Table 4 Quality scoring of included studies; systematic review; N = 26

Prospective cluster controlled crossover trial to compare the impact of an improved hydrogen peroxide disinfectant and a quaternary ammonium-based disinfectant on surface contamination and health care outcomes [32]

4

2

4

4

3

A

Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study [48]

4

4

4

4

3

A

An environmental cleaning bundle and health-care-associated infections in hospitals (REACH): a multicentre, randomised trial [47]

4

4

4

4

3

A

Effectiveness of ultraviolet disinfection in reducing hospital-acquired Clostridium difficile and vancomycin-resistant Enterococcus on a bone marrow transplant unit [23]

1

2

0

4

4

B

Environmental disinfection with photocatalyst as an adjunctive measure to control transmission of methicillin-resistant Staphylococcus aureus: a prospective cohort study in a high-incidence setting [34]

1

2

0

4

4

B

Comparison of the effect of detergent versus hypochlorite cleaning on environmental contamination and incidence of Clostridium difficile infection [44]

3

0

4

2

2^a

B

Protective isolation in a burns unit: the use of plastic isolators and air curtains [25]

3

1

4

2

2^a

B

Implementation of hospital-wide enhanced terminal cleaning of targeted patient rooms and its impact on endemic Clostridium difficile infection rates [35]

0

4

0

4

4

B

Use of a daily disinfectant cleaner instead of a daily cleaner reduced hospital-acquired infection rates [33]

3

0

2

4

4

B

Environmental services impact on healthcare-associated Clostridium difficile reduction [38]

2

3

2

4

4

B

A Multicenter Randomized Trial to Determine the Effect of an Environmental Disinfection Intervention on the Incidence of Healthcare-Associated Clostridium difficile Infection [39]

4

4

4

0

3

B

Lack of nosocomial spread of Varicella in a pediatric hospital with negative pressure ventilated patient rooms [28]

1

1

2

0

2^b

C

Evaluation of an ultraviolet room disinfection protocol to decrease nursing home microbial burden, infection and hospitalization rates [24]

1

2

0

0

3

C

Reduction in Clostridium difficile infection associated with the introduction of hydrogen peroxide vapour automated room disinfection [36]

1

2

0

0

3

C

Reducing health care-associated infections by implementing separated environmental cleaning management measures by using disposable wipes of four colors [42]

1

2

0

0

4

C

Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile environmental contamination and transmission in a healthcare setting [31]

1

0

0

4

3

C

Pulsed-xenon ultraviolet light disinfection in a burn unit: Impact on environmental bioburden, multidrug-resistant organism acquisition and healthcare associated infections [30]

1

1

0

2

4

C

Implementation and impact of ultraviolet environmental disinfection in an acute care setting [29]

0

3

0

2

4

C

A Successful Vancomycin-Resistant Enterococci Reduction Bundle at a Singapore Hospital [45]

1

4

0

2

3

C

Controlling methicillin-resistant Staphylococcus aureus (MRSA) in a hospital and the role of hydrogen peroxide decontamination: an interrupted time series analysis [46]

0

2

0

4

4

C

A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction [26]

0

2

0

4

4

C

Copper surfaces reduce the rate of healthcare-acquired infections in the intensive care unit [37]

4

2

2

2

0

C

Control of endemic multidrug-resistant Gram-negative bacteria after removal of sinks and implementing a new water-safe policy in an intensive care unit [43]

1

3

0

2

4

C

Clostridium difficile infection incidence: impact of audit and feedback programme to improve room cleaning [40]

0

4

0

2

4

C

Implementation of human factors engineering approach to improve environmental cleaning and disinfection in a medical center [41]

1

0

0

0

4

D

Impact of pulsed xenon ultraviolet light on hospital-acquired infection rates in a community hospital [27]

1

2

0

0

2

D