Comparison of hydrogen peroxide and peracetic acid as isolator sterilization agents in a hospital pharmacy

Abstract

The efficacy of hydrogen peroxide and peracetic acid as isolator sterilization agents was compared. Sterilization and efficacy tests were conducted in a flexible 0.8-m3 transfer isolator using a standard load of glass bottles and sterile medical devices in their packing paper. Bacillus stearothermophilus spores were placed in six critical locations of the isolator and incubated at 55 degrees C in a culture medium for 14 days. Sterilization by 4.25 mL/m3 of 33% vapor-phase hydrogen peroxide and 12.5 mL/m3 of 3.5% peracetic acid was tested in triplicate. Sterility was validated for hydrogen peroxide and peracetic acid at 60, 90, 120, and 180 minutes and at 90, 120, 150, 180, 210, and 240 minutes, respectively. In an efficacy test conducted with an empty isolator, the sterilization time required to destroy B. stearothermophilus spores was 90 minutes for both sterilants, indicating that they have comparable bactericidal properties. During the validation test with a standard load, the sterilization time using hydrogen peroxide was 150 minutes versus 120 minutes with peracetic acid. The glove cuff was particularly difficult for hydrogen peroxide to sterilize, likely due to its slower diffusion time than that of peracetic acid. Hydrogen peroxide is an environmentally safer agent than peracetic acid; however, its bacteriostatic properties, lack of odor, and poor diffusion time may limit its use in sterilizing some materials. Hydrogen peroxide is a useful alternative to peracetic acid for isolator sterilization in a hospital pharmacy or parenteral nutrition preparation unit.