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Decontamination of Targeted Pathogens from Patient Rooms Using an Automated Ultraviolet-C-Emitting Device

Published online by Cambridge University Press:  02 January 2015

Deverick J. Anderson*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Duke University Medical Center, Durham, North Carolina
Maria F. Gergen
Affiliation:
Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina
Emily Smathers
Affiliation:
Duke Infection Control Outreach Network, Duke University Medical Center, Durham, North Carolina
Daniel J. Sexton
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Duke University Medical Center, Durham, North Carolina
Luke F. Chen
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Duke University Medical Center, Durham, North Carolina
David J. Weber
Affiliation:
Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
William A. Rutala
Affiliation:
Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
*
DUMC Box 102359, Durham, NC 27110 (dja@duke.edu)

Abstract

Objective.

To determine the effectiveness of an automated ultraviolet-C (UV-C) emitter against vancomycin-resistant enterococci (VRE), Clostridium difficile, and Acinetobacter spp. in patient rooms.

Design.

Prospective cohort study.

Setting.

Two tertiary care hospitals.

Participants.

Convenience sample of 39 patient rooms from which a patient infected or colonized with 1 of the 3 targeted pathogens had been discharged.

Intervention.

Environmental sites were cultured before and after use of an automated UV-C-emitting device in targeted rooms but before standard terminal room disinfection by environmental services.

Results.

In total, 142 samples were obtained from 27 rooms of patients who were colonized or infected with VRE, 77 samples were obtained from 10 rooms of patients with C. difficile infection, and 10 samples were obtained from 2 rooms of patients with infections due to Acinetobacter. Use of an automated UV-C-emitting device led to a significant decrease in the total number of colony-forming units (CFUs) of any type of organism (1.07 log10 reduction; P < .0001), CFUs of target pathogens (1.35 log10 reduction; P < .0001), VRE CFUs (1.68 log10 reduction; P < .0001), and C. difficile CFUs (1.16 log10 reduction; P < .0001). CFUs of Acinetobacter also decreased (1.71 log10 reduction), but the trend was not statistically significant P = .25). CFUs were reduced at all 9 of the environmental sites tested. Reductions similarly occurred in direct and indirect line of sight.

Conclusions.

Our data confirm that automated UV-C-emitting devices can decrease the bioburden of important pathogens in real-world settings such as hospital rooms.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Cohen, AL, Calfee, D, Fridkin, SK, et al.Recommendations for metrics for multidrug-resistant organisms in healthcare settings: SHEA/HICPAC position paper. Infect Control Hosp Epidemiol 2008;29(10):901913.CrossRefGoogle ScholarPubMed
2.Neely, AN, Maley, MP. Survival of enterococci and staphylococci on hospital fabrics and plastic. J Clin Microbiol 2000;38(2):724726.CrossRefGoogle ScholarPubMed
3.Weber, DJ, Rutala, WA. Role of environmental contamination in the transmission of vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 1997;18(5):306309.CrossRefGoogle ScholarPubMed
4.Catalano, M, Quelle, LS, Jeric, PE, Di Martino, A, Maimone, SM. Survival of Acinetobacter baumannii on bed rails during an outbreak and during sporadic cases. J Hosp Infect 1999;42(1):2735.Google Scholar
5.Jawad, A, Seifert, H, Snelling, AM, Heritage, J, Hawkey, PM. Survival of Acinetobacter baumannii on dry surfaces: comparison of outbreak and sporadic isolates. J Clin Microbiol 1998;36(7):19381941.Google Scholar
6.Musa, EK, Desai, N, Casewell, MW. The survival of Acinetobacter calcoaceticus inoculated on fingertips and on formica. J Hosp Infect 1990;15(3):219227.Google Scholar
7.Kim, KH, Fekety, R, Batts, DH, et al.Isolation of Clostridium difficile from the environment and contacts of patients with antibiotic-associated colitis. J Infect Dis 1981;143(1):4250.Google Scholar
8.Datta, R, Platt, R, Yokoe, DS, Huang, SS. Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants. Arch Intern Med 2011;171 (6):491494.Google Scholar
9.Drees, M, Snydman, DR, Schmid, CH, et al.Prior environmental contamination increases the risk of acquisition of vancomycin-resistant enterococci. Clin Infect Dis 2008;46(5):678685.CrossRefGoogle ScholarPubMed
10.Huang, SS, Datta, R, Platt, R. Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch Intern Med 2006;166(18):19451951.Google Scholar
11.Shaughnessy, MK, Micielli, RL, DePestel, DD, et al.Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol 2011;32(3):201206.CrossRefGoogle ScholarPubMed
12.Carling, PC. Evaluating the thoroughness of environmental cleaning in hospitals. J Hosp Infect 2008;68(3):273274.Google Scholar
13.Carling, PC, Parry, MF, Von Beheren, SM. Identifying opportunities to enhance environmental cleaning in 23 acute care hospitals. Infect Control Hosp Epidemiol 2008;29(1):17.Google Scholar
14.Carling, PC, Von Beheren, S, Kim, P, Woods, C. Intensive care unit environmental cleaning: an evaluation in sixteen hospitals using a novel assessment tool. J Hosp Infect 2008;68(1):3944.CrossRefGoogle ScholarPubMed
15.Nerandzic, MM, Cadnum, JL, Pultz, MJ, Donskey, CJ. Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms. BMC Infect Dis 2010;10:197.Google Scholar
16.Conner-Kerr, TA, Sullivan, PK, Gaillard, J, Franklin, ME, Jones, RM. The effects of ultraviolet radiation on antibiotic-resistant bacteria in vitro. Ostomy Wound Manage 1998;44(10):5056.Google ScholarPubMed
17.Setlow, P. Spores of Bacillus subtilisr. their resistance to and killing by radiation, heat and chemicals. J Appi Microbiol 2006;101(3):514525.Google Scholar
18.Boyce, JM, Havill, NL, Moore, BA. Terminal decontamination of patient rooms using an automated mobile UV light unit. Infect Control Hosp Epidemiol 2011;32(8):737742.CrossRefGoogle ScholarPubMed
19.Rutala, WA, Gergen, MF, Weber, DJ. Room decontamination with UV radiation. Infect Control Hosp Epidemiol 2010;31(10):10251029.Google Scholar
20.Rastogi, VK, Wallace, L, Smith, LS. Disinfection of Acinetobacter baumannii-contaminated surfaces relevant to medical treatment facilities with ultraviolet ? light. Mil Med 2007;172(11):11661169.Google Scholar
21.Nerandzic, MM, Cadnum, JL, Pultz, MJ, Donskey, CJ. Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms. BMC Infect Dis 2010;10:197.CrossRefGoogle ScholarPubMed
22.Sweeney, CP, Dancer, SJ. Can hospital computers be disinfected using a hand-held UV light source? J Hosp Infect 2009;72(1):9294.Google Scholar
23.Kac, G, Podglajen, I, Si-Mohamed, A, Rodi, A, Grataloup, C, Meyer, G. Evaluation of ultraviolet C for disinfection of endocavitary ultrasound transducers persistently contaminated despite probe covers. Infect Control Hosp Epidemiol 2010;31(2):165170.CrossRefGoogle ScholarPubMed
24.Sitzlar, B, Vajravelu, RK, Jury, L, Donskey, CJ, Jump, RL. Environmental decontamination with ultraviolet radiation to prevent recurrent Clostridium difficile infection in 2 roommates in a long-term care facility. Infect Control Hosp Epidemiol 2012;33(5):534536.Google Scholar
25.Nerandzic, MM, Cadnum, JL, Eckart, KE, Donskey, CJ. Evaluation of a hand-held far-ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens. BMC Infect Dis 2012;12:120.Google Scholar