Application and efficacy evaluation of a novel electrolytic water-disinfecting toilet for infection prevention and control in healthcare facility restrooms

Background Hospital restrooms are a weak link in infection control due to high pathogen loads, poor ventilation, and limitations of conventional disinfection. This study developed a smart toilet featuring a novel electrolytic disinfection technology to assess its clinical efficacy in decontaminating restroom surfaces and air, while exploring its potential for microbial control within hospital settings. Methods A prospective controlled experimental study was conducted in four inpatient public restrooms at Zhongnan Hospital of Wuhan University between July and August 2025. The intervention utilized an onsite electrolysis device that electrolyzed a diluted sodium chloride solution to produce neutral electrolyzed water containing hypochlorous acid as the primary biocidal agent. Bench tests confirmed that a concentration of 40 mg/L achieved a 100% kill rate against E. coli within 9 min. The system was integrated into smart toilets. Surface samples ( n = 216) and air samples ( n = 72) were collected at 0, 5, and 30 min after use. Disinfection qualification rate, bactericidal efficacy, and natural microbial decay were compared against routine cleaning. Results The surface qualification rate was 53.7% before and 61.1% after the intervention, a difference that was not statistically significant ( p > 0.05). The toilet seat (5 min after use) and inner bowl (30 min after use) both reached 100% compliance, whereas the flush button demonstrated limited and inconsistent bactericidal efficacy. The air sterilization rate reached 89.7% at 30 min, which was significantly higher than the natural decay rate of 49.8% in the control group ( p < 0.05). Conclusion This smart toilet with novel electrolytic disinfection technology improves environmental hygiene in hospital restrooms and overcomes key limitations of manual cleaning. Nevertheless, the flush button remains a high risk site because it is not directly subjected to disinfection, thereby necessitating design optimization.