group's potency was most pronounced in wet zones at 1 hour (P=0.004), where the bioburden was highest. Conclusion: The DDAC+Si-QAC wipe provides superior and sustained antimicrobial activity compared to standard hospital protocols, particularly in challenging high-bioburden wet environments. While the statistical advantage diminished at 24 hours, the persistent coating effect of Si-QAC offers a robust alternative to conventional point-in-time disinfection. Integrating these wipes into routine environmental management may help prevent the formation of microbial reservoirs and contribute to reducing HAIs.

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